title: Cystic neutrophilic granulomatous mastitis: an underappreciated pattern strongly associated with gram-positive bacilli.
abstract: Although granulomatous lobular mastitis is associated with gram-positive bacilli such as Corynebacterium, this association is not well known. We report 3 cases of mastitis caused by gram-positive bacilli. All 3 abscesses were suppurative with distinct enlarged cystic spaces in which rare gram-positive bacilli were identified. Two cases were also granulomatous. Cultures in all 3 cases were negative. All 3 patients recovered after biopsy and tetracycline-based therapy. Infection in the breast by gram-positive bacilli is associated with a distinct histologic pattern, including cystic spaces in the setting of neutrophilic/granulomatous inflammation that can be recognized and should prompt careful search for the organism within enlarged vacuoles.
authors.affiliation: Dept of Pathology, Baptist Hospital, Miami, FL 33176, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Renshaw
authors.forename: Robert P
authors.initials: RP
authors.lastname: Derhagopian
authors.forename: Edwin W
authors.initials: EW
authors.lastname: Gould
mesh_terms: D000328:Adult; D005260:Female; D006094:Gram-Positive Bacteria; D058890:Granulomatous Mastitis / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009504:Neutrophils / Q000382:microbiology* / Q000473:pathology