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Thapaliya I, Kumari K, Oli P, Karki S, Deo A. Diagnostic challenge: a case report of primary breast tuberculosis mimicking recurrent pyogenic breast abscess. Ann Med Surg (Lond) 2024; 86:3743-3747. [PMID: 38846826 PMCID: PMC11152773 DOI: 10.1097/ms9.0000000000002118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/13/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Breast tuberculosis (BTB) is a rare form of extrapulmonary tuberculosis with its primary form considered even rarer. Case presentation A 28-year-old female initially diagnosed with a breast abscess presented with chronic right breast pain and nipple discharge. Despite initial treatment, symptoms recurred, and further investigations revealed a space-occupying lesion. Fine needle aspiration confirmed recurrent breast abscess, but subsequent DNA detection of tubercular bacilli in the pus sample led to a diagnosis of primary BTB, necessitating antitubercular therapy. Clinical discussion BTB, being rare and often misdiagnosed as an abscess, poses diagnostic challenges. However, persistent symptoms despite treatment should prompt consideration of BTB in TB endemic regions. Conclusion Primary BTB might not have any systemic symptoms to drag the clinician towards a possible diagnosis so culturing the aspirate for acid-fast bacilli or looking for MTB DNA in the available clinical sample should always be kept in mind for better outcomes.
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Zhang W, Zhang Y, Yang G, Yu T. Features of breast tuberculosis determined by ultrasound imaging: report of 45 cases. J Int Med Res 2020; 48:300060520910891. [PMID: 32727242 PMCID: PMC7394031 DOI: 10.1177/0300060520910891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to characterize the ultrasound (US) imaging features of breast tuberculosis (BTB) to clarify the process of disease progression and provide valuable clinical information. Methods We retrospectively reviewed 45 patients with pathologically or GeneXpert-confirmed BTB from January 2010 to December 2017. We assessed the US features of target lesions including size, shape, orientation, margin, echogenicity, calcification, posterior acoustic features, and blood-flow signal. Results The patients were classified with nodular (55.5%, 25/45), abscess (15.6%, 7/45), or sinus (28.9%, 13/45) type according to their US features. Forty lesions (88.9%, 40/45) extended in a parallel orientation and five extended in a non-parallel orientation. Calcifications were found in eight cases, including six macrocalcifications and two microcalcifications. Enlarged axillary lymph nodes were observed in three cases (6.7%, 3/45). In addition, 44 of the 45 cases (97.8%, 44/45) exhibited hypovascularity or avascularity according to color Doppler flow imaging (CDFI). Conclusion BTB lesions can be classified as nodular, abscess, or sinus type according to their US imaging features. Poor blood supply detected by CDFI might be a common US feature of BTB. Characterization of its US features may facilitate the clinical diagnosis of BTB.
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Affiliation(s)
- Wenzhi Zhang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Ying Zhang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Gaoyi Yang
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
| | - Tianzhuo Yu
- Department of Ultrasonography, Chinese and Western Hospital of Zhejiang Province (Hangzhou Red Cross Hospital), Hangzhou, Zhejiang, P.R. China
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Quaglio G, Pizzol D, Isaakidis P, Bortolani A, Tognon F, Marotta C, Di Gennaro F, Putoto G, Olliaro PL. Breast Tuberculosis in Women: A Systematic Review. Am J Trop Med Hyg 2020; 101:12-21. [PMID: 31115305 DOI: 10.4269/ajtmh.19-0061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Breast tuberculosis (TB) is rarely reported and poorly described. This review aims to update the existing literature on risk factors, clinical presentations, constitutional symptoms, diagnostic procedures, and medical and surgical treatments for breast TB. In all, 1,478 cases of breast TB were collected. Previous history of TB was reported in 19% of cases. The most common clinical appearance of the lesion was breast lump (75%). The most common associated finding was axillary lymphadenitis (33%) followed by sinus or fistula (24%). The most common symptoms were pain and fever, reported in 42% and 28% of cases, respectively. The most used diagnostic method was fine-needle aspiration cytology (32%), followed by biopsy (27%), acid-fast bacteria Ziehl-Neelsen stain (26%), culture (13%), and polymerase chain reaction (2%). These tested positive in 64%, 93%, 27%, 26%, and 58% of cases, respectively. The majority (69%) of patients received a 6-month anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol). Surgery consisted of excision in 39% of cases, drainage in 23%, and mastectomy in 5%. The great majority of patients had a positive outcome. It often mimics breast cancer, which makes it difficult to diagnose. Most patients, when diagnosed in time, respond to antitubercular therapy alone.
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Affiliation(s)
- Gianluca Quaglio
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, University of Maastricht, Maastricht, The Netherlands.,Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy.,European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa CUAMM, Beira, Mozambique
| | - Petros Isaakidis
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
| | - Arianna Bortolani
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Francesca Tognon
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Claudia Marotta
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | | | - Giovanni Putoto
- Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy
| | - Piero L Olliaro
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Special Programme for Research and Training in Tropical Diseases, World Health Organization (WHO/TDR), Geneva, Switzerland
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Perrone C, Altieri AM, D'Antonio S, Leonetti C, Alma MG. Breast Tuberculosis after Chest Trauma - a Case Report and Review of the Literature. Breast Care (Basel) 2016; 11:200-3. [PMID: 27493621 DOI: 10.1159/000446977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breast involvement of tuberculosis (TB) is well known but uncommon. It can resemble other diseases, including breast cancer, and diagnosis is quite difficult. So, when facing a breast lesion, a possible tubercular etiology should always be born in mind, relying on qualified laboratories to confirm the diagnosis. CASE REPORT We describe a 42-year-old woman with a mammary fistula complicating a post-traumatic lump. A critical analysis of the diagnostic process was performed together with a review of the literature, also considering the potential role of trauma in inducing such a rare complication.
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Affiliation(s)
- Claudio Perrone
- Unit of Pneumology and h Phthisiology 'San Camillo-Forlanini' Hospital, Rome, Italy, Rome, Italy
| | - Alfonso M Altieri
- Unit of Pneumology and h Phthisiology 'San Camillo-Forlanini' Hospital, Rome, Italy, Rome, Italy
| | - Salvatore D'Antonio
- Unit of Pneumology and h Phthisiology 'San Camillo-Forlanini' Hospital, Rome, Italy, Rome, Italy
| | - Clara Leonetti
- Unit of Pneumology and h Phthisiology 'San Camillo-Forlanini' Hospital, Rome, Italy, Rome, Italy
| | - Mario G Alma
- Unit of Pneumology and h Phthisiology 'San Camillo-Forlanini' Hospital, Rome, Italy, Rome, Italy
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El Hammoumi M, Ktaibi A, El Oueriachi F, Arsalane A, Kabiri EH. [Breast cancer-mimicking tuberculosis with pacchypleurite in male]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:249-251. [PMID: 24932505 DOI: 10.1016/j.pneumo.2014.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 03/06/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Affiliation(s)
- M El Hammoumi
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed-V, Riad 10100 Rabat, Maroc; Faculté de médecine et de pharmacie, université Mohamed-V, Souissi, 10100 Rabat, Maroc.
| | - A Ktaibi
- Faculté de médecine et de pharmacie, université Mohamed-V, Souissi, 10100 Rabat, Maroc; Département d'anatomie pathologique, hôpital militaire d'instruction Mohammed-V, Rabat, Maroc
| | - F El Oueriachi
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed-V, Riad 10100 Rabat, Maroc; Faculté de médecine et de pharmacie, université Mohamed-V, Souissi, 10100 Rabat, Maroc
| | - A Arsalane
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed-V, Riad 10100 Rabat, Maroc; Faculté de médecine et de pharmacie, université Mohamed-V, Souissi, 10100 Rabat, Maroc
| | - E H Kabiri
- Département de chirurgie thoracique, hôpital militaire d'instruction Mohammed-V, Riad 10100 Rabat, Maroc; Faculté de médecine et de pharmacie, université Mohamed-V, Souissi, 10100 Rabat, Maroc
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