Lupus panniculitis involving the breast

Sabaté, Josep M.; Gómez, Álvaro Díaz; Torrubia, Sofía; Salinas, Teresa; Clotet, Montse; Lerma, Enrique

doi:10.1007/s00330-005-2810-1

Cited by 29 publications

(26 citation statements)

References 8 publications

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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%

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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Section: Discussionmentioning

confidence: 99%

Lupus Mastitis

Kinonen

Gattuso

Reddy

2010

American Journal of Surgical Pathology

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“…For example, systemic lupus erythematosus may cause panniculitis, with approximately 60% of cases involving the breast skin (33). This rare disease may mimic a locally advanced breast cancer at mammography due to suspect microcalcifications and skin thickening, or it may mimic fat necrosis at MR imaging (33).…”

Section: Infectious and Inflammatory Mastitismentioning

confidence: 99%

Lesions of the Skin and Superficial Tissue at Breast MR Imaging

Kalli

Freer²,

Rafferty³

2010

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Although numerous studies have outlined the benefits of contrast material-enhanced magnetic resonance (MR) imaging for the detection of breast parenchymal findings, the assessment of lesions of the skin and superficial tissue at breast MR imaging has largely been overlooked. Such lesions, both benign and malignant, are commonly encountered at breast MR imaging, and their detection and diagnosis are often imperative. These lesions include superficial, locally extensive, inflammatory, and recurrent breast cancers; iatrogenic changes; sebaceous cysts; and less prevalent diseases such as granulomatous mastitis and angiosarcomas, among others. As MR imaging continues to be used with increasing frequency in both the screening and diagnostic settings, these lesions will be encountered more often; consequently, a better understanding of which lesions may be ignored and which require further evaluation will become increasingly important. Frequently, MR imaging alone may not clearly indicate the cause of lesions of the breast skin and superficial tissue. However, radiologists should thoroughly assess such lesions, taking into consideration the spectrum of possible causes. Mammography, ultrasonography, consultation with clinicians or dermatologists regarding physical examination findings, and, when necessary, correlation with pathologic findings in biopsy specimens may be used in conjunction with MR imaging to establish both the importance of these lesions and their definitive diagnoses.

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“…However, it can also present as a spontaneous breast lump in a woman, with or without a history of breast trauma. Fat necrosis can occur post-radiation treatment for breast carcinoma,34 and very rarely, lupus panniculitis has been reported in the breast of patients with systemic lupus erythematosus 35…”

Section: Differential Diagnosesmentioning

confidence: 99%

Histiocytoid breast carcinoma: an enigmatic lobular entity

et al. 2011

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Histiocytoid breast carcinoma is an uncommon entity that is mostly regarded as a variant of lobular carcinoma. Its occurrence with apocrine lobular carcinoma in situ and consistent expression of gross cystic disease fluid protein 15 suggest apocrine differentiation. Its recognition is often challenging, particularly when histiocytoid tumour cells occur in a metastatic site before the primary diagnosis of breast carcinoma, or in limited core biopsy or cytology material. In the breast, its bland histological appearances can lead to a benign diagnosis. Clues to the correct conclusion include finding tumour cells with more cytological atypia, the presence of cytoplasmic vacuoles and secretions, coexistence with more traditional invasive lobular carcinoma patterns and/or lobular neoplasia, and the use of immuohistochemistry to confirm their epithelial nature. Close clinicoradiological correlation and awareness of histological mimics are needed to achieve an accurate diagnosis of this enigmatic condition that should be appropriately subsumed within the invasive lobular histological subtype.

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Lupus panniculitis involving the breast

Cited by 29 publications

References 8 publications

Lupus Mastitis

Lupus Mastitis

Lesions of the Skin and Superficial Tissue at Breast MR Imaging

Histiocytoid breast carcinoma: an enigmatic lobular entity

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