Abstract:

Objective

To explore the value of acid-fast stain test in the diagnosis of non-lactational mastitis.

Methods

We retrospectively analyzed the clinical data of 54 cases of non-lactational mastitis(including 33 cases of pathologically diagnosed periductal mastitis and 21 cases of granulomatous mastitis) in Chengdu Women and Children's Central Hospital from February to December in 2014. All histological specimens were pathologically detected and acid-fast stain was conducted to look for the acid-fast bacilli. The acid-fast stain positive rates were compared between periductal mastitis group and granulomatous mastitis group using Chi-square test.

Results

The main clinical manifestations in 54 cases of non-lactational mastitis included breast mass, protracted abscess, sinus and red swelling. Among 33 cases of periductal mastitis,there were 28(84.8%) patients with dilated ducts, 24 (72.7%) with abscess, 11 (33.3%) with numerous neutrophils infiltrating,24(72.7%) with numerous plasma cells and lymphocytes infiltrating and 24 (72.7%)positive in acid-fast stain. Among 21 cases of granulomatous mastitis, there were 18(85.7%) patients with granulomatous structure,12(57.1%) with microabscess,21(100%) with neutrophils, lymphocytes and other inflammatory cells infiltrating and 2 (9.5%) positive in acid-fast stain. For acid-fast stain test, the positive rate of periductal mastitis patients was significantly higher than that of granulomatous mastitis patients (χ² =20.534, P＜0.001).

Conclusion

The acid-fast stain test is helpful in the differential diagnosis of periductal mastitis and granulomatous mastitis, which can provide the pathological reference for using triple antimicrobial therapy (rifampin, isoniazid and ethambutol) in the treatment of periductal mastitis.

Key words: Breast, Mastitis, Granuloma, Staining and labeling