Ultrasonographic Findings of Idiopathic Granulomatous Mastitis in a Case Series from a Tertiary Center

Background: Idiopathic granulomatous mastitis (IGM) is one of the uncommon benign relapsing diseases of the breast and the imaging features of IGM can be indistinguishable from invasive or inflammatory breast carcinoma. Therefore, the assessment of the ultrasound features could be diagnostically helpful. Material and Methods: This retrospective research involved a total of ۲۶ patients who had a final pathologic diagnosis of IGM and who underwent high-resolution ultrasound (US) and color Doppler evaluation. Results: Overall, ۲۶ patients met the inclusion criteria. The age range of the patients was between ۲۴ and ۵۲ years old with an average of ۳۴.۸۱. About half of the patients (۵۳.۸%) reported pain as a presenting symptom and the most common physical finding was a palpable mass in ۵۳.۸% of the cases. Ultrasonography revealed the most common mass shape to be oval and irregular both with a frequency of ۴۷.۱%. Mass margins were mostly indistinct (۷۰.۶%) while angular and circumscribed margins were also seen. Heterogeneous echogenicity was observed in ۷۱.۴%, increased echogenicity of perilesional fat in ۸۴.۶%, posterior acoustic enhancement in ۵۷.۷%, peripheral vascularity in ۳۰.۸%, and subcutaneous collections in ۱۹% of the patients., Internal vascularity was seen in ۷% of the cases. Conclusion: In the US of IGM, increased echogenicity of subcutaneous and perilesional fat were a common ultrasound feature (۸۴.۶%) while perilesional fat edema has not been mentioned in previous studies. In this study, other ultrasound features of IGM such as tubular extension, subcutaneous collection, indeterminate irregular masses, and collections were observed. They may contribute to the diagnosis of granulomatous mastitis in a proper clinical setting.

Keywords:

Breast disease , Granulomatous mastitis , Mastitis