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Tuberculosis mastitis presenting as bilateral breast masses

  • Yujie Qiao
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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  • Jessica H. Hayward
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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  • Ronald Balassanian
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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  • Kimberly M. Ray
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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  • Bonnie N. Joe
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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  • Amie Y. Lee
    Correspondence
    Corresponding author at: University of California San Francisco, Department of Radiology and Biomedical Imaging, 1600 Divisadero Street, Room C250, Box 1667, San Francisco, CA 94115, USA.
    Affiliations
    Department of Radiology and Biomedical Imaging, University of California San Francisco, 1600 Divisadero Street, San Francisco, CA 94115, USA
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Published:February 22, 2018DOI:https://doi.org/10.1016/j.clinimag.2018.02.013

      Highlights

      • Imaging findings and clinicopathologic features of tuberculosis mastitis are reviewed.
      • Tuberculosis (TB) mastitis is a challenging diagnosis, often presenting with imaging findings suspicious for malignancy.
      • Negative AFB stains and cultures do not fully rule-out TB, especially when a high level of clinical suspicion exists.
      • The diagnosis should be considered in patients with risk factors for TB with a diagnosis of granulomatous mastitis.

      Abstract

      Tuberculosis mastitis can be a challenging diagnosis, often presenting with clinical and imaging findings that are suspicious for malignancy. We present a case of a 49-year-old female with a breast mass initially diagnosed as idiopathic granulomatous mastitis. Failure to respond to standard treatments, development of new breast masses, and discovery of a concurrent ulcerating thigh rash with similar histologic findings as the breast masses prompted further investigation, which ultimately lead to the diagnosis of tuberculosis mastitis. There was rapid resolution of both breast and skin symptoms after initiation of empiric drug therapy.

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