Sarcoidosis of the breast

Abstract

We report a case of sarcoidosis of the breast in a 31-year-old woman who presented with a palpable breast mass. The mammography showed a spiculated mass without any microcalcifications. Ultrasonogram showed a hypoechoic mass. Computed tomography showed a spiculated nodule. T2-weighted MR images with fat-suppression technique showed a mass with irregular border that appeared to be an accumulation of small nodules. Gadolinium-enhanced dynamic study showed gradually increasing signal intensity. She underwent excisional biopsy and the pathological findings were consistent with that of sarcoidosis. The MRI findings were well correlated with histopathological appearance.

Primary Sarcoid of the Breast with Incidental Malignancy

“…Ishimaru et al, reported a case of breast sarcoid presenting as an irregular mass which demonstrated slow progressive enhancement on serial post contrast MRI imaging. [5] However, other authors have reported breast sarcoid lesions demonstrating rapid enhancement with wash-out phenomenon which is commonly seen in breast carcinoma, making sarcoid lesions very difficult to distinguish from cancer. [1]…”

Sarcoid of the breast associated with microcalcifications on mammogram

“…[3][4][5] Mammograms may be completely negative. 6 Microcalcifications associated with breast sarcoid have not been reported previously. 6 Ultrasound findings may also be indicative of malignancy with irregular hypoechoic masses being most common, although non-specific findings are more common.…”

“…5 Only two case reports discuss magnetic resonance imaging findings describing non-specific findings. 6…”

Diagnosis of Sarcoidosis from a Biopsy of a Dilated Mammary Duct

“…Mammographic fi ndings can range from a spiculated mass suspicious for carcinoma to an ill-defi ned or irregular lesion (3,4). Microcalcifi cations are not associated with sarcoidosis (6). Th e ultrasound appearance can be variable, but typically demonstrates irregular hypoechoic masses (4).…”