Abstract
A 78-year-old woman who had noticed a palpable left breast mass since April 2006 was seen at a hospital in June of the year, when a 4.9×4.5 cm tumor in the B area or the left breast with fixation to the thoracic wall was identified. From CT, MRI, US and MMG findings, breast cancer was suspected, but fine needle aspiration cytology performed twice demonstrated no malignant cells. Subsequently the patient was referred to our department for close exploration and treatment. On physical examinations, a 5-cm diameter, elastic-hard, and ill-movable tumor was palpated in the B area of the left breast, but no axillary lymph node swelling was noted. Breast US disclosed an ill-defined and irregular-shaped mass with heterogeneous inner portion in the B area of the left breast, but the chest wall was not involved and malignant findings were lacked. The mass was suggested to be an inflammatory change. Mycobacterium tuberculosis was isolated from the aspirated fluid and smear staining resulted in Gaffky 6. The culture of the fluid was also positive. Tuberculosis of the mammary gland was thus diagnosed. Sputa culture for M. tuberculosis performed at the same time was negative, and there were no findings suggestive of pulmonary tuberculosis on chest CT scan. Treatments according to those for pulmonary tuberculosis were carried out and thereafter the patient has strictly been followed on an ambulant basis.
As tuberculosis of the mammary gland unassociated with pulmonary tuberculosis is extremely rare, this case is presented here, together with some bibliographic comments.
