Breast Cancer

, Volume 16, Issue 2, pp 141–146 | Cite as

A case of lymphocytic mastopathy requiring differential diagnosis from primary breast lymphoma

  • Masaru Oba
  • Motoko Sasaki
  • Toru Ii
  • Masahiro Hoso
  • Hideyuki Ajisaka
  • Nobuo Matsuki
  • Koichi Miwa
Case Report

Abstract

Lymphocytic mastopathy is a benign breast disease characterized by dense fibrosis, lobular atrophy, and aggregates of lymphocytes in a periductal and perivascular distribution. The condition affects young to middle-aged women and frequently shows an association with diabetes mellitus or autoimmune disorders. Here, we report a case of the disease clinically and radiologically mimicking primary breast neoplasms. The patient was a 50-year-old woman without diabetes who presented with two firm lumps in her right breast. Breast imaging findings from mammography, ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), respectively, revealed an abnormal appearance suspicious of malignancy. A core-needle biopsy specimen showed atypical accumulation of lymphoid cells, which was not easy to differentiate from primary breast lymphomas. Moreover, 18fluorodeoxyglucose positron emission tomography (FDG-PET) examination detected abnormal uptake in the same lesions. Histological examination of a surgically obtained specimen showed characteristic appearance of lymphocytic mastopathy, which predominantly consisted of B-lymphocytes. In our case, it was difficult to distinguish this entity from breast cancer or low-grade B-cell lymphoma without surgical biopsy.

Keywords

Lymphocytic mastopathy Diabetic mastopathy Breast lymphoma 

References

  1. 1.
    Soler NG, Khardori R. Fibrous disease of the breast, thyroiditis, and cheiroarthropathy in type 1 diabetes mellitus. Lancet. 1984;1:193–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Schwartz IS, Strauchen JA. Lymphocytic mastopathy. An autoimmune disease of the breast? Am J Clin Pathol. 1990;93:725–30.PubMedGoogle Scholar
  3. 3.
    Tomaszewski JE, Brooks JS, Hicks D, Livolsi VA. Diabetic mastopathy: a distinctive clinicopathologic entity. Hum Pathol. 1992;23:780–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Morgan MC, Weaver MG, Crowe JP, Abdul-Karim FW. Diabetic mastopathy: a clinicopathologic study in palpable and nonpalpable breast lesions. Mod Pathol. 1995;8:349–54.PubMedGoogle Scholar
  5. 5.
    Ely KA, Tse G, Simpson JF, Clarfeld R, Page DL. Diabetic mastopathy. A clinicopathologic review. Am J Clin Pathol. 2000;113:541–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Lammie GA, Bobrow LG, Staunton MD, Levison DA, Page G, Millis RR. Sclerosing lymphocytic lobulitis of the breast–evidence for an autoimmune pathogenesis. Histopathology. 1991;19:13–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Aozasa K, Ohsawa M, Saeki K, et al. Malignant lymphoma of the breast. Immnologic type and association with lymphocytic mastopathy. Am J Clin Pathol. 1992;97:699–704.PubMedGoogle Scholar
  8. 8.
    Chetty R, Butler AE. Lymphocytic mastopathy associated with infiltrating lobular breast carcinoma. J Clin Pathol. 1993;46:376–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Coyne JD, Baildam AD, Asbury D. Lymphocytic mastopathy associated with ductal carcinoma in situ of the breast. Histopathology. 1995;26:579–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Sotome K, Ohnishi T, Miyoshi R. An uncommon case of diabetic mastopathy in type II non-insulin dependent diabetes mellitus. Breast Cancer. 2006;13:205–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Honda M, Mori Y, Nishi T, Mizuguchi K, Ishibashi M. Diabetic mastopathy of bilateral breasts in an elderly Japanese woman with type 2 diabetes: a case report and a review of the literature in Japan. Intern Med. 2007;46:1573–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Ashton MA, Lefkowitz M, Tavassoli FA. Epithelioid stromal cells in lymphocytic mastitis-a source of confusion with invasive carcinoma. Mod Pathol. 1994;7:49–54.PubMedGoogle Scholar
  13. 13.
    Wong KT, Tse GMK, Yang WT. Ultrasound and MR imaging of diabetic mastopathy. Clin Radiol. 2002;57:730–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Haj M, Weiss M, Herskovits T. Diabetic sclerosing lymphocytic lobulitis of the breast. J Diabetes Complicat. 2004;18:187–91.PubMedCrossRefGoogle Scholar
  15. 15.
    Mak CW, Chou CK, Chen SY, et al. Case report: diabetic mastopathy. Br J Radiol. 2003;76:192–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Fong D, Lann MA, Finlayson C, Page DL, Singh M. Diabetic (lymphocytic) mastopathy with exuberant lymphohistiocytic and granulomatous response: a case report with review of the literature. Am J Surg Pathol. 2006;30:1330–6.PubMedCrossRefGoogle Scholar
  17. 17.
    Shaffrey JK, Askin FB, Gatewood OM, Brem R. Diabetic fibrous mastopathy: case reports and radiologic-pathologic correlation. Breast J. 2000;6:414–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Valdez R, Thorson J, Finn W, et al. Lymphocytic mastitis and diabetic mastopathy: a molecular, immunophenotypic, and clinicopathologic evaluation of 11 cases. Mod Pathol. 2003;16:223–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Lamovec J, Wotherspoon A, Jacquemier J. Malignant lymphoma and metastatic tumours. In: Tavassoli FA, Devilee P, editors. World health Organization classification of tumours: pathology & genetics: tumours of the breast and female genital organs. Lyon: IARC; 2003. p. 107–9.Google Scholar

Copyright information

© The Japanese Breast Cancer Society 2008

Authors and Affiliations

  • Masaru Oba
    • 1
    • 3
  • Motoko Sasaki
    • 2
  • Toru Ii
    • 1
  • Masahiro Hoso
    • 2
  • Hideyuki Ajisaka
    • 1
  • Nobuo Matsuki
    • 1
  • Koichi Miwa
    • 1
  1. 1.Department of SurgeryToyama Rosai HospitalUozuJapan
  2. 2.Department of Human PathologyKanazawa University Graduate School of MedicineKanazawaJapan
  3. 3.Department of Gastroenterological SurgeryKanazawa Medical University HospitalIshikawaJapan

Personalised recommendations