Lymphocytic mastitis

Case contributed by Giorgio M Baratelli
Diagnosis almost certain

Presentation

Family history of breast carcinoma (sister), presented with a painless right breast mass of about 3 cm. There was no history of previous pregnancy, fever, diabetes mellitus, or autoimmune diseases.

Patient Data

Age: 70 years
Gender: Female
mammography

Mammograms show a high density, irregular lesion of the outer-upper quadrant of the right breast (BIRADS 5).

ultrasound

Ultrasound revealed an irregular hypoechoic lesion of 3 cm, with marked posterior acoustic shadowing (the lesion was considered as BI-RADS 5).

Echo color Doppler shows a peripheral straight vessel penetrating the lesion, but no internal vessels.

Case Discussion

Clinical, echographic and radiological findings were highly suggestive of breast carcinoma. A fine-needle aspiration biopsy was inconclusive, due to the firmness of the mass, and a core needle biopsy was not performed. A wide local excision was performed, and the histopathological diagnosis was "sclerosing lymphocytic mastitis".

The reported case of sclerosing lymphocytic mastitis is not associated with type I diabetes or autoimmune disease, as often occurs. Core biopsy is the most indicated method for establishing the diagnosis and it can eliminate the need for more aggressive procedures.

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