Lymphocytic mastitis

Mimickers of
breast malignancy: imaging findings, pathologic concordance and clinical management. Lymphocytic mastopathy. A 37-year-old woman presented with right breast palpable retroareolar mass, swelling, erythema, and tenderness. Craniocaudal and lateral mammography (a, b) shows a focal asymmetry (solid arrows) and skin thickening (dashed arrows) associated with the triangular palpable marker in the lateral breast. Grayscale (c) and color Doppler breast ultrasound (d) reveals multiple retroareolar, vascular masses (arrows). Core needle biopsy showed acute and chronic inflammation and granulation tissue. The patient’s symptoms resolved within a month. The patient presented 2 years later with a contralateral palpable breast mass and nipple inversion. Craniocaudal and lateral mammographic views (e, f) reveal a focal asymmetry in the central breast associated with the palpable marker (arrows). Grayscale (c) and color Doppler (d) breast ultrasound reveals a vascular heterogeneous mass (arrows). Core needle biopsy revealed benign breast tissue with lymphoplasmacytic infiltrate. The patient’s symptoms improved over the following 6 months. She did not have a history of diabetes or other known immunologic condition
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Lymphocytic mastitis, also known as lymphocytic mastopathy or sclerosing lymphocytic lobulitis, is a rare benign inflammatory disease of the breast that can mimic breast cancer.

Terminology

Diabetic mastopathy is a closely-related entity although it is sometimes used synonymously in the literature.

Clinical presentation

Lymphocytic mastitis may present as a palpable mass, which may be painful and may be bilateral.

Pathology

Lymphocytic mastitis is associated with autoimmune disease (e.g. Hashimoto thyroiditis, systemic lupus erythematosus, Sjogren syndrome) .

Macroscopic appearance

Dense fibrous tissue with hard lesions, that can be large (up to 6 cm) .

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