Type:
Educational Exhibit
Keywords:
Abscess, Biopsy, Ultrasound, MR, Mammography, Breast
Authors:
N. Alberdi, P. Lopez Sala, G. Unzue, T. Lage Vidal, L. A. De Llano Ibisate, C. Saavedra Gutierrez, N. Baraibar Argota, I. San Martin San martin, C. Alfaro; Pamplona/ES
DOI:
10.26044/ecr2019/C-1358
Conclusion
Idiopathic granulomatous mastitis is an infrequent non caseating granulomatous inflammatory disease,
which typically affects women within 6 years of pregnancy.
The most frequent clinical signs are unilateral breast mass,
pain,
skin erythema,
edema and warmth.
There are no radiologic pathognomonic findings specific to this entity due to the wide spectrum of mammography,
ultrasound and MR imagings of IGM.
At mammography,
the most common findings are focal asymmetric density,
diffuse asymmetric opacity or an irregular focal mass.
Ultrasound usually shows hypo-echoic or heterogeneous mass or masses with tubular extensions.
Finally,
at MRI,
asymmetrical hyperintense signal on T2 images,
and heterogeneously or rim-enhancing mass in combination with non-mass lesions enhancement during contrast enhanced are frequent manifestations.
It should be considered in the differential diagnosis of breast lesions due to nonspecific findings,
which usually overlap with other benign and malignant breast entities.
The main differential diagnosis must be breast cancer,
because IGM mimics a breast carcinoma (especially inflammatory type) clinically and radiographically very often.
Although the certain diagnosis is histological,
the radiological image is important to determine extension and prognosis,
to evaluate treatment response and for the follow-up of cases.
Sometimes,
we can obviate the biopsy with acceptable safety margins.