BREAST: BR12

PLASMA CELL MASTITIS: A REPORT CASE

L. EL ASSASSE, R. LATIB, S. BOUTACHALI, L. JROUNDI, I. CHAMI, M.N BOUJIDARadiology service. National Institute of Oncology. Rabat. Morocco

Introduction: The plasma cell mastitis is a chronic

inflammatory benign mastopathy, relatively rare.

We illustrate through this work the typical appearance on imaging of a case of plasma cell mastitis.

Observation: A 6O-year-old woman without medical

history, was addressed to the radiology service of the National Institute of Oncology in Rabat for screening mammography.

Mammography and breast ultrasound were performed.

Results : Mammography found bilateral diffuse and

thick calcifications, tapered in barley sugar.

Ultrasound demonstrates bilateral dilatation of galactophorous ducts allowing to confirm the diagnosis of plasma cell mastitis.

Mammogram shows diffuse and thick calcifications tapered in barley sugar.

Discussion : The plasma cell mastitis is seen mainly in

women over 40 years, characterized by dilated lactiferous ducts with periductal inflammation and fibrosis.

Its etiology remains unknown, although several theories autoimmune traumatic iatrogenic or infectious are discussed.

Discussion : At the beginning stage it may be

asymptomatic or cause multiple duct discharge often bilateral, thick whitish or greenish, spontaneous or induced.

Nipple retraction may be subsequently.

Retroareolar mass simulating cancer is sometimes observed. (biopsy is necessary in this case).

Discussion : Mammography:

is typical with the presence of calcifications in regular sticks or thick tapered in “barley sugar” distributed throughout the gland.

Discussion : Ultrasound:

Retroareolar duct dilatation.

Sometimes ill-defined retroareolar mass.

Discussion: Treatment of plasma cell mastitis is useless.

Where there are clinical signs (inflammation, infection, fistula): anti-inflammatory and or antibiotherapy.

Recurrence is common and can lead to damage to cosmetic breast.

Conclusion: When appearance is typical the radiological

diagnosis of plasma cell mastitis is easy.

In the clinical and radiological atypical forms, the differential diagnosis with carcinomatous mastitis is eliminated by histology.

REFERENCES:

Barrero RP, Benavides AM, Leon MB, Barrero DV, Vargas VV. Mastitis granulomatosa idiopatica y mastitis de células plasmaticas. Experiencia de tres anos. Rev Chil Obst et Ginecol 2005; 70(5):323-27.

Kharmach M, Filali A, Saadi N, El Barnoussi L, Khachani M, Zouhlal A, Alami H, Bezad R, Chraïbi C, Alaoui MT. Mastite à plasmocytes. A propos d’un cas. Médecine du maghreb 2004; N122: 46-8.

Amrani N, Khachani M, Mounzil CD, Bensaid F, Dehayni H, Bezad R, Chraibi CC, El Fehri HS, Alaoui MT. Mastite granulomateuse. A propos d’un cas. Revue de la littérature. Médecine du Maghreb 1998; N70: 28-30.

Dixon JM. Periductal mastitis duct ectasia. World J Surg; 1989; 13: 715-20.

Loubet R, Loubet A, Lavres J, Pichereau D, Leboutet MJ. Mastite granulomateuse à plasmocytes iatrogénique. Gynécologie 1989; 33: 12-91.