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육아종성 유선염의 초음파 소견과 임상적 특징

Sonographic Finding and Clinical Significance of Granulomatous Mastitis

건양의대학술지 2004년 4권 2호 p.162 ~ 166
김금원, 윤대성, 황철목, 조영준, 박용성, 정동진, 설혜정, 김재균,
소속 상세정보
김금원 ( Kim Keum-Won ) - 건양대학교 의과대학 영상의학교실
윤대성 ( Yoon Dae-Sung ) - 건양대학교 의과대학 외과학교실
황철목 ( Hwang Cheol-Mog ) - 건양대학교 의과대학 영상의학교실
조영준 ( Cho Young-Jun ) - 건양대학교 의과대학 영상의학교실
박용성 ( Park Yong-Sung ) - 건양대학교 의과대학 영상의학교실
정동진 ( Chung Dong-Jin ) - 건양대학교 의과대학 영상의학교실
설혜정 ( Sul Hae-Joung ) - 건양대학교 의과대학 병리학교실
김재균 ( Kim Jae-Kyun ) - 건양대학교 의과대학 영상의학교실

Abstract


The purpose of this study is to evaluate the clinical and sonographic findings of granulomatous mastitis and to know the usefulness of sonoguided core biopsy. We reviewed the clinical and radiologic findings of 4 patients (age range 30 to 44 years) with pathologically proven granulomatous mastitis. Three mammography were analized for the shape, margin of mass, microcalcification and skin thickening, Four ultrasonography were analized for the shape, margin, internal echo pattern, boundary, posterior echo pattern of mass, skin thickening, subcutaneousfat tissue obliteration, and location of lesions. USG-guided core biopsy (n=4) and excisional operation (n=2) were performed. All pathologic slides were analized for the granuloma involving the lobule, fat globule surrounding granuloma, and microabcess. Our cases showed palpable mass (4/4), pain (4/4) and serous nipple discharge (1/4). Mammography showed focal asymmetry (2/3), partially obscured margin (1/3), cooper’s ligament thickening (2/3), and skin thickening (1/3). Ultrasonography showed irregular shape (4/4), ill defined margin (4/4), heterogenonus internal echogenicity (3/4), thick boundary echogenicity (4/4) and subcutaneous fat obliteration (4/4). All cases were located at subareolar or less than 2 cm from nipple (4/4). Histopathologic examination showed granuloma involving lobule (4/4), fat globule surrounding granuloma (2/4), microabscess (4/4) and PCR for mycobacterium were negative in all cases. Granulomatous mastitis should be considered in differential diagnosis of child bearing age women with painful breast mass, showing irregular shaped heterogeneous hypoechoic mass and thick echogenic boundary in sonography. For final diagnosis of GM, all cases require correlation with radiologic, histopathologic and clinical features.

키워드

Granulomatous mastitis;breast USG;Core biopsy

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