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Division
East Florida
Hospital
HCA Florida Westside Hospital
Specialty
Pathology
Document Type
Poster
Publication Date
2024
Keywords
cystic neutrophilic granulomatous mastitis, CNGM, mastitis, breast diseases
Disciplines
Female Urogenital Diseases and Pregnancy Complications | Medicine and Health Sciences | Pathology | Skin and Connective Tissue Diseases
Abstract
Introduction. Cystic neutrophilic granulomatous mastitis (CNGM) is an uncommon subtype of granulomatous mastitis (GM) affecting young to middle-aged parous women. Although there is no universally accepted diagnostic criteria, CNGM has a highly distinct histological pattern characterized by suppurative lipogranulomas composed of central lipid vacuoles rimmed by neutrophils with an outer cuff of epithelioid histiocytes.
Case 1: 42-year-old recently pregnant woman with a history of left breast mastitis and abscess treated with incision and drainage (I&D) six months prior, presented with contralateral right breast mastitis with abscess without improvement on oral antibiotics. Histologic examination revealed CNGM, with Corynebacterium identified on Gram stain.
Case 2: 33-year-old ESRD on hemodialysis female with a 4-month history of multiple right breast abscesses who underwent I&D with biopsy revealing CNGM, with Pseudomonas identified by culture.
Discussion. CNGM is often associated with Corynebacterium species seen inside the lipid vacuoles as sparse, rod-shaped, gram-positive bacilli. However, other infectious causes exist and should be considered in the absence of Corynebacterium. Pseudomonas has been identified as the most common bacterial cause of granulomatous mastitis in general. Therefore, proper investigation of other infectious agents with special stains and cultures should be performed to ensure proper medical management.
Conclusion: Familiarity of CNGM is needed for all physicians treating breast disease. This diagnosis is often missed or delayed due to its rarity and mimickers. Most importantly, the causative infectious organisms should be identified to offer patients the most appropriate antimicrobial treatment and avoid unnecessary surgical treatment.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Sacasa, Astrid; Naeem, Mohtashim; and Ferra, Susana, "Cystic Neutrophilic Granulomatous Mastitis with Corynebacterium and Pseudomonas species: A comparison" (2024). East Florida Division GME Research Day 2024. 39.
https://scholarlycommons.hcahealthcare.com/eastflorida2024/39
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Female Urogenital Diseases and Pregnancy Complications Commons, Pathology Commons, Skin and Connective Tissue Diseases Commons