Male Breast Abscess Secondary to Actinomycosis: A Case Report.

Primary breast actinomycosis is a rare condition that has been previously reported in the female breast. Male breast infection is uncommon and most often associated with trauma to the skin or predisposing conditions like diabetes. We report the first case to our knowledge of primary breast actinomycosis in the male breast caused by Actinomycesneuii (A. neuii), a rare strain of Actinomyces. Mammography demonstrated periareolar skin thickening with a mottled pattern. Sonography showed multiple small cystic structures. Definitive diagnosis was made by culture of the nipple discharge.

Granulomatous mastitis: changing clinical and imaging features with image-guided biopsy correlation.

OBJECTIVES: To review clinical presentation, revisit patient demographics and imaging findings in granulomatous mastitis and determine the optimal biopsy method for diagnosis. METHODS: A retrospective study was performed to review the clinical presentation, imaging findings and biopsy methods in patients with granulomatous mastitis. Twenty-seven patients with pathology-proven granulomatous mastitis were included. RESULTS: The average age at presentation was 38.0 years (range, 21-73 years). Seven patients were between 48 and 73 years old. Twenty-four patients presented with symptoms and three patients were asymptomatic. Nineteen patients were imaged with mammography demonstrating mammographically occult lesions as the predominant finding. Twenty-six patients were imaged with ultrasound and the most common finding was a mass lesion. Pathological diagnosis was made by image-guided biopsy in 44 % of patients. The imaging features of granulomatous mastitis on mammography are infrequently described. CONCLUSIONS: Our study demonstrates that granulomatous mastitis can occur in postmenopausal or asymptomatic patients, although previously reported exclusively in young women with palpable findings. Presentation on mammography as calcifications requiring mammographically guided vacuum-assisted biopsy has not been previously described. The diagnosis of granulomatous mastitis can easily be made by image-guided biopsy and surgical excision should be reserved for definitive treatment. KEY POINTS: • Characterizes radiographic appearance of granulomatous mastitis in postmenopausal or asymptomatic patients. • Granulomatous mastitis can present exclusively as calcifications on mammography. • The diagnosis of granulomatous mastitis is made by image-guided biopsy techniques.

Granular cell tumor in a male breast: mammographic, sonographic, and pathologic features.

Granular cell tumor (myoblastoma) is a rare soft tissue tumor that can present in the breast, producing mammographic and physical exam findings that may be indistinguishable from breast carcinoma. Multifocal lesions in male patients are very unusual. We present a case of a male patient with a granular cell tumor of the breast that was imaged on mammography and sonography. Definitive diagnosis was made with ultrasound-guided core biopsy followed by surgical excision. On clinical examination, the patient demonstrated multiple subcutaneous lesions that were also found to represent granular cell tumor.

Breast abscess after nipple piercing: sonographic findings with clinical correlation.

The purpose of this series was to review the spectrum of clinical and sonographic features associated with infection after nipple piercing. Between 2002 and 2010, 6 patients presented to our breast center with a breast abscess after nipple piercing. A retrospective analysis of the imaging findings was performed with clinical and pathologic correlation. Patients with breast infections after nipple piercing tend to be young, and the timing since piercing varies from 2 weeks to 17 months. Sonography showed a complex or hypoechoic mass in 5 of 6 patients. Treatment of breast abscesses included surgical incision and drainage, percutaneous drainage, and antibiotic therapy. Surgical evacuation is commonly performed; however, sonographically guided aspiration may be an appropriate management strategy.

Breast problems presenting in the emergency room.

A variety of breast complaints may present in the emergency setting. Therefore, the radiologist in the emergency department must be familiar with the pathology encountered and the associated imaging findings. While mammography is the most commonly and frequently used modality for breast imaging, in the emergency setting, ultrasound may be more readily available and better tolerated by the patient. This pictorial essay describes the spectrum of breast complaints encountered in the acute setting and the associated mammographic and sonographic findings.

Mucocelelike lesions of the breast: mammographic findings with pathologic correlation.

OBJECTIVE: The purpose of this study was to review the imaging features of mucocelelike breast lesions, correlate the mammographic and pathologic findings, and determine recommendations for management. CONCLUSION: Mucocelelike lesions are more common than previously reported and are likely to exhibit indeterminate calcifications on mammography. Diagnosis is most often made with Mammotome biopsy. A large number of patients have associated atypia or carcinoma. For patients with purely benign histologic findings at Mammotome biopsy, optimal management should be excisional biopsy to exclude associated malignancy.