Lymphocytic mastitis: Difference between revisions
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'''Lymphocytic mastitis''' is a rare pathology of the [[breast]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = | |||
| Width = | |||
| Caption = | |||
| Synonyms = | |||
| Micro = lymphocytic infiltrates (breast lobules, perivascular), enlarged stromal fibroblasts, stromal collagen with keloid-like changes. | |||
| Subtypes = | |||
| LMDDx = [[lymphoma]] ([[small cell lymphomas|small cell]]), diabetic mastopathy (need history) | |||
| Stains = | |||
| IHC = CD20 > CD3, CD43 -ve | |||
| EM = | |||
| Molecular = negative for clonality | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[breast]] | |||
| Assdx = +/-[[diabetes mellitus]] (known as [[diabetic mastopathy]]) | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = +/-tenderness | |||
| Symptoms = | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = breast tumour - possibly malignant | |||
| Tx = +/-excision | |||
}} | |||
'''Lymphocytic mastitis''' is a rare pathology of the [[breast]]. If the individual has [[diabetes mellitus]] (DM) it is called '''diabetic mastopathy'''.<ref name=pmid12640102>{{Cite journal | last1 = Valdez | first1 = R. | last2 = Thorson | first2 = J. | last3 = Finn | first3 = WG. | last4 = Schnitzer | first4 = B. | last5 = Kleer | first5 = CG. | title = Lymphocytic mastitis and diabetic mastopathy: a molecular, immunophenotypic, and clinicopathologic evaluation of 11 cases. | journal = Mod Pathol | volume = 16 | issue = 3 | pages = 223-8 | month = Mar | year = 2003 | doi = 10.1097/01.MP.0000056627.21128.74 | PMID = 12640102 }}</ref> | |||
==General== | ==General== | ||
* | *Typically in long-standing [[diabetes mellitus]].<ref name=pmid23966831>{{Cite journal | last1 = Alhabshi | first1 = SM. | last2 = Rahmat | first2 = K. | last3 = Westerhout | first3 = CJ. | last4 = Md Latar | first4 = NH. | last5 = Chandran | first5 = PA. | last6 = Aziz | first6 = S. | title = Lymphocytic mastitis mimicking breast carcinoma, radiology and pathology correlation: review of two cases. | journal = Malays J Med Sci | volume = 20 | issue = 3 | pages = 83-7 | month = May | year = 2013 | doi = | PMID = 23966831 }}</ref><ref>{{Cite journal | last1 = Bayer | first1 = U. | last2 = Horn | first2 = LC. | last3 = Schulz | first3 = HG. | title = Bilateral, tumorlike diabetic mastopathy-progression and regression of the disease during 5-year follow up. | journal = Eur J Radiol | volume = 26 | issue = 3 | pages = 248-53 | month = Feb | year = 1998 | doi = | PMID = 9587750 }}</ref> | ||
* | *Rare -- less the 1% of breast lesions, though may be seen in up 13% of individuals with long-standing (insulin-dependent) diabetes mellitus.<ref name=pmid9269908>{{Cite journal | last1 = Hunfeld | first1 = KP. | last2 = Bässler | first2 = R. | title = Lymphocytic mastitis and fibrosis of the breast in long-standing insulin-dependent diabetics. A histopathologic study on diabetic mastopathy and report of ten cases. | journal = Gen Diagn Pathol | volume = 143 | issue = 1 | pages = 49-58 | month = Jul | year = 1997 | doi = | PMID = 9269908 }}</ref> | ||
Clinical:<ref name=pmid23966831/> | |||
*+/-Tenderness. | |||
*May mimic malignancy clinically. | |||
*May be managed with follow-up if diabetic.<ref name=pmid22371658/> | |||
==Microscopic== | ==Microscopic== | ||
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*[http://www.webpathology.com/image.asp?n=1&Case=655 Lymphocytic mastitis - low mag. (webpathology.com)]. | *[http://www.webpathology.com/image.asp?n=1&Case=655 Lymphocytic mastitis - low mag. (webpathology.com)]. | ||
*[http://www.webpathology.com/image.asp?case=655&n=2 Lymphocytic mastitis - high mag. (webpathology.com)]. | *[http://www.webpathology.com/image.asp?case=655&n=2 Lymphocytic mastitis - high mag. (webpathology.com)]. | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743988/figure/f3-mjms-20-3-083/ Lymphocytic mastitis (nih.gov)].<ref name=pmid23966831/> | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282604/figure/f2-ijwh-4-035/ Diabetic mastopathy (nih.gov)].<ref name=pmid22371658>{{Cite journal | last1 = Dilaveri | first1 = CA. | last2 = Mac Bride | first2 = MB. | last3 = Sandhu | first3 = NP. | last4 = Neal | first4 = L. | last5 = Ghosh | first5 = K. | last6 = Wahner-Roedler | first6 = DL. | title = Breast manifestations of systemic diseases. | journal = Int J Womens Health | volume = 4 | issue = | pages = 35-43 | month = | year = 2012 | doi = 10.2147/IJWH.S27624 | PMID = 22371658 }}</ref> | |||
==IHC== | ==IHC== | ||
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==Molecular== | ==Molecular== | ||
*Negative clonality studies. | *Negative clonality studies. | ||
==Sign out== | |||
*''Lymphocytic mastitis'' if no history of diabetes mellitus. | |||
*''Diabetic mastopathy'' if there is a well-documented history of [[diabetes mellitus]]. | |||
==See also== | ==See also== | ||