Lupus mastitis in male mimicking a breast lump

Martella, Stefano; Matthes, Ângelo Gustavo Zucca; Bassi, Fabio; Fasani, Roberta; Lorenzi, Francesca De; Gatti, Giovanna; Luini, Alberto

doi:10.1016/j.ijsu.2007.02.009

Cited by 11 publications

(15 citation statements)

References 7 publications

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“… 12 Its coexistence is more common with DLE (33%) compared with SLE (10%). 10 Until 2011, only 31 cases had been reported, out of which, 4 were in males; 19 in cases with SLE; 8 in cases with DLE; and in 4 cases, lupus was not categorized. 13 …”

Section: Discussionmentioning

confidence: 99%

Lupus mastitis of the male breast

et al. 2016

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A 39-year-old male with no known co-morbid conditions presented with gradually increasing bilateral breast lumps for 1.5 years. Clinically, tender subcutaneous masses were detected. Mammograms revealed masses on both sides that on ultrasound were hyperechoic and showed internal vascularity. An MRI was suggested to assess the extent of the disease that confirmed bilateral masses but was otherwise inconclusive. Core biopsy revealed evidence of panniculitis with likely autoimmune aetiology. Evaluation of autoimmune markers was carried out that was positive and multidisciplinary team discussion concluded the diagnosis as lupus mastitis. Male breast pathology and lupus mastitis are both uncommon conditions, making lupus mastitis of male breast an extremely unusual presentation. However, its close clinical and radiological similarity with malignancy makes it important in spite of its rarity. Here we report a case of bilateral lupus mastitis in male breast with its radiological features.

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Section: Discussionmentioning

confidence: 99%

Lupus mastitis of the male breast

et al. 2016

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“…2,6,7,9,17 Ultrasound can show a similarly ill-defined, isoechoic, or hyperechoic mass. 1,3,4,8,17,19,21 There is a single case of LM evaluated by magnetic resonance imaging, where T2-weighted images showed a lobular heterogeneous mass, involving the subcutaneous fat. Postcontrast magnetic resonance images showed a focal mass with irregular margins and rim enhancement.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocytic vasculitis involving medium and small vessels is also a common feature. 1,8,14,19,21 Fibrinoid necrosis of the vessel wall has been reported, 1,14 but is generally absent. In addition to the inflammatory component, the presence of hyaline fat necrosis is critical for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the inflammatory component, the presence of hyaline fat necrosis is critical for the diagnosis. 1,6,7,10,13,19,21,22,24 This is characterized by anucleated adipocytes in a background of a glassy appearing collagenous stroma. Additional features which have been reported include ductal and lobular atrophy, 3 fibrosis, 2,20 and microcalcifications.…”

Section: Discussionmentioning

confidence: 99%

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Lupus Mastitis

Kinonen

Gattuso

Reddy

2010

American Journal of Surgical Pathology

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Lupus mastitis is an uncommon presentation of lupus erythematosus profundus or lupus panniculitis, a rare variant of lupus erythematosus characterized by inflammation of the subcutaneous fat. Lupus mastitis can present as single or multiple subcutaneous or deep breast masses, often clinically mimicking malignancy. Although lupus mastitis is rare, with less than 25 cases reported, the histologic features are distinct. Awareness of the entity and familiarity with the histologic features allow for accurate diagnosis and appropriate patient management. It most commonly affects women with a mean age at diagnosis of 40 years and an age range of 18 to 70 years. Typical histologic findings in lupus mastitis include a lymphocytic lobular panniculitis with plasma cells and hyaline fat necrosis. The lymphocytic infiltrate can be nodular, diffuse, periductal, and/or perilobular and germinal centers can frequently be identified. Lymphocytic vasculitis is also common. Immunohistochemistry shows a mixed T and B-cell population, with predominantly CD3+ CD4+ T cells intermixed with CD20-positive B cells and polyclonal plasma cells. Most commonly, lupus mastitis is seen in patients with a previous diagnosis of systemic or discoid lupus; however, it can also be the initial presentation of lupus in some patients. We report on 2 cases of lupus mastitis where the clinical impression was to rule out malignancy and review the literature to highlight the key clinicopathologic features.

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“…Des affections dermatologiques peuvent simuler un cancer du sein posant ainsi un problème de diagnostic différentiel : pilomatricome, fibrome cutané, neurofibrome, kyste épidermoïde, lipome, hémangiome souscutané, tumeur annexielle bénigne ou maligne, myélome multiple, plasmocytome, léiomyome, métastase mammaire de cancer de prostate [19][20][21][22][23][24][25][26][27][28]. Des cas de panniculite lupique ou tuberculeuse et de mastite granulomateuse avec ou sans modification cutanée, peuvent aussi simuler un cancer du sein d'autant plus qu'elles peuvent s'accompagner d'une rétraction du mamelon et d'adénopathies axillaires [28][29][30][31]. La biopsie cutanée et/ou mammaire permet dans la plupart des cas un diagnostic précis évitant ainsi une mastectomie inutile [31].…”

Section: Discussionunclassified