J Breast Cancer.  2014 Sep;17(3):295-298. 10.4048/jbc.2014.17.3.295.

Recurrent Bilateral Breast Abscess Due to Nontuberculous Mycobacterial Infection

• Yoo H
• Choi SH
• Kim YJ
• Kim SJ
• Cho YU
• Choi SJ

• KMID: 2286359
• DOI: http://doi.org/10.4048/jbc.2014.17.3.295

Abstract

Since recurrent bilateral breast infection due to nontuberculous mycobacterium (NTM) is rare, its diagnosis is easily overlooked; in addition, complete recovery is often difficult to achieve. We report a case of recurrent bilateral infection in a 35-year-old woman who had completed treatment for NTM. Although various infectious diseases show similar clinical conditions and imaging findings, recurrences should raise suspicion of NTM infection, and this possibility should be considered in differential diagnoses.

Keyword

Abscess; Breast; Nontuberculous mycobacterial infections

MeSH Terms

Abscess*
Adult
Breast*
Communicable Diseases
Diagnosis
Diagnosis, Differential
Female
Humans
Nontuberculous Mycobacteria
Recurrence

Figure

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  Figure 1 B-mode gray scale ultrasonography of the left breast. (A) Ultrasonogram shows an approximately 2.8 cm ill-defined and partially multilobulating contoured mass with heterogeneous internal echogenicity in the subareolar area. (B) Additional findings of diffuse edematous changes in the left breast, with marked heterogeneous underlying parenchymal echogenicity and skin thickening.

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  Figure 2 Magnetic resonance imaging: sagittal view of the left breast. (A) Contrast-enhanced magnetic resonance imaging shows an ill-defined and partially multilobular contoured lesion with rim-like enhancement in the subareolar area of the left breast (arrowheads) with additional diffuse parenchymal enhancement. The lesion (arrowheads) visible in the subareolar area correlates to the lesion detected by B-mode gray scale ultrasonography (Figure 1). This lesion appeared to be an abscess consistent with mastitis (1.5-T MR scanner, 3D fat-suppressed T1-weighted Gradient Echo Sequences; contrast injection of 0.2 mL/kg gadodiamide [OmniscanTM; GE Healthcare] was administered by manually followed by a 20-mL saline flush). (B) T2-weighted image showing high signal intensity diffuse edematous changes with skin thickening (arrows) and an ill-defined high signal intensity lesion in the subareolar area (arrowhead), correlated with the lesion with rim-like enhancement.

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  Figure 3 Histopathologic findings. Histologic sections of the lesion specimen obtained by ultrasound-guided core needle biopsy (A, lower magnified image, ×20; B, higher magnified image, ×100) show inflamed breast tissue with granulomatous reaction on hematoxylin and eosin staining (arrows).

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