La radiologia medica

, Volume 117, Issue 4, pp 529–538 | Cite as

Multimodality imaging features of idiopathic granulomatous mastitis: outcome of 12 years of experience

  • M. Dursun
  • S. Yilmaz
  • A. Yahyayev
  • A. Salmaslioglu
  • E. Yavuz
  • A. Igci
  • G. Acunas
  • M. Tunacı
Breast Radiology / Senologia

Abstract

Purpose

This study was done to determine mammographic, sonographic and magnetic resonance imaging (MRI) appearances of idiopathic granulomatous mastitis, an entity clinically and radiographically resembling breast carcinoma.

Materials and methods

A total of 36 women (mean age 37 years, range 21–51 years) with histopathological diagnosis of idiopathic granulomatous mastitis were enrolled in the study. The Breast Imaging Reporting and Data System (BI-RADS) was used to categorise the levels of suspicion of malignancy on mammography. Mammography findings were classified also according to density, margin, architectural distortion and number of lesions. Lesions were classified according to number, heterogeneity and echogenic features on sonography. Dynamic MRI findings were categorised as enhancing mass lesion, nonmass lesion or both mass lesions and nonmass lesions together. Subclassification criteria for MRI included lesion shape, margin, border and internal enhancement pattern.

Results

The most common mammographic finding was either focal or diffuse asymmetric density (n=15, 44%). The most common sonographic findings were solitary or multiple circumscribed heterogeneous hypoechoic masses (n=19, 52%). Among other sonographic findings were diffuse abscess formation with fistulae and massive parenchymal heterogeneity and hypoechogenicity in 12 (33%) and five (13%) women, respectively. On MRI, enhancing mass lesions were detected in 24 patients, whereas enhancing nonmass lesions were observed in 28. Sixteen patients had both enhancing mass lesions and nonmass lesions together.

Conclusions

Although not characteristic for this entity, asymmetric density on mammography, solitary or multiple clustered heterogeneous hypoechogenicity with a tubular configuration on sonography and round, smooth-contoured masslike lesion with rim enhancement or segmental non-mass-like lesion on MRI are the most common features of the disease.

Keyword

Idiopathic granulomatous mastitis Mammography Ultrasonography MR imaging Breast carcinoma 

Aspetti radiologici della mastite granulomatosa idiopatica: risultati di dodici anni di esperienza

Riassunto

Obiettivo

Lo scopo del lavoro è determinare gli aspetti in mammografia, ecografia e risonanza magnetica della mastite granulomatosa idiopatica, un’entità clinicamente e radiologicamente simile al carcinoma mammario.

Materiali e metodi

Sono state arruolate nello studio 36 donne (età media: 37 anni, range: 21–51 anni) con diagnosi isto-patologica di mastite granulomatosa idiopatica. è stato utilizzato il Breast Imaging Reporting and Data System (BI-RADS) per classificare il livello di sospetto e di malignità sulla base della mammografia. I rilievi mammografici sono stati classificati anche in base a densità, margini, distorsione strutturale e numero di lesioni. Le lesioni sono state classificate all’ecografia secondo il numero, l’eterogeneità e le caratteristiche di ecogenicità. I reperti sono stati classificati in risonanza magnetica come lesioni con aumentato enhancement di tipo masslike, non-masslike, o contestualmente masslike e non-masslike. Ulteriori criteri in risonanza magnetica hanno incluso forma, margini, bordi e pattern interno di enhancement della lesione.

Risultati

Il rilievo mammografico più comune era caratterizzato da densità asimmetriche sia focali che diffuse (n=15, 44%). I reperti ecografici più comuni erano masse circoscritte, solitarie o multiple, eterogenee ed ipoecogene (n=19, 52%). Altri segni ecografici tipici erano diffuse formazioni ascessuali con fistole, caratterizzate da intensa eterogeneità in 12 (33%) donne ed ipoecogenicità parenchimale in 5 (13%) donne. Sulla base della risonanza magnetica, lesioni masslike sono state rilevate in 24 pazienti, mentre lesioni non-masslike sono state osservate in 28 donne. Sedici pazienti avevano contemporaneamente lesioni masslike e non-masslike.

Conclusioni

Sebbene non specifiche di questa entità, le più comuni caratteristiche della mastite granulomatosa idiopatica sono risultate essere: lesioni con densità asimmetrica alla mammografia, lesioni eterogeneamente ipoecogne, solitarie o multiple, con configurazione tubulare, in ecografia, e lesioni masslike, rotondeggianti a margini lisci, con enhancement anulare, o lesioni segmentate non-masslike, in risonanza magnetica.

Parole chiave

Mastite granulomatosa idiopatica Mammografia Ecografia RM Carcinoma mammario 

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • M. Dursun
    • 1
  • S. Yilmaz
    • 1
  • A. Yahyayev
    • 1
  • A. Salmaslioglu
    • 1
  • E. Yavuz
    • 2
  • A. Igci
    • 3
  • G. Acunas
    • 1
  • M. Tunacı
    • 1
  1. 1.Radiology Department, Istanbul Faculty of MedicineIstanbul University, Millet Caddesi, CapaIstanbulTurkey
  2. 2.Pathology DepartmentIstanbul University, Istanbul Faculty of MedicineIstanbulTurkey
  3. 3.General Surgery Department, Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey

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