Table1: Findings from literature review for IGM
Age
-Most women of childbearing age, several months to years after breastfeeding. -Rare cases were reported in 11 and 80 years-old
(5, 19)
Mentioned etiopathogenesis
-The etiopathogenesis is still unknown -Inflammation as a result of reaction to trauma, autoimmunity, and an infection such as Corynebacterium spp, and Corynebacterium kroppenstedtii -Metabolic or abnormal hormonal processes such as hyperprolactinemia, -Lactation disorders
(4, 8, 17, 20-22)
Pathology
- Noncaseating granulomas of a lobule-centric pattern (multi-nucleated giant cells, and epithelioid histiocytic located in the center of the lobules as well as neutrophils, lymphocytes, plasma cells, and a small number of eosinophils in the surrounding tissue) -lesions can be multifocal and form micro abscesses and vary in size
(4, 8, 21)
Differential diagnosis
-Idiopathic granulomatous lobular mastitis, -Periductal mastitis -Fibrocystic changes, and -Sclerosing lymphocytic lobulitis or diabetic mastopathy, -Tuberculosis, fungal infections -Malignancy
(10)
Imaging
-Ultrasonographic findings: hypo-echoic or heterogeneous mass with or without tubular extensions -Magnetic resonance imaging (MRI) findings: focal or diffuse asymmetrical signal intensity changes without significant mass effect -On dynamic contrast-enhanced MRI findings: IGM patients with mass-like or non-mass-like contrast enhancement, some of them with abscess positive -Mammographic presence of multiple contiguous iso-dense masses, the reniform contour of axillary lymph nodes with the preserved fatty hilum -Contrast-enhanced cone-beam breast-CT (CBBCT) findings: IGM mainly manifests as a non-mass enhancement on CBBCT, with persistently enhancing or plateau TDC
(9, 23-27)
Treatment
-Surgical, -Immunosuppressants, steroids, methotrexate, leflunomide, and antibiotics drugs -Prolactin-lowering medications .
(11, 12, 14-16, 28-31)