Lymphocytic mastitis

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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:

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. 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. 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.
  3. 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.
  4. 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. 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.
  6. URL: http://www.breastpathology.info/Case_of_the_month/2007/COTM_0707%20discussion.html. Accessed on: 28 November 2010.