Abstract：
BACKGROUND: Tuberculous mastitis (TBM), is an uncommon form of extra-pulmonary tuberculosis. Clinical and radiological overlap of tuberculous mastitis with malignancy and other granulomatous conditions, along with its paucibacillary nature, make it a diagnostic challenge. In our study, we aim to assess the radiological response of microbiologically negative granulomatous mastitis cases to anti-tuberculous treatment (ATT) in an endemic country.
METHODS: Eighty-seven cases demonstrating granulomatous lesions on breast biopsy were identified. Of these, 49 patients who were treated with ATT and had at least two serial ultrasound follow-ups were included in our study. Mammogram and ultrasound were used for initial imaging. Subsequently, ultrasound was used for serial follow-up. Mantoux skin test, acid fast staining and histological examination of tissue sample were the other investigations used.
RESULTS: Radiologically, on ultrasound, well-circumscribed hypoechoic masses were noted in 18 patients, followed by ill-defined collections with tubular extensions in 15 cases, abscesses in 8, and a focal heterogeneity in 8 patients. Following ATT, 17 patients showed radiological resolution in 4 weeks, 18 of them at 3 months, and nine of them in 6 months.
CONCLUSIONS: Excellent and prompt radiological response to ATT, indicates the need for a high degree of suspicion for tuberculous mastitis (TBM), in endemic countries, even though microbiological tests may turn out negative.
METHODS: Eighty-seven cases demonstrating granulomatous lesions on breast biopsy were identified. Of these, 49 patients who were treated with ATT and had at least two serial ultrasound follow-ups were included in our study. Mammogram and ultrasound were used for initial imaging. Subsequently, ultrasound was used for serial follow-up. Mantoux skin test, acid fast staining and histological examination of tissue sample were the other investigations used.
RESULTS: Radiologically, on ultrasound, well-circumscribed hypoechoic masses were noted in 18 patients, followed by ill-defined collections with tubular extensions in 15 cases, abscesses in 8, and a focal heterogeneity in 8 patients. Following ATT, 17 patients showed radiological resolution in 4 weeks, 18 of them at 3 months, and nine of them in 6 months.
CONCLUSIONS: Excellent and prompt radiological response to ATT, indicates the need for a high degree of suspicion for tuberculous mastitis (TBM), in endemic countries, even though microbiological tests may turn out negative.
摘要：
背景：结核性乳腺炎（TBM），是一种罕见的肺外结核.结核性乳腺炎与恶性肿瘤和其他肉芽肿性疾病的临床和放射学重叠，连同它的低杆菌性质，让它成为诊断挑战。在我们的研究中,我们的目的是评估一个流行国家的微生物阴性肉芽肿性乳腺炎病例对抗结核治疗(ATT)的放射学反应.
方法：分析87例乳腺活检显示肉芽肿性病变的患者。其中,我们的研究包括49例接受ATT治疗并至少进行了两次连续超声随访的患者。乳房X线照片和超声用于初始成像。随后，超声用于连续随访.Mantoux皮肤测试,抗酸染色和组织样本的组织学检查是其他使用的研究。
结果：放射学，在超声波上，在18例患者中注意到界限清楚的低回声肿块，其次是15例带有管状延伸的不明确集合，脓肿8例，局灶性异质性8例。ATT之后,17例患者在4周内表现出放射学分辨率，其中18人在3个月时，6个月内有9个.
结论：对ATT的出色和迅速的放射学反应，表明需要高度怀疑结核性乳腺炎（TBM），在流行国家，即使微生物测试结果可能是阴性的。
方法：分析87例乳腺活检显示肉芽肿性病变的患者。其中,我们的研究包括49例接受ATT治疗并至少进行了两次连续超声随访的患者。乳房X线照片和超声用于初始成像。随后，超声用于连续随访.Mantoux皮肤测试,抗酸染色和组织样本的组织学检查是其他使用的研究。
结果：放射学，在超声波上，在18例患者中注意到界限清楚的低回声肿块，其次是15例带有管状延伸的不明确集合，脓肿8例，局灶性异质性8例。ATT之后,17例患者在4周内表现出放射学分辨率，其中18人在3个月时，6个月内有9个.
结论：对ATT的出色和迅速的放射学反应，表明需要高度怀疑结核性乳腺炎（TBM），在流行国家，即使微生物测试结果可能是阴性的。
