Difference between revisions of "Lymphocytic mastitis"
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| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = +/-tenderness | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = rare | | Prevalence = rare | ||
Line 27: | Line 27: | ||
| Prognosis = benign | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = breast tumour - possibly malignant | ||
| Tx = | | Tx = +/-excision | ||
}} | }} | ||
'''Lymphocytic mastitis''' is a rare pathology of the [[breast]]. | '''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== | ||
Line 52: | Line 57: | ||
*[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== | ||
Line 59: | Line 66: | ||
==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== |
Latest revision as of 21:02, 16 February 2014
Lymphocytic mastitis | |
---|---|
Diagnosis in short | |
| |
LM | lymphocytic infiltrates (breast lobules, perivascular), enlarged stromal fibroblasts, stromal collagen with keloid-like changes. |
LM DDx | lymphoma (small cell), diabetic mastopathy (need history) |
IHC | CD20 > CD3, CD43 -ve |
Molecular | negative for clonality |
Site | breast |
| |
Associated Dx | +/-diabetes mellitus (known as diabetic mastopathy) |
Signs | +/-tenderness |
Prevalence | rare |
Prognosis | benign |
Clin. DDx | breast tumour - possibly malignant |
Treatment | +/-excision |
Lymphocytic mastitis is a rare pathology of the breast. If the individual has diabetes mellitus (DM) it is called diabetic mastopathy.[1]
General
- Typically in long-standing diabetes mellitus.[2][3]
- Rare -- less the 1% of breast lesions, though may be seen in up 13% of individuals with long-standing (insulin-dependent) diabetes mellitus.[4]
Clinical:[2]
- +/-Tenderness.
- May mimic malignancy clinically.
- May be managed with follow-up if diabetic.[5]
Microscopic
Features:[6]
- Lymphocytic infiltrates - key feature:
- Lobules.
- Perivascular.
- Enlarged stromal fibroblasts.
- Stromal collagen with keloid-like changes.
DDx:
- Diabetic mastopathy - if individual has diabetes.
- Primary lymphoma of the breast.
Images
www:
- Lymphocytic mastitis - low mag. (webpathology.com).
- Lymphocytic mastitis - high mag. (webpathology.com).
- Lymphocytic mastitis (nih.gov).[2]
- Diabetic mastopathy (nih.gov).[5]
IHC
- B cell predominant (CD20 > CD3).[1]
- B cells CD43 -ve.
Molecular
- 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
References
- ↑ 1.0 1.1 Valdez, R.; Thorson, J.; Finn, WG.; Schnitzer, B.; Kleer, CG. (Mar 2003). "Lymphocytic mastitis and diabetic mastopathy: a molecular, immunophenotypic, and clinicopathologic evaluation of 11 cases.". Mod Pathol 16 (3): 223-8. doi:10.1097/01.MP.0000056627.21128.74. PMID 12640102.
- ↑ 2.0 2.1 2.2 Alhabshi, SM.; Rahmat, K.; Westerhout, CJ.; Md Latar, NH.; Chandran, PA.; Aziz, S. (May 2013). "Lymphocytic mastitis mimicking breast carcinoma, radiology and pathology correlation: review of two cases.". Malays J Med Sci 20 (3): 83-7. PMID 23966831.
- ↑ Bayer, U.; Horn, LC.; Schulz, HG. (Feb 1998). "Bilateral, tumorlike diabetic mastopathy-progression and regression of the disease during 5-year follow up.". Eur J Radiol 26 (3): 248-53. PMID 9587750.
- ↑ Hunfeld, KP.; Bässler, R. (Jul 1997). "Lymphocytic mastitis and fibrosis of the breast in long-standing insulin-dependent diabetics. A histopathologic study on diabetic mastopathy and report of ten cases.". Gen Diagn Pathol 143 (1): 49-58. PMID 9269908.
- ↑ 5.0 5.1 Dilaveri, CA.; Mac Bride, MB.; Sandhu, NP.; Neal, L.; Ghosh, K.; Wahner-Roedler, DL. (2012). "Breast manifestations of systemic diseases.". Int J Womens Health 4: 35-43. doi:10.2147/IJWH.S27624. PMID 22371658.
- ↑ URL: http://www.breastpathology.info/Case_of_the_month/2007/COTM_0707%20discussion.html. Accessed on: 28 November 2010.