Cystic neutrophilic granulomatous mastitis : sensitivity and specificity of 16s rRNA and Sanger sequencing for Corynebacterium spp

© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ..

AIMS: Cystic neutrophilic granulomatous mastitis (CNGM) is a subtype of granulomatous mastitis (GM) associated with Corynebacterium spp infection. We aimed to analyse the prevalence of Corynebacteria in CNGM and non-CNGM cases.

METHODS: Breast specimens diagnosed as granulomatous inflammation between 2010 and 2020 were reviewed to identify a CNGM cohort and a non-CNGM cohort. Polymerase chain reaction-based identification of Corynebacteria by 16S ribosomal RNA (16S rRNA) primers, followed by confirmatory Sanger sequencing (SS), was performed on all cases. Clinical, radiological and microbiology data were retrieved from the electronic patient records.

RESULTS: Twenty-eight CNGM cases and 19 non-CNGM cases were identified. Compared with the non-CNGM cohort, patients in the CNGM cohort were more likely to be multiparous (p=0.01), breast feeding (p=0.01) and presenting with a larger breast mass (p<0.01), spontaneous drainage (p=0.05) and skin irritation (p<0.01). No significant difference in the prevalence of Corynebacteria between the cohorts (7% vs 11%, p=0.68) by microbiological culture was identified. Compared with microbiology culture, the sensitivity and specificity of each Corynebacterial detection method were 50% and 81% for Gram stain, and 25% and 100% for 16S rRNA combined with SS. Regardless of the diagnosis, patients positive for Corynebacteria were more likely to have a persistent disease (p<0.01).

CONCLUSION: CNGM presents as a large symptomatic breast mass in multiparous breastfeeding women. The importance of adequate sampling and repeated microbiology culture in conjunction with sequencing on all GM cases with persistent disease is paramount.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:77

Enthalten in:

Journal of clinical pathology - 77(2024), 5 vom: 18. Apr., Seite 306-311

Sprache:

Englisch

Beteiligte Personen:

Yang, Ellen [VerfasserIn]
Kozak, Robert [VerfasserIn]
Nofech-Mozes, Sharon [VerfasserIn]
Salvant, Elsa [VerfasserIn]
Olkhov-Mitsel, Ekaterina [VerfasserIn]
Slodkowska, Elzbieta [VerfasserIn]
Plotkin, Anna [VerfasserIn]
Hanna, Wedad [VerfasserIn]
Lu, Fang-I [VerfasserIn]

Links:

Volltext

Themen:

Breast Diseases
Corynebacterium
DIAGNOSIS
Journal Article
RNA, Ribosomal, 16S

Anmerkungen:

Date Completed 22.04.2024

Date Revised 22.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1136/jcp-2022-208651

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM352077468