Authors: Lihanimpo Djalogue, Komi Dzidzonu Nemi, Toyi Tchamdja, Kodjo Agbeko Djagadou, Abdou Razak Moukaila, Komi Edem Mossi, Abago Balaka, Mohaman Awalou Djibril.
Background: The mammary site is a rare site of extrapulmonary tuberculosis and poses the problem of differential diagnosis with breast cancer. We report one case in a postmenopausal HIV-negative woman.
Case report: A 60-year-old woman had consulted for swelling of the left breast which had been evolving for about 4 months in a febrile context, without any notion of tuberculosis contagion and without any other tuberculosis foci. Physical examination revealed an inflammatory, indurated left breast about 15cm in diameter with an orange peel appearance, painful with irregular contours but without breast discharge and without axillary adenopathies. The hemogram showed hyperleukocytosis (15000/mm3) to neutrophilic polynucleosis (8200/mm3) and hyperlymphocytosis (6800/mm3). Histology of a skin biopsy had objectified a granulomatous inflammatory lesion made of epithelioid cells with caseous necrosis, rare giant Langhans cells as well as lymphoplasmocytes and patches of suppurated necrosis foci with sometimes altered neutrophil polynuclei. The intradermal tuberculin reaction was positive. The diagnosis of primary tubercular mastitis was therefore retained and the patient had been receiving anti tuberculosis treatment for six months during which time we noted a favorable evolution, without recurrence.
Conclusion: This observation reports a case of mammary tuberculosis and raises the difficulty of differential diagnosis with breast cancer in a postmenopausal woman. It confirms the interest of histology in the diagnosis of these mammary tuberculoses, whose well-conducted antituberculosis treatment leads to a cure.
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