Abstract
Abstract: Problem statement: Granulomatous Lobular Mastitis (GLM) or autoimmune mastitis is a rare and benign disease which, except one case reported in an old man, is usually seen during pregnancy or lactation period. This disease was described for the first time by Kessler. Approach: Our case is a 34 year-old woman who has a child with a history of using OCP that primary complaint was swelling, heat and erythema in the right breast. She was diagnosed with mastitis and treated with antibiotics for one month, later on she had experienced stiffness in the breast and a mass was also palpable. The patient was performed surgical drainage and treated with wide spectrum antibiotics being diagnosed with abscess. After one month, a solid mass was palpable so, mammography was performed and the mass was surgically resected with a suspicion of tumor. Results: The pathology report revealed granulomatous mastitis with non caseified granuloma. For Anti-TB treatment was started as medication regime and after 40 days fistula with frequent secretions appeared. Antituberculosis medications stopped and other conditions resulting in none caseified granuloma. In microscopic view granulomatous mastitis along with abscess was reported. Corticosteroids were started and the mass became smaller gradually, the fistula also closed and secretions dried out. Conclusion: Granulomatous Lobular Mastitis is a benign inflammatory breast disease. Cause of disease is still unknown, but some factors have been suggested such as local autoimmune, reaction to the delivery, previous use of contraceptives and infectious causes. The best treatment proposed is corticosteroid therapy in which the mass dwindle and the fistula is closed and secretions dried. The case is now under treatment with corticosteroids and all her symptoms have improved.
Highlights
Granulomatous Lobular Mastitis (GLM) or autoimmune mastitis is a rare and benign disease which, except one case reported in an old man, is usually seen during pregnancy or lactation period. (Heer et al, 2003; Goldberg et al, 2000) Idiopathic granulomatous mastitis is a rare and benign breast disease which was described by Kessler and Wolloch (1972) for the first time in 1972
Idiopathic granulomatous mastitis which is called as autoimmune mastitis and granulomatous lobular mastitis is a benign inflammatory disease of the breast which was described almost 30 years ago
Diesing et al (2004) and Kim et al (2003) it is essential to ruled out infectious causes in corticotherapy cases and antibiotic treatment should start before administration of oral steroid in abscess cases
Summary
Granulomatous Lobular Mastitis (GLM) or autoimmune mastitis is a rare and benign disease which, except one case reported in an old man, is usually seen during pregnancy or lactation period. (Heer et al, 2003; Goldberg et al, 2000) Idiopathic granulomatous mastitis is a rare and benign breast disease which was described by Kessler and Wolloch (1972) for the first time in 1972. (Heer et al, 2003; Goldberg et al, 2000) Idiopathic granulomatous mastitis is a rare and benign breast disease which was described by Kessler and Wolloch (1972) for the first time in 1972. The etiology of this disease is known as chronic, necrotizing granulomatous lobulitis and is similar to breast carcinoma regarding clinical features. For Anti-TB treatment was started as medication regime and after 40 days fistula with frequent secretions appeared This was the time when the patient referred to me and I stopped anti-tuberculosis medications and suggested some tests. Ana Anti_Top(ECL) Wright Combs wright Anti Brucella (IgG) CBC WBC RBC Hb Hct PLT ESR_1 ESR_2 CRP
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