Lymphocytary Mastopathy in the Absence of Diabetes: A Case Report

Abstract

INTRODUCTION: The diabetic mastopathy is a rare form of mastitis, characterized by fibrous lesions and inflammatory mammary stroma that simulates the infiltratingcarcinoma in the general Medicine and in the radiology. It is also known as fibrous mastopathy, diabetic mastopathy and sclerosing lymphocytic mastopathy. It occurs more frequently in association with type 1 diabetes of long standing, in patients with type 2 diabetes mellitus who have developed auto-immune diseases and in patients with no associated diseases. In this paper we report a case of a patient with histopathological diagnosis of lymphocytic mastopathy with no association with diabetes mellitus or other pathologies. CASE REPORT: Female patient, 28 years, complaining of pain and lump which appeared suddenly in the right breast. Physical examination revealed a hardened and irregular area with approximately 3, 0 x 2, 0 cm located at a “9 hours” periareolar region. A breast ultrasound was done and it showed BIRADS US 0, due to this a histopathological evaluation was recommended. A magnetic resonance imaging showed a nodular area between the external quadrants of the right breast, measuring about 3. 6 x 3. 2 cm with characteristics of a benign lesion. Then a core-biopsy was carried out and the histopathological diagnosis was fibrosis. Later, after a lumpectomy with an expansion of margins, the histopathological diagnosis was immunohistochemical lymphocytic mastopathy. At present, the patient hasn’t uttered any complaints and is happy with the aesthetic result of the surgery. DISCUSSION: The lymphocytary mastitis is a rare disorder, representing less than 1% of the benign breast lesions, and occurs in up to 13% of diabetic patients. In this case report, however, there is no association with diabetes or auto-immune diseases, thus we emphasize the peculiarity of the case. The histopathological description is characteristicand shows dense stroma fibrosis and periductal and perivascular lymphocytic infiltrate. The differential diagnosis of these lesions is infiltrative breast carcinoma.