Tuberculous mastitis: A review of 32 cases.

BACKGROUND: Breast tuberculosis (TB) is a rare disease, still present in endemic areas. The significance of breast TB is due to its rare occurrence and its resemblance to malignant breast lesions. The objective of this study was to study various clinical presentations and imaging features of different forms of tuberculous mastitis. METHODS: A retrospective study was conducted over a 10-year period. Thirty-two consecutive patients diagnosed with tuberculous mastitis were included. RESULTS: There was only one male patient in this series. The patients ranged in age from 25 to 60 years (mean age was 33.69 years). A solitary breast mass was the most common clinical presentation, which was associated with inflammatory findings in the majority of cases. The most common mammographic finding was diffusely increased density and the most common pathological finding was solitary mass. The most common appearance on ultrasound was of multiple intercommunicating breast masses with axillary lymphadenopathy. CONCLUSIONS: Breast TB should be considered in the differential diagnosis in the presence of a painful breast mass, discharging sinuses, mastitis, or a breast abscess that does not respond to conventional medical treatment. A multidisciplinary approach is required to aid timely diagnosis and to provide appropriate management and treatment in order to avoid complications.

Breast Angiosarcoma with Exophytic Growth.

Primary angiosarcoma of the breast is a rare malignant tumor. Diagnostic breast imaging includes mammography and ultrasound, which are usually nonspecific. A 42-year-old woman with angiosarcoma of the breast is presented. Physical findings showed a hard exophytic mass in the upper part of the left breast, with skin discoloration overlaying the mass. Mammography revealed a high density well defined mass in the left breast, without any micro-calcification and speculation. On ultrasound examination, a hypoechoic mass with a well-defined margin and heterogenous echogenicity was detected. A core needle biopsy and excisional biopsy were performed, and histological examination confirmed the diagnosis of angiosarcoma. The patient underwent simple mastectomy. We present the mammographic and ultrasonographic features of a case of primary breast angiosarcoma with exophytic growth.

The Extrapulmonary Manifestations of Systemic Sclerosis on Chest High Resolution Computed Tomography.

BACKGROUND: Systemic sclerosis (SS) is a collagen vascular disease of unknown etiology that is characterized by connective tissue abnormalities. This study aimed to evaluate the extra-pulmonary manifestations of SS on chest high resolution computed tomography (HRCT). MATERIALS AND METHODS: The medical records of patients with SS who presented to our hospital in a 10-year period were retrospectively reviewed. Forty patients with SS were included in this study. The extra pulmonary manifestations of SS were evaluated in these patients, including esophageal involvement, pulmonary arterial dilatation, pleural abnormalities, pericardial disease and mediastinal lymph node involvement. RESULTS: The most common extra-pulmonary manifestation was esophageal dilatation, which was detected in 70% of the cases followed by pleural involvement. Pulmonary arterial dilatation was seen in 20%, pleural involvement in 40%, pericardial involvement in 40% and mediastinal lymphadenopathy in 30%. The most common pleural abnormality was diffuse pleural thickening and the most common pericardial abnormality was pericardial effusion. There was an association between the severity of lung fibrosis with the incidence of esophageal dilatation and pulmonary arterial hypertension (PAH) in our series. Patients with SS and interstitial lung disease (ILD) who had PAH, had more severe lung fibrosis than those without PAH. CONCLUSION: Patients with SS may have a variety of extra-pulmonary manifestations, which can be detected using HRCT. Our study evidenced that HRCT was useful for detecting extra-pulmonary findings of SS such as esophageal dysmotility and dilatation, enlargement of main pulmonary artery and PAH, pleuropericardial involvement and mediastinal lymphadenopathy.

Hysterosalpingographic findings in women with genital tuberculosis.

BACKGROUND: Genital tuberculosis (TB) is an important cause of infertility in the developing countries, where hysterosalpingography (HSG) remains an initial diagnostic procedure in the evaluation of tubal and peritoneal factors leading to infertility. OBJECTIVE: The aim of this study was to determine the HSG findings of genital TB in infertile women. MATERIALS AND METHODS: We retrospectively reviewed HSG findings in 20 women with genital tuberculosis. HSG was performed in these women as part of infertility work up over 5 years. The other diagnostic procedures used included endometrial curettage and biopsy, histological examination, culture, laparoscopy, hysteroscopy and polymerase chain reaction. RESULTS: The mean age of the participants was 30.5±8 years. All women had clinical history of infertility for at least 4 years. Women presented with pelvic abdominal pain (30-35%) and menstrual disturbances (20-25%). Reviewing 20 cases of female genital TB were encountered various presentations on HSG. CONCLUSION: HSG is an invaluable procedure in suggesting the diagnosis of genital TB in patients being investigated for infertility.

An intracystic papillary carcinoma of the breast.

Intracystic carcinoma of the breast is a rare form of breast carcinoma. Among allmalignant breast tumors, this lesion has an incidence of 0.2-0.5%. These neoplasms have certain characteristic imaging findings which help to differentiate these lesions from other focal breast abnormalities.This report is on the case of a 48-year-old woman with a palpable, painless lump in her right breast. Mammography demonstrated an oval well-circumscribed mass without calcification. Breast ultrasonography showed a cystic lesion with an intracystic solid component projecting from its posterior wall. Cyst aspiration revealed a hemorrhagic fluid and a suspicious cytology. Excisional biopsy revealed papillary carcinoma suggesting of intracystic papillary carcinoma.