Radiologic findings of idiopathic granulomatous mastitis.
OBJECTIVE
To describe the radiological findings of idiopathic granulomatous mastitis (IGM).


METHODS
Radiologic findings of 30 women with histopathological diagnosis of IGM were retrospectively evaluated. All had breast feeding history. All the patients had ultrasonography (US), with 12 of them having additional Doppler US. Of 30 patients, 11 had mammography (MG) and 5 MRI.


RESULTS
US showed multiple irregular hypoechoic masses and collection areas with tubular connections in 25 of 30. The collection area with low-level internal echoes but without tubular connections, suggesting an abscess were seen in 2 of 30 (6.6%); a hypoechoic mass with an indistinct border in 2 of 30 (6.6%); multiple milimetric hypoechoic nodular masses in 1 of 30 (3.3%). On MG, normal findings were noted in 5 (45.4%); focal asymmetric density in 4 (36.4%), parenchymal distortion in 1 (9%) and diffuse asymmetric opacity with trabecular thickening in 1 (9%) of 30 patients. On MRI, segmental T2 hyperintensity with contrast-enhancement on T1 were seen in 4 of 5 (80%). An enhancing T2 hypointense mass with irregular margin was present in 1 of 5 (20%). Time-signal intensity curve of lesions showed slow enhancement in 1 and moderate in 4 of 5 patients.


CONCLUSIONS
In IGM, MG findings were nonspecific. In US, multiple irregular hypoechoic masses and collections with tubular connections with fingerlike aspects, and fistulae formation to the skin in patients with breastfeeding history suggested IGM rather than carcinoma. Due to the limited number of patients, no conclusion was reached regarding MRI of IGM.
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey. E-mail: drseymayildiz@gmail.com.
Seyma
S
Yildiz
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Ayse
A
Aralasmak
Department of Surgery, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Huseyin
H
Kadioglu
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Huseyin
H
Toprak
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Huseyin
H
Yetis
Department of Pathology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Zuhal
Z
Gucin
Department of Radiology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Ercan
E
Kocakoc
D000328:Adult; D005260:Female; D058890:Granulomatous Mastitis / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D014962:X-Ray Film; D055815:Young Adult