Sclerosing lymphocytic lobulitis of the breast–evidence for an autoimmune pathogenesis

Lammie, G A; Bobrow, Lynda G.; Staunton, Marie; Levison, David A.; Page, Gareth Le; Millis, Rosemary R.

doi:10.1111/j.1365-2559.1991.tb00889.x

Cited by 110 publications

(78 citation statements)

References 22 publications

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“…The investigation of autoimmune diseases in the present patient indicated the inexistence of other diseases that might be associated to the diabetic mastopathy, such as systemic lupus erythematosus and hypothyroidism (16)(17)(18). The incidence of diabetic mastopathy among healthy individuals, as is the case of the patient, has been described by other authors (9,(19)(20)(21).…”

Section: Discussionsupporting

confidence: 70%

“…Other factors may also be involved in the pathogenesis of diabetic mastopathy, since there are cases of non-diabetic patients or patients who have never used exogenous insulin (16)(17)(18), as it is the case reported. The patient did not develop gestational diabetes and her only relation to diabetes mellitus was the fact that her father and grandfather from father's side had type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 91%

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Regression of the fibrous disease of the breast in a non-diabetic woman after pregnancy and breastfeeding

Pereira

Segura

Santos

et al. 2007

Arq Bras Endocrinol Metab

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Fibrous mastopathy, also known as diabetic mastopathy and lymphocytic mastopathy, may mimic breast cancer at the physical examination, mammography, and ultrasound. We report a case of a woman who presented a non-tender mass clinically suggestive of breast carcinoma; however, the fine-needle aspiration cytology indicated atypia and the core needle biopsy revealed lymphocytic mastopathy. The magnetic resonance imaging of the breast showed a lesion with benign features. It was not demonstrated diabetics mellitus and autoimmune diseases. The patient got pregnant, breastfed, and it was observed the progressive regression of the lesion, with complete disappearance of the solid mass. Three years and three months later, there was no palpable mass at the clinical examination and ultrasound. In conclusion, fibrous mastopathy shall be considered for all breast lesions, regardless of the diagnosis of diabetes mellitus. Once a definitive diagnosis of this pathology is reached, it is recommended clinical, imaging studies and fine-needle aspiration biopsy follow-up of the patient, avoiding unnecessary surgical procedures. RESUMO Regressão de Mastopatia Fibrótica após Gravidez e Amamentação em uma Mulher Não Diabética.A mastopatia fibrótica, também conhecida como mastopatia diabética e mastopatia linfocítica, pode, ao exame clínico, mamografia e ultra-som, simular um carcinoma mamário. Descrevemos o relato de uma mulher na qual o nódulo foi inicialmente suspeito de carcinoma mamário, mas o diagnóstico pela punção aspirativa com agulha fina foi de atipia, e o com biópsia com agulha grossa foi de mastopatia linfocítica. A ressonância magnética da mama mostrou a lesão com características de benignidade. Não foram demonstradas diabetes mellitus e doenças auto-imunes. A paciente engravidou, amamentou e foi observada regressão progressiva da lesão, com desaparecimento da mesma. A paciente persiste sem lesão na mama ao exame clínico e de ultra-som após acompanhamento de três anos e três meses. Em conclusão, a mastopatia fibrótica deve ser considerada para todas as lesões de mama, mesmo em pacientes sem diabetes mellitus. Quando o diagnóstico definitivo da patologia for realizado, é recomendável o acompanhamento da paciente com estudos clínicos e de imagem e biópsia com agulha fina, evitando-se procedimentos cirúrgicos desnecessários.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 91%

Regression of the fibrous disease of the breast in a non-diabetic woman after pregnancy and breastfeeding

Pereira

Segura

Santos

et al. 2007

Arq Bras Endocrinol Metab

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“…Lymphocytic mastitis and the closely related entity of diabetic mastopathy are uncommon benign breast diseases that are believed to be induced by autoimmune phenomena (3,12). Similar to other select autoimmune-related inflammatory lesions, but distinctly unlike almost all other reactive infiltrates in epithelial tissues, the lymphoid population in these entities consists of predominantly B lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

“…This lesion typically occurs in women (and rarely in men) with either longstanding Type I diabetes mellitus (diabetic mastopathy) or other types of autoimmune disease (lymphocytic mastitis) (1)(2)(3)(4). The clinicopathologic criteria for establishing a diagnosis of lymphocytic mastitis and diabetic mastopathy have been well characterized and described in the literature (5,6).…”

mentioning

confidence: 99%

Book Review

Helsel¹

2003

Modern Pathology

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Lymphocytic mastitis and diabetic mastopathy are uncommon fibroinflammatory breast diseases. The lesions seen in these entities are unique in that the associated lymphoid infiltrates are composed of predominantly B cells. In addition, B-cell lymphoepithelial lesions, a finding commonly associated with extranodal marginal zone B-cell/mucosaassociated lymphoid tissue (MALT) lymphomas, are also often present in lymphocytic mastitis and diabetic mastopathy. Although the clinical and immunomorphologic features are well characterized, the clonality of the B-cell infiltrate and the lymphomatous potential of lymphocytic mastitis and diabetic mastopathy have not been emphasized in the literature. We evaluated 11 cases of lymphocytic mastitis/diabetic mastopathy for immunoglobulin heavy chain gene rearrangement and correlated the findings with all available clinical data. A longstanding history of Type I diabetes mellitus was present in seven patients. One nondiabetic patient had Sjogren's syndrome, and two patients had no history of diabetes mellitus or other autoimmune disease. Clinical data were unavailable for one patient. B-cell-predominant lymphoid infiltrates were seen in all cases, and B-cell lymphoepithelial lesions were found in five. No evidence of a B-cell clone was found in any of the 11 cases by appropriately controlled immunoglobulin heavy chain gene rearrangement studies, and none of the patients developed lymphoma during follow-up intervals ranging from 2-126 months. These findings suggest that despite the presence of B-cell-predominant lymphoid infiltrates and lymphoepithelial lesions, lymphocytic mastitis and diabetic mastopathy do not appear to be associated with an increased risk for lymphoma.

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“…Thus, it seems that the proposed features are not as specific as previously maintained, or the appearance of diabetic mastopathy in the breast may precede the onset of clinical diabetes or another autoimmune process 4) . Lymphatic infiltration in diabetic mastopathy consists predominantly of B -cells, in contrast to non -diabetic mastitis in which lymphocytic infiltration consists mostly of T -cells 2,14) . This B -cell predominance is similar to the lymphocytic infiltrate seen in other autoimmune disorders, such as Hashimoto's thyroiditis and benign lymphoepithelial lesion of salivary gland 6) .…”

Section: Case Reportmentioning

confidence: 92%

Diabetic Mastopathy in an Elderly Woman: A Case Report

Tsuchiya

Tsunoda²,

Seino³

et al. 2010

FJMS

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: We report a case of diabetic mastopathy in an elderly woman with type II diabetes. The patient, a 66 -year -old woman with a 6 -year history of diabetes mellitus, has been received an oral diabetic agent. She noticed a lump in her right breast two months previously. Mammography of the breast showed a low density mass, but there was no microcalcification or architectural distortion. Ultrasonography of the lesion revealed a hypoechoic mass with a distinct margin. Fine needle aspiration cytology was performed but sufficient tissue was not obtained. However, a cluster of small epithelial cells with nucleus swelling and increased chromatin was demonstrated. Excisional biopsy was performed and diabetic mastopathy was demonstrated histologically.

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Sclerosing lymphocytic lobulitis of the breast–evidence for an autoimmune pathogenesis

Cited by 110 publications

References 22 publications

Regression of the fibrous disease of the breast in a non-diabetic woman after pregnancy and breastfeeding

Regression of the fibrous disease of the breast in a non-diabetic woman after pregnancy and breastfeeding

Book Review

Diabetic Mastopathy in an Elderly Woman: A Case Report

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