Breast tuberculosis is a rare form of extrapulmonary tubercular infection. Our aim is to highlight the nonspecific clinical presentations, diagnostic difficulties and therapeutic approaches of mammarian tuberculosis. Forty-six patients diagnosed with breast tuberculosis between 2005 and 2015 were reviewed retrospectively. Clinical features, all diagnostic methods, and the outcomes of treatment were analysed. All cases were female with a mean age of 36.4 years. Breast mass and pain were the most common complaints. While 34.8% of the cases had a physical examination with suspicions for malignancy, 43.5% of the patients had Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 lesions suggested malignancy radiologically. Definitive diagnosis was based on histopathologic examination through core needle biopsy (n = 29), excisional biopsy (n = 12), and open biopsy (n = 5) taken from the abscess wall during drainage. Standard antiTB therapy for 6 months was given to all cases. Thirty-three patients recovered with standard 6-month therapy while extended treatment for 9-12 months was needed in 13 (28.2%) cases. Surgery was carried out in 17 cases. Two patients developed recurrence. Breast tuberculosis can be easily confused with breast cancer, suppurative abscess, and other causes of granulomatous mastitis, both clinically and radiologically. A multidisciplinary approach is required to prevent diagnostic delays and unnecessary surgical interventions. Although antiTB therapy is the mainstay treatment of breast TB, surgery is usually indicated in patients refractory to medical treatment.
ÖZETPerianal tüberküloz (TB) tüberküler enfeksiyonun nadir bir formudur ve akut apse, kronik ülser, nodüler lezyon ve fistül gibi değişken klinik şekilleri vardır. Ülseratif, verrüköz, lupoid ve miliyer formlarda prezente olmasına karşın, yüzeysel ülser en sık bildirilen morfolojik tiptir. Crohn hastalığı, herpetik ülser, malignite ve diğer granülomatöz hastalıklar perianal tüberkülozun ayırıcı tanısında düşünülmelidir. Tanı esas olarak histolojik ve/veya bakteriyolojik incelemelere dayanır. Altı aylık anti-tüberküloz tedavisi standart tedavidir, ve cerrahi sadece fistül ve apsede endikedir. Burada, diabetes mellituslu bir erkek hastada nadir bir perianal tüberküloz olgusu sunuldu.Anahtar kelimeler: Diyabet, erkek, perianal tüberküloz, tanı, tedavi ABSTRACTPerianal tuberculosis is a rare form of tubercular infection, and has variable clinical pictures such as acute abscess, chronic ulcer, nodulary lesion, and fistula. Although it can be presented in ulcerative, verruous, lupoid and miliary forms, superficial ulceration is the most commonly reported morphological type. Crohn's disease, herpetic ulcer, malignancy, and other granulomatous diseases should be considered in the differential diagnosis of perianal tuberculosis. The diagnosis mainly depends on histologic and/or bacteriologic examination. Six-month anti-tuberculous therapy is the standard treatment, and surgery is only indicated for fistula and abscess. Herein, a rare case of perianal tuberculosis in a male patient with diabetes mellitus was presented.
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