Idiopathic granulomatous mastitis igm is a diagnosis of. Forms of nonlactational mastitis include periductal mastitis and idiopathic granulomatous mastitis. Serum samples were analyzed for autoantibodies by indirect immunofluorescence iif using a substrate. Since the first report of the disease in 1972 by kessler and wolloch, igm has posed great diagnostic and therapeutic dilemmas. Radiologic protocols are not sufficiently precise to establish a differential. Idiopathic granulomatous mastitis igm is a rare benign chronic inflammatory breast disease of unknown etiology that may be clinically and. Idiopathic granulomatous mastitis igm, also known as nonpuerperal mastitis or granulomatous lobular mastitis, is a rare benign chronic inflammatory breast disease that was first described by kessler and wolloch in 1972. Granulomatous lobular mastitis genetic and rare diseases. The effect of corticosteroid treatment on bilateral. Idiopathic chronic granulomatous mastitis igm is a rare breast condition that may mimic bacterial abscesses, malignant neoplasms, and several other breast diseases. Early misdiagnosis as bacterial mastitis is common. Distinguishing it from either breast carcinoma or infections both clinically and radiologically can be. Clinical and therapeutic characteristics were analyzed.
Idiopathic granulomatous mastitis the american journal of surgery. Idiopathic granulomatous mastitis presenting as a breast. It is characterized by chronic, necrotizing granulomatous lobulitis of unknown etiology, and its clinical features mimic those of mammary carcinoma. Patel ra, strickland p, sankara ir, pinkston g, many w jr, rodriguez m. We retrospectively evaluated the clinical features, radiological findings, and treatment approaches in 14. It is a diagnosis made only after excluding other causes, and although the disease is nonmalignant it may be both locally aggressive and recurrent. As a granulomatous form of lobular mastitis, igm may be differentiated from granulomatous forms of periductal mastitis, as well as from granulomatous.
Mastitis refers to inflammation of the breast tissue that may or may not be accompanied by infection. Idiopathic granulomatous mastitis igm, also known as nonpuerperal mastitis or granulomatous lobular mastitis, is a rare benign chronic inflammatory breast disease that was first described by kessler and wolloch 1 in 1972. Antituberculosis treatment for idiopathic granulomatous. Occurs in parous women, same as idiopathic granulomatous mastitis. Mastitis does not necessarily occur during lactation, is not always accompanied by microbial infection, and may not resolve with antibiotics. Pdf idiopathic granulomatous mastitis researchgate.
May 24, 2019 introduction despite over forty years since the first major publication 1 identifying idiopathic granulomatous mastitis igm, this benign breast disease has remained enigmatic. The diagnosis of igm is made by breast biopsy showing noncaseating granuloma after other causes of granulomatous. Moreover, it does not have a specific radiographic finding, so the only way to reach a definitive diagnosis is by core biopsy and histology. Granulomas with neutrophils and cystic spaces containing gram positive bacilli. G ranulomatous lobular mastitis is a rare inflammatory disease of the breast. Idiopathic granulomatous mastitis igm is a chronic inflammatory disease of the breast of unclear etiology. The aim of this study was to report and describe the clinical signs, radiological findings, management, clinical course and the recurrence. Idiopathic granulomatous mastitis is a rare benign breast disease of women of reproductive age. Idiopathic granulomatous mastitis igm is a rare, benign, chronic inflammatory condition of the breast that can mimic inflammatory breast cancer and periductal mastitis pdm.
Originally described by kessler and wolloch in 1972, idiopathic granulomatous mastitis igm is a rare disease of unknown etiology, which often mimics infection or malignancy and remains a diagnosis of exclusion. Pdf background idiopathic granulomatous mastitis igm is a benign rare inflammatory disease of the breast. Idiopathic granulomatous mastitis igm is the commonly encountered form of granulomatous mastitis that may result into repetitive infections andor abscess formation. Once the diagnosis was made with biopsy and further evaluation to exclude other causes of granulomatous disease, sinus tract debridement and. The management remains challenging with a possible role of immunosuppression in some patients.
It is characterized pathologically by chronic granulomatous inflammation of the lobules without necrosis. Granulomatous mastitis can be divided into idiopathic granulomatous mastitis also known as granular lobular mastitis and granulomatous mastitis occurring as a rare secondary complication of a great variety of other conditions such as tuberculosis and other infections, sarcoidosis and granulomatosis with polyangiitis. Idiopathic granulomatous mastitis igm is an inflammatory mass in the breast. Owing to wide spectrum of igm it is difficult to standardize and optimize the treatment. Idiopathic granulomatous mastitis is a rare chronic inflammatory condition of the breast. This study aimed to investigate the autoimmune basis of idiopathic granulomatous mastitis igm by determining the antinuclear antibody ana and extractable nuclear antigen ena levels of patients diagnosed with igm. The symptoms and radiologic findings may be mistaken for nonpuerperal mastitis, a breast abscess, or, most mastitis and breast abscess in children and adolescents view in chinese. Idiopathic granulomatous mastitis igm is an uncommon breast disease often mistaken for breast infection or abscess. Antituberculosis treatment for idiopathic granulomatous mastitis mimicking breast cancer. Idiopathic granulomatous mastitis igm is a benign breast disease that was first described by kessler and wolloch in 1978 1. Granulomatous mastitisidiopathiccorticosteroidssurgery. Cureus idiopathic granulomatous mastitisa mystery yet. Idiopathic granulomatous mastitis is a rare benign breast disease, first described by kessler and wolloch in 1972.
Idiopathic granulomatous mastitis mdedge dermatology. Idiopathic granulomatous mastitis igm, also known as idiopathic granulomatous lobular mastitis, is a chronic benign inflammatory disease of the breast with unknown etiology. This disease usually affects women of childbearing age or those who use oral contraceptive medication. The full text of this article is available in pdf format. Clinical characteristics and medical management of. Idiopathic granulomatous mastitis igm is a rare idio pathic benign breast disorder, selflimiting, but with slow resolution. Idiopathic granulomatous mastitis of breast and its. There are several agents that may induce a granulomatous mastitis table 62. Idiopathic granulomatous mastitis igm is a rare inflammatory breast lesion of unknown etiology that occurs in women of childbearing age. Igm typically presents with a tender, firm breast mass that may be accompanied by redness, irritation, and drainage. Idiopathic granulomatous mastitis igm is a rarely seen inflammatory breast disease without a clearly elucidated etiology. A case of idiopathic granulomatous mastitis mimicking breast carcinoma clinically and radiographically is reported with mammography, sonography and mr images.
Idiopathic granulomatous mastitis igm is a rare inflammatory disease. The etiology has not yet been fully elucidated but may be due to an autoimmune process, infection, a chemical reaction associated with oral contraceptive medication, or. Idiopathic granulomatous mastitisa mystery yet to be. The diagnosis is based on biopsy and exclusion of malignancy, infections and systemic inflammatory diseases with granuloma. Pdf idiopathic granulomatous mastitis igm is a rare, benign, inflammatory disorder of the breast that can imitate a broad range of conditions. The occurrence of axillary lymphadenopathy was more common in tubercular mastitis than idiopathic granulomatous mastitis with an incidence of 50 and 20. Retrospective study of all patients who were diagnosed with idiopathic granulomatous mastitis from 1st january 2006 to 31st december 2014 at kasturba hospital, manipal, india a tertiary care referral. Idiopathic granulomatous mastitis igm is an uncommon benign chronic inflammatory disease. Pdf idiopathic granulomatous mastitis gokhan yagci. Mastitis may develop secondary to a systemic disorder such as tuberculosis, diabetes mellitus, or rheumatoid arthritis, or it may develop as an idiopathic disorder. Granulomatous lobular mastitis glm or autoimmune mastitis is a rare and benign disease which, except one case reported in an old man, is usually seen during pregnancy or lactation period.
Special forms of granulomatous mastitis occur as complication of diabetes. Granulomatous mastitis is a relatively uncommon disease that involves the development of an inflammatory mass in the breast that may be difficult to differentiate from malignancy. It can be confused with breast cancer, so it is often misdiagnosed and proper treatment is delayed. Idiopathic granulomatous mastitis is a distinct benign breast condition of unknown etiology but several triggers are suspected, including inflammatory, infectious, and hormonal factors. The main symptoms include a palpable mass, skin or nipple retraction, and pain and swelling in the breast. This disease usually affects women of childbearing age or those with a history of oral contraceptive use. Idiopathic granulomatous mastitis igm is a term that has been proposed for a granulomatous inflammatory process of the breast characterised by the presence of noncaseating granulomas confined to breast lobules, in which no microorganisms are found. Idiopathic granulomatous mastitis, corticosteroids, recurrence g ranulomatous mastitis gm is a rare chronic in. Because of its uncommon etiology and rareness, diagnosis and treatment is still a challenge. To study idiopathic granulomatous mastitis with respect to its various clinical features, etiologic factors, treatment modalities and complications. Idiopathic granulomatous mastitis in hispanic women indiana, 20062008. Idiopathic granulomatous mastitis, tubercular mastitis, histopathology, treatment access this article online. Idiopathic granulomatous mastitis in hispanic women. Pathology outlines idiopathic granulomatous mastitis.
It usually has a recurrent or prolonged natural disease course that. Human development index hdi was used to define two groups of study. Igm is a very rare chronic inflammatory breast disease. Igm is characterized by sterile noncaseating lobulocentric granulomatous inflammation 1,2. Idiopathic granulomatous mastitis and expectant line of management should be the treatment of choice for uncomplicated disease and in those who are compliant to follow up. Idiopathic granulomatous mastitis igm is an inflammatory breast disease occurring primarily in young to middleaged women 1, 2. To discuss the clinical and radiological features and treatment approaches in 14 patients diagnosed with idiopathic granulomatous mastitis gm. Idiopathic granulomatous mastitis is a rare, benign breast disease of unknown etiology characterized by chronic inflammation. Granulomatous lobular mastitis is a rare inflammatory disease of the breast that was first described by kessler and wolloch in 1972. We present a case of igm diagnosed after prolonged ineffective treatment of presumed infectious mastitis with abscess. Idiopathic granulomatous mastitis is a rare benign breast disease. A rare inflammatory condition of the breast, it usually occurs in young parous women with a history of breastfeeding 16. Idiopathic granulomatous mastitis is a rare benign inflammatory breast disease that affects women of childbearing age with a history of breastfeeding. Differential diagnosis in idiopathic granulomatous.
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