TUBERCULOUS ABSCESS IN RETROMAMMARY REGION - CT FINDINGS

Purpose: Our goal was to evaluate CT findings of tuberculous abscess i n the retromammary region of the breast. Method: Four patients with tu berculosis extending from the retromammary region to the pleura were e xamined by CT and the findings were evaluated, All cases were also exa mined with mammography and two cases were evaluated with sonography. D iagnosis was confirmed by acid-fast bacillus stain, culture, and histo logic examination. Results: Mammography showed relatively smoothly mar ginated, round mass density in two cases, nodular density in one, and focal bulging of the pectoral wall in one. A sonogram demonstrated in two cases a fistulous connection from the heterogeneous, fluid-contain ing lesion with floating internal debris in the retromammary region to the thoracic cavity. In all four cases, CT showed relatively smoothly marginated, inhomogeneous, hypodense lesions with surrounding rims of the cold abscess type. A direct fistulous connection from the retroma mmary lesion through the thoracic wall into the pleura was seen in two cases. Destroyed rib fragments within the abscess were noted in two c ases. Conclusion: A tuberculous abscess in the retromammary region usu ally showed on CT a focal, smoothly marginated, inhomogeneous, hypoden se lesion with a surrounding enhancing rim. A direct fistulous connect ion with the pleura or a destroyed rib fragment in the abscess as reve aled by CT can be helpful in the differential diagnosis of other infec tious types of retromammary abscess.