International Journal of Clinical Case Reports 2017, Vol.7, No.19, 86-90
86
Research Report Open Access
Breast Tuberculosis: a Diagnosis Often Unknown, Case Report
Ragmoun H.
1
, Ajili A
1
, Daadoucha A.
2
, Benhlima N.
3
1 Department of Obstetric Gynecology Ibn El Jazzar Hospital Kairouan, University hospital assistant in gynecology obstetrics, Ibn El Jazzar Street, Kairouan
3100, Tunisia
2 Department of Radiology Ibn El Jazzar Hospital Kairouan, University hospital assistant in radiology, Ibn El Jazzar Street, Kairouan 3100, Tunisia
3 Department of Cardiology Ibn El Jazzar Hospital Kairou, University hospital assistant in cardiology, Ibn El Jazzar Street, Kairouan 3100, Tunisia
Corresponding author email
International Journal of Clinical Case Reports 2017, Vol.7, No.19 doi
Received: 31 Oct., 2017
Accepted: 27 Nov., 2017
Published: 15 Dec., 2017
Copyright © 2017
Ragmoun et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Ragmoun H., Ajili A., Daadoucha A., and Benhlima N., 2017, Breast tuberculosis: a diagnosis often unknown, case report, 7(19): 86-90 (doi:
Abstract
Breast tuberculosis is a rare condition. It poses a differential diagnosis problem with breast cancer because the clinic and
imaging are not specific. Breast tuberculosis should be mentioned mainly in endemic countries or in immunocompromised
individuals. We report a case of breast tuberculosis in a postmenopausal woman through this case, we describe the particularity
Clinical and evolving of this entity, and we discuss the diagnostic difficulties.
Keywords
Tuberculosis; Breast
Background
Tuberculosis has been gaining renewed interest for several years, mainly because of the resurgence of
extrapulmonary forms in western and tropical countries, and in the Maghreb. This could be explained by the
increasing of the prevalence of HIV infection, the emergence of strains of mycobacteria that are resistant to usual
treatments, the immigration of populations from high rate of tuberculosis and the release of anti-tuberculosis
campaigns (Ben et al., 2005).
The elective extrapulmonary localizations are, in order of decreasing frequency: the ganglia, the peritoneum, the
pericardium, the kidneys, the skin, the joints, the meninges and the bone (Elmrabet et al., 2002; Ben et al., 2005).
Breast localization is very rare, accounting for less than 0.1% of cases. Nearly 900 cases have been reported in the
world literature (Luh et al., 2007; Fadaei-Araghi et al., 2008). This location can be primitive or secondary to
locoregional tuberculosis or disseminated, and it often poses diagnostic difficulties both clinically and paraclinically
(Ben et al., 2005; Fadaei-Araghi, et al., 2008).
1 Observation
Mrs.G.N, 68 years old, multiparous, with no particular antecedents, in particular no concept of tuberculous
contagion, who presented herself to our service for mastodynia appeared since two months. The clinical
examination found a right inflammatory breast (Figure 1; Figure 2) with presence of homolateral axillary
lymphadenopathies suggestive of breast cancer progressively advanced. The left breast was without abnormality
the rest of the clinical examination also.
Mammography (Figure 3) showed an increase in right breast density with diffuse thickening of the soft tissues
without nodular lesions or micro calcifications. Breast ultrasound revealed diffuse cutaneous thickening with an
infiltrated aspect of the mammary tissues, especially in retro-areolar, associated with multiple hypoechogenic
axillary lymphadenopathies, the largest of which was 32 mm x 16 mm. The lesion was classified as ACR 4. A
cutaneous biopsy and a biopsy with the axillary lymphadenopathy were carried out the anatomopathological
examination objectified non-specific chronic fibro-inflammatory changes of the skin, and the presence of
epithelio-giganto-cellular granuloma with caseous necrosis for the biopsy axillary lymphadenopathy. The
