1
|
Chin S, Cumper M, Thomas A, Wylie E. Think of ink: Tattoo pigment masquerading as a breast mass. J Med Imaging Radiat Oncol 2024. [PMID: 38632859 DOI: 10.1111/1754-9485.13659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
Migration of tattoo pigment to axillary lymph nodes mimicking calcifications is a recognized phenomenon, however, pigment in an intra-mammary node masquerading as a breast mass is a rare complication of cosmetic tattoos. As the prevalence of tattooing increases among women presenting to Breastscreen, radiologists may expect to encounter this lesion mimicking a breast neoplasm. We present a 50-year-old female with extensive tattoos on her arms, chest wall and abdomen, recalled for a small calcified breast mass on her first screening mammogram. Tomosynthesis-guided vacuum-assisted biopsy demonstrated intra-mammary lymph node with abundant tattoo pigment.
Collapse
Affiliation(s)
- Sian Chin
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Marissa Cumper
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
- BreastScreen WA, Perth, Western Australia, Australia
| | - Anitha Thomas
- Department of Anatomical Pathology, PathWest QEII Medical Centre, Perth, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth Wylie
- Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
2
|
Roberts JT, Nguyen QD. Unknown Case: Breast and Axillary Lymph Node Calcifications. JOURNAL OF BREAST IMAGING 2024:wbae020. [PMID: 38615270 DOI: 10.1093/jbi/wbae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Indexed: 04/15/2024]
Affiliation(s)
- James T Roberts
- Department of Radiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Quan D Nguyen
- Breast Imaging Division, Department of Radiology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
3
|
Tannous AM, Bastow BD. Cutaneous Tattoo Ink as a Mimicker of Endometriosis-Like Lesions on Diagnostic Laparoscopy. Cureus 2024; 16:e59212. [PMID: 38807789 PMCID: PMC11131970 DOI: 10.7759/cureus.59212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/30/2024] Open
Abstract
This paper presents the case of a 28-year-old with a history of chronic pelvic pain suspicious of endometriosis. She underwent a diagnostic laparoscopy and biopsy of lesions along the posterior cul-de-sac and right sidewall near the external iliac artery. Histopathological examination revealed no evidence of endometriosis but did comment on benign lymph node tissue with tattoo-like pigment. These findings correspond to the patient's tattoos located along the lower extremities. It is suspected there was cutaneous tattoo ink migration causing intra-abdominal lymphadenopathy, which visually mimicked endometriosis on diagnostic laparoscopy. Surgeons should become familiar with and recognize this phenomenon, as it can be misleading in the setting of endometriosis and diagnostic laparoscopy. Surgeons undertaking these cases must be able to identify and safely excise abnormal-appearing lesions in many different locations to prevent a missed or delayed diagnosis of endometriosis.
Collapse
|
4
|
da Costa Vieira RA, da Rocha CA, Falcão-Junior PC, de Oliveira LCN. Lymph node microcalcifications after neoadjuvant chemotherapy: A therapeutic response marker. Breast Dis 2023; 42:17-21. [PMID: 36872760 DOI: 10.3233/bd-220025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Lymph node microcalcifications are rare events, and when they are accompanied by neoplasia, they usually seem to be associated with a metastatic condition. We present a case of a patient with breast cancer and lymph node microcalcifications undergoing neoadjuvant chemotherapy (NCT). A change in the calcification pattern towards becoming coarse was observed. Calcification represented a marker of axillary disease, and it was resected after NCT. This is the first report of a patient with lymph node microcalcification undergoing NCT. We observed a change in the calcification format, which facilitated lymph node sentinel identification. Pathological evaluation indicated metastatic disease.
Collapse
Affiliation(s)
- René Aloisio da Costa Vieira
- Department of Surgical Oncology, Breast Division, Muriaé Cancer Hospital, Muriaé, MG, Brazil.,Department of Radiology, Breast Division, Muriaé Cancer Hospital, Muriaé, MG, Brazil
| | | | | | - Luiz Carlos Navarro de Oliveira
- Department of Surgical Oncology, Breast Division, Muriaé Cancer Hospital, Muriaé, MG, Brazil.,Department of Radiology, Breast Division, Muriaé Cancer Hospital, Muriaé, MG, Brazil
| |
Collapse
|
5
|
Jung J, Peters G, Donovan S, Peters G. Tattoo Pigment in an Intramammary Lymph Node Mimicking Breast Malignancy. Cureus 2022; 14:e30336. [PMID: 36407269 PMCID: PMC9663708 DOI: 10.7759/cureus.30336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
There are many patterns of microcalcification in mammography. Distinguishing between these patterns can be challenging. A malignant cause needs to be assessed through further diagnostic workup. We present a case of a 36-year-old BRCA1 mutation carrier, presenting with a small mass containing calcification on her screening mammogram. A vacuum-assisted biopsy under tomosynthesis guidance was performed and demonstrated an intramammary lymph node showing prominent extracellular black pigment. To our knowledge, this is the first case report of tattoo pigment mimicking breast malignancy on mammography.
Collapse
|
6
|
Yepes MM, Feliciano Y, Net J, Betancur V, Gomez-Fernandez C, Collado-Mesa F. Axillary lymph node "bubbly" calcifications and body tattoo: A case series and proposed algorithm to minimize lymph node biopsies. Breast Dis 2022; 41:397-406. [PMID: 36530068 DOI: 10.3233/bd-220011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The presence of mammographically evident hyperdense foci within axillary lymph nodes elicits concern for calcium deposits, which in turn have a wide differential diagnosis including both benign and malignant entities. Tissue sampling, most commonly by way of image-guided core needle biopsy, is needed in many cases when a definite etiology cannot be clinically established. In this case series we present history, imaging findings, and pathology results (or long term follow-up stability as biopsy surrogate) of several women with body tattoos who at mammography were noted to have a characteristic pattern of "bubbly" pseudo-calcifications within axillary lymph nodes, and absence of other mammographic, sonographic and clinical abnormalities.
Collapse
Affiliation(s)
- Monica M Yepes
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yara Feliciano
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jose Net
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - Fernando Collado-Mesa
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
7
|
Barber-Axthelm IM, Kelly HG, Esterbauer R, Wragg KM, Gibbon AM, Lee WS, Wheatley AK, Kent SJ, Tan HX, Juno JA. Coformulation with Tattoo Ink for Immunological Assessment of Vaccine Immunogenicity in the Draining Lymph Node. THE JOURNAL OF IMMUNOLOGY 2021; 207:735-744. [PMID: 34244296 DOI: 10.4049/jimmunol.2001299] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/17/2021] [Indexed: 11/19/2022]
Abstract
Characterization of germinal center B and T cell responses yields critical insights into vaccine immunogenicity. Nonhuman primates are a key preclinical animal model for human vaccine development, allowing both lymph node (LN) and circulating immune responses to be longitudinally sampled for correlates of vaccine efficacy. However, patterns of vaccine Ag drainage via the lymphatics after i.m. immunization can be stochastic, driving uneven deposition between lymphoid sites and between individual LN within larger clusters. To improve the accurate isolation of Ag-exposed LN during biopsies and necropsies, we developed and validated a method for coformulating candidate vaccines with tattoo ink in both mice and pigtail macaques. This method allowed for direct visual identification of vaccine-draining LN and evaluation of relevant Ag-specific B and T cell responses by flow cytometry. This approach is a significant advancement in improving the assessment of vaccine-induced immunity in highly relevant nonhuman primate models.
Collapse
Affiliation(s)
- Isaac M Barber-Axthelm
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Hannah G Kelly
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia.,Australian Research Council Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Melbourne, Victoria, Australia
| | - Robyn Esterbauer
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Kathleen M Wragg
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Anne M Gibbon
- Monash Animal Research Platform, Monash University, Clayton, Victoria, Australia; and
| | - Wen Shi Lee
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia.,Australian Research Council Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Hyon-Xhi Tan
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia
| | - Jennifer A Juno
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne Victoria, Australia;
| |
Collapse
|
8
|
Heaney RM, Sweeney L, Smith C, O'Brien A. Much 'tattoo' about nothing; Tattoo pigment mimicking breast microcalcifications on mammography. Radiol Case Rep 2021; 16:1833-1835. [PMID: 34040686 PMCID: PMC8141413 DOI: 10.1016/j.radcr.2021.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Mimics of calcifications on mammography are not uncommon and result in additional investigations that can cause patient anxiety. We describe the case of a 63 year old male who underwent further investigation of calcifications in the superior right breast. Additional imaging and patient examination revealed that the calcifications were located in a color tattoo overlying the medial right pectoralis muscle and actually represented the radio-opaque metallic compounds found in tattoo pigment.
Collapse
Affiliation(s)
- Roisin M Heaney
- Breast Health, Mater Misericordiae University Hospital, 38 Eccles Street, Dublin 7, Ireland
| | - Laura Sweeney
- Breast Health, Mater Misericordiae University Hospital, 38 Eccles Street, Dublin 7, Ireland
| | - Clare Smith
- Breast Health, Mater Misericordiae University Hospital, 38 Eccles Street, Dublin 7, Ireland
| | - Angela O'Brien
- Breast Health, Mater Misericordiae University Hospital, 38 Eccles Street, Dublin 7, Ireland
| |
Collapse
|