Wegener's granulomatosis of the breast

Abstract

Wegener's granulomatosis is a multisystem disorder characterized by necrotizing granulomatous inflammation and vasculitis of small vessels and can affect any organ system. The most common sites of involvement are upper and lower respiratory tracts, and kidneys. Breast involvement is unusual and very rare. We report a case of breast Wegener's granulomatosis in a 32-year-old woman who presented with pulmonary lesions and palpable masses in the left breast. Mammography showed multiple, sharply delineated nodules without microcalcifications. Ultrasonography revealed multiple hypoechoic solid lesions, some of them with anechoic areas of necrosis. Computed tomography showed multiple nodules. Histopathology of excision biopsy specimens of breast lesions revealed necrotizing granulomatous material consistent with Wegener's granulomatosis. Twenty reports of breast involvement in this rare disease were found in the literature; however, the respective ultrasonographic and computed tomography findings have not hitherto been described.

Idiopathic granulomatous lobular mastitis

“…Giant cell arteritis of the breast and breast carcinoma can occur simultaneously 48,49 . Other forms of systemic vasculitis such as polyarteritis nodosa and Wegener’s granulomatosis have also been reported to involve the breasts 50,51 . The presentation is that of painful breast masses, sometimes associated with ulceration 52 .…”

Breast manifestations of systemic diseases

“…Mammographic findings have been reported as ill-defined or irregular masses suspicious for carcinoma 30. Ultrasonographic findings include irregular hypoechoic masses 30.…”

“…Ultrasonographic findings include irregular hypoechoic masses 30. The diagnosis is made by breast biopsy, but it can be difficult to establish if there are only small fragments of core needle biopsy material available versus an adequate tissue specimen.…”

Breast Involvement in Anti-Neutrophil Cytoplasmic Antibodies Positive Granulomatosis With Polyangiitis in a 64-Year-Old Female Patient

“…The most frequently affected organs are the upper respiratory tract, lungs, and kidney (89%, 67%, and 48%, respectively), while the skin, salivary glands, breast, and genital involvements occur in less than 5% of cases. [1][2][3] Not more than a few dozen of such cases have been described to date. Allende and Booth, 4 in a report published in 2009, described only 27 of these patients.…”