Lupus mastitis – a cause of recurrent breast lumps

Abstract

growth hormone was found. In addition, the majority of cells were immunoreactive for oestrogen receptor and progesterone receptor, while no immunoreactivity for p53 or c-erb-B2 was found. Ultrastructural examination confirmed the neuroendocrine nature of the tumour, showing densely granulated cells. Neuroendocrine secretory granules were large (approximately 300 nm), round and homogeneous (Figure 2), closely resembling those of intestinal neurotensinproducing cells (N-cells). 6 The histological examination of the smaller tumour (10 mm in diameter) revealed an invasive ductal carcinoma negative for all panendocrine markers. Metastases showing the same features as those of the NEC were found in three of the 29 axillary lymph nodes isolated. To exclude possible metastasis from an occult intestinal or pancreatic neuroendocrine tumour, the patient underwent 111 In-pentetreotide scintigraphy, which did not show any abnormal abdominal uptake of the radiocompound. Moreover, the concomitant presence in the breast NEC of both an in situ and invasive component was additional proof of the primary breast origin of the tumour. Systemic chemotherapy was given and after 13 years of follow-up the patient is alive and free of disease. 1. Ellis IO, Schnitt SJ, Sastre-Garau X et al. Invasive breast carcinoma. In Tavassoli FA, Devilee P eds. WHO classification of tumours. Pathology and genetics of tumours of the breast and female genital organ. Lyon: IARC Press, 2003; 13-59. 2. Cross AS, Azzopardi JG, Krausz T et al. A morphological and immunocytochemical study of a distinctive variant of ductal carcinoma in-situ of the breast. Histopathology 1985; 9; 21-37. 3. Nesland JM, Ottestad L, Heikilla R et al. C-erbB-2 protein and neuroendocrine expression in breast carcinomas. Anticancer Res. 1991; 11; 161-167. 4. Souazé F, Dupouy S, Viardot-Foucault V et al. Expression of neurotensin and NT1 receptor in human breast cancer: a potential role in tumor progression. Cancer Res. 2006; 66; 6243-6249. 5. Papotti M, Macri L, Finzi G et al. Neuroendocrine differentiation in carcinomas of the breast: a study of 51 cases. Semin. Diagn. Pathol. 1989; 6; 174-188. 6. Solcia E, Capella C, Buffa R et al. Endocrine cells of the gastrointestinal tract and related tumors.

Lupus Mastitis in Systemic Lupus Erythematosus: A Rare Condition Requiring a Minimally Invasive Diagnostic Approach

“…Most of the published reports on lupus mastitis have particularly stressed imaging and pathological features of this peculiar and rare breast disease (10)(11)13), rather than clinical and immunopathological features. Diffuse, bilateral calcifications on mammography, mainly related to calcified foci of degenerated or necrotic fat tissue, and ultrasonographic findings of recurrent breast lumps support the diagnosis of lupus mastitis (14)(15). In addition, evidence of necrosis in the adipose tissue and peri glandular or perivascular lymphocyte infiltrations contribute to substantiate the diagnosis (11,(16)(17).…”

“…Diffuse, bilateral calcifications on mammography, mainly related to calcified foci of degenerated or necrotic fat tissue, and ultrasonographic findings of recurrent breast lumps support the diagnosis of lupus mastitis (14)(15). In addition, evidence of necrosis in the adipose tissue and peri glandular or perivascular lymphocyte infiltrations contribute to substantiate the diagnosis (11,(16)(17).…”

Nonsuppurative Nodular Panniculitis of the Breast

“…However, as the calcifications increase in size and become increasingly coarse or dystrophic, they acquire a more benign appearance, and are also more easily visualized on ultrasound and MRI. [9][10][11] Our patient presented at a relatively early stage, and demonstrated no distinct course of dystrophic calcifications and a breast MRI was performed for further evaluation. Benign MRI features include high signal intensity on T1-weighted images and low signal intensity on fat-suppressed images suggesting fat, local cutaneous involvement, and continuous rim enhancement on MRI kinetic analysis instead of a wash-out curve.…”

Lupus mastitis in men

“…The association between necrosis, sclerosis of the dermis collagen, and lymphocytic infiltrate is responsible for the hardened consistency of the lesion on clinical examination and increased breast densification in radiology (Nigar et al, 2007).…”