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Naeem M, Zulfiqar M, Ballard DH, Billadello L, Cao G, Winter A, Lowdermilk M. "The unusual suspects"-Mammographic, sonographic, and histopathologic appearance of atypical breast masses. Clin Imaging 2020; 66:111-120. [PMID: 32470708 DOI: 10.1016/j.clinimag.2020.04.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/16/2020] [Accepted: 04/30/2020] [Indexed: 01/23/2023]
Abstract
Breast malignancy is the second most common cause of cancer death in women. However, less common breast masses can mimic carcinoma and can pose diagnostic challenges. This case-based review describes a spectrum of rare breast neoplastic and non-neoplastic masses ranging from malignant to benign entities. Malignant masses in this review include adenoid cystic carcinoma, spindle cell lipoma, granular cell tumor, angiosarcoma, glomus tumor, adenosquamous carcinoma, and myofibroblastoma. Benign masses include sarcoidosis, diabetic mastopathy, and cat scratch disease. Demographics and, when relevant, clinical presentation are summarized. Breast imaging appearance on mammography and ultrasound are highlighted along with radiology-pathology correlation with the appearance and characteristics of the histopathological specimen of these rare masses.
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Affiliation(s)
- Muhammad Naeem
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, United States of America.
| | - Maria Zulfiqar
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, United States of America.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, United States of America.
| | - Laura Billadello
- Department of Radiology, St Louis University School of Medicine, United States of America.
| | - Guihua Cao
- Department of Pathology, SSM Health St Mary's Hospital, United States of America.
| | - Andrea Winter
- Department of Radiology, St Louis University School of Medicine, United States of America
| | - Mary Lowdermilk
- Department of Radiology, St Louis University School of Medicine, United States of America.
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Goulabchand R, Hafidi A, Van de Perre P, Millet I, Maria ATJ, Morel J, Le Quellec A, Perrochia H, Guilpain P. Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players. J Clin Med 2020; 9:jcm9040958. [PMID: 32235676 PMCID: PMC7231219 DOI: 10.3390/jcm9040958] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/13/2022] Open
Abstract
Mastitis frequently affects women of childbearing age. Of all the pathological breast conditions requiring specific management, autoimmune mastitis is in the third position after infection and breast cancer. The aim of this literature review was to make a comprehensive description of autoimmune diseases targeting the mammary gland. Four main histological patterns of autoimmune mastitis are described: (i) lymphocytic infiltrates; (ii) ductal ectasia; (iii) granulomatous mastitis; and (iv) vasculitis. Our literature search found that all types of autoimmune disease may target the mammary gland: organ-specific diseases (diabetes, thyroiditis); connective tissue diseases (such as systemic erythematosus lupus or Sjögren’s syndrome); vasculitides (granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, giant cell arteritis, polyarteritis nodosa, Behçet’s disease); granulomatous diseases (sarcoidosis, Crohn’s disease); and IgG4-related disease. Cases of breast-specific autoimmune diseases have also been reported, including idiopathic granulomatous mastitis. These breast-limited inflammatory diseases are sometimes the first symptom of a systemic autoimmune disease. Although autoimmune mastitis is rare, it is probably underdiagnosed or misdiagnosed. Early diagnosis may allow us to detect systemic diseases at an earlier stage, which could help to initiate a prompt, appropriate therapeutic strategy. In case of suspected autoimmune mastitis, we hereby propose a diagnostic pathway and discuss the potential pathophysiological pathways leading to autoimmune breast damage.
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Affiliation(s)
- Radjiv Goulabchand
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Internal Medicine Department, Caremeau University Hospital, 30029 Nimes, France
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Assia Hafidi
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Gui de Chauliac Hospital, Pathology Department, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, Univ Montpellier, INSERM, EFS, Montpellier University Hospital, 34394 Montpellier, France;
| | - Ingrid Millet
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Lapeyronie Hospital, Montpellier University, Medical Imaging Department, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Alexandre Thibault Jacques Maria
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Jacques Morel
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Department of Rheumatology, CHU and University of Montpellier, 34295 Montpellier, France
| | - Alain Le Quellec
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
| | - Hélène Perrochia
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Gui de Chauliac Hospital, Pathology Department, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Philippe Guilpain
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-467-337332
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Sarcoidosis: una causa infrecuente de nódulo mamario. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2019. [DOI: 10.1016/j.gine.2018.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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4
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Granulomatous diseases of the breast and axilla: radiological findings with pathological correlation. Insights Imaging 2018; 9:59-71. [PMID: 29404980 PMCID: PMC5825314 DOI: 10.1007/s13244-017-0587-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/05/2017] [Accepted: 12/13/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives This article reviews our experience and describes the literature findings of granulomatous diseases of the breast and axilla. Methods After approval of the Institutional Review Board was obtained, the surgical pathological records from January 2000 to January 2017 were searched for the keyword granulomatous. Clinical, imaging and histology findings were reviewed by both a fellowship-trained radiologist and a breast-imaging consultant radiologist, reviewing 127 patients (age range, 32–86 years; 126 women and 1 man). Results Most common causes of granulomatous lesions of the breast and axilla included silicone granulomas 33% (n = 42), fat necrosis 29% (n = 37) and suture granulomas 11% (n = 14). In 16% (n = 20), no cause could be found and clinical history was consistent with idiopathic granulomatous mastitis. Other granulomatous aetiologies included granulomatous infections, sarcoidosis and Sjögren’s syndrome. Causes of axillary granulomatous disease were similar to the breast; however, a case of cat-scratch disease was found that only involved the axillary lymph nodes. They can have a variable appearance on imaging and may mimic malignancy with irregular masses seen on mammography, ultrasound and magnetic resonance imaging. Fistulas to the skin and nipple retraction can suggest chronicity and a granulomatous aetiology. Combination of clinical history, laboratory and imaging findings can be diagnostic. Conclusions Granulomatous processes of the breast are rare. The diagnosis can, however, be made if there is relevant history (prior trauma, silicone breast implants, lactation), laboratory (systemic or infectious processes) and imaging findings (fistula, nipple retraction). Recognising these entities is important for establishing pathological concordance after biopsy and for preventing unnecessary treatment. Teaching points Breast granulomatous are rare but can mimic breast carcinoma on imaging Imaging with clinical and laboratory findings can correctly diagnosis specific granulomatous breast diseases Recognition of the imaging findings allows appropriate pathological concordance and treatment
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Mason C, Yang R, Hamilton R, Punar M, Shah Z, Spigel J, Wang J. Diagnosis of sarcoidosis from a biopsy of a dilated mammary duct. Proc AMIA Symp 2017; 30:197-199. [PMID: 28405081 DOI: 10.1080/08998280.2017.11929584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Sarcoidosis is an immunologic disease of unknown etiology that manifests most frequently within the lungs or associated lymph nodes. Sarcoidosis involving the breast is seen in <1% of cases and usually is diagnosed in patients with multisystem disease. The clinical and imaging presentations of sarcoidosis of the breast can be variable. Though uncommon, sarcoidosis should be considered in the differential diagnosis of a breast lesion, and given that imaging characteristics cannot distinguish between sarcoidosis and malignancy, all breast lesions in patients with sarcoidosis should be biopsied. Our case study demonstrates a diagnosis of sarcoidosis in an asymptomatic patient presenting with a single dilated duct and associated filling defect within the right breast.
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Affiliation(s)
- Callan Mason
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Robert Yang
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Raynal Hamilton
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Metin Punar
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Zeeshan Shah
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Joseph Spigel
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
| | - Jean Wang
- Departments of Radiology (Mason, Yang, Hamilton, Shah, Spigel, Wang) and Pathology (Punar), Baylor University Medical Center at Dallas, Texas
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Guidry C, Fricke RG, Ram R, Pandey T, Jambhekar K. Imaging of Sarcoidosis. Radiol Clin North Am 2016; 54:519-34. [DOI: 10.1016/j.rcl.2015.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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7
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Mario J, Venkataraman S, Dialani V, Slanetz PJ. Benign breast lesions that mimic cancer: Determining radiologic-pathologic concordance. APPLIED RADIOLOGY 2015. [DOI: 10.37549/ar2214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Isley LM, Cluver AR, Leddy RJ, Baker MK. Primary sarcoid of the breast with incidental malignancy. J Clin Imaging Sci 2012; 2:46. [PMID: 22919560 PMCID: PMC3424916 DOI: 10.4103/2156-7514.99180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 06/22/2012] [Indexed: 11/23/2022] Open
Abstract
Breast sarcoidosis is rare and usually presents in patients with known sarcoid involving other organ systems. In the breast, sarcoidosis may mimic malignancy which must be excluded by core biopsy. We report a very unusual case of primary breast sarcoidosis with incidentally discovered breast carcinoma. The roles of mammography, ultrasound, and MRI in the diagnosis as well as other potential differential diagnosis are discussed.
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Affiliation(s)
- Laura M Isley
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
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9
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Diaforodiagnostic dilemma of a breast tumor in a patient with known history of chest sarcoidosis: a diagnostic approach. Open Med (Wars) 2011. [DOI: 10.2478/s11536-011-0068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractBreast sarcoidosis is extremely rare, substantially less frequent than other extrapulmonary manifestations of sarcoidosis. It can mimic a benign or malignant tumor of the breast. We describe the case of a patient with a history of pulmonary sarcoidosis referred to our hospital for a screening mammography. Mammographic findings raised the suspicion for a breast mass. An additional breast ultrasound and fine -needle aspiration biopsy were performed. Finally, patient underwent a excisional biopsy of the left breast and the histopathological report revealed sarcoidosis.
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10
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Rafi H, Latib R, Faik J, Kanouni L, Chami I, Boujida N, Jroundi L. Sarcoïdose mammaire chez une patiente traitée pour cancer du sein. IMAGERIE DE LA FEMME 2009. [DOI: 10.1016/j.femme.2009.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Hermann G, Nagi C, Mester J, Tierstein A. Unusual presentation of sarcoidosis of the breast. Br J Radiol 2008; 81:e231-3. [PMID: 18769011 DOI: 10.1259/bjr/11877313] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report a case of sarcoidosis with an unusual radiological appearance. The patient was a 41-year-old asymptomatic woman who presented for a baseline screening mammogram, which revealed an asymmetric, slightly increased density in the upper outer quadrant of her left breast. Ultrasonography failed to demonstrate any mass. Her past medical history was remarkable for sarcoidosis. Stereotactic core biopsy revealed sarcoidosis diffusely infiltrating the breast parenchyma.
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Affiliation(s)
- G Hermann
- Department of Radiology, Division of Pulmonary and Critical Care Medicine, Mount Sinai School of Medicine, 1 Gustave L Levy Place, New York, NY 10029, USA.
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12
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Chopier J, Kadi N, Salem C, Antoine M, Uzan S. Diagnostic en imagerie conventionnelle et en IRM d’une lésion mammaire. IMAGERIE DE LA FEMME 2005. [DOI: 10.1016/s1776-9817(05)80656-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Mona EK, Pascal C, Charley H, Françoise B, Véronique B, Marie-Madeleine P. Quiz case. Breast sarcoidosis presenting as a metastatic breast cancer. Eur J Radiol 2005; 54:2-5. [PMID: 15797288 DOI: 10.1016/j.ejrad.2004.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Revised: 11/26/2004] [Accepted: 11/29/2004] [Indexed: 11/30/2022]
Abstract
A case of sarcoidosis presenting initially as a breast mass with subclinical pulmonary and medullary involvement highly mimicking metastatic breast carcinoma is reported. The mammographic, ultrasound and CT scan findings are described with a review of the literature.
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Affiliation(s)
- El Khoury Mona
- Department of radiology, Centre René Huguenin, 35, Rue Dailly, 92210 Saint Cloud, France
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14
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Cherel P, Becette V, Hagay C. Stellate images: anatomic and radiologic correlations. Eur J Radiol 2005; 54:37-54. [PMID: 15797292 DOI: 10.1016/j.ejrad.2004.11.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2004] [Revised: 11/26/2004] [Accepted: 11/29/2004] [Indexed: 11/23/2022]
Abstract
The stellate images are the most well-known and most typical finding in the diagnosis of breast cancer. Its positive predictive value is very high. However, in some cases, the stellate images can correspond to benign lesions. Stellate images require high quality mammograms, precise analysis, and as always in senology, confirmation by clinical examination, ultrasound if necessary, and in the case of palpable lesions, cytology. In this work, we will study malignant and benign stellate images mammographic-pathologic correlation as well as the importance of stellate images in the detection of non-palpable lesions. The typical stellate finding is correlated with the phenomena of fibrosis and elastosis and it is impossible to distinguish benign spicules from malignant spicules on mammography. We will present guidelines in the face of stellate image. Stellate images are for the most part suggestive of malignant lesions, and their discovery should lead to suspicion of cancer until the contrary is proven.
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Affiliation(s)
- P Cherel
- Department of Radiology, René Huguenin Center, St. Cloud, France.
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15
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Sabaté JM, Clotet M, Gómez A, De las Heras P, Torrubia S, Salinas T. Radiologic Evaluation of Uncommon Inflammatory and Reactive Breast Disorders. Radiographics 2005; 25:411-24. [DOI: 10.1148/rg.252045077] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Sarcoidosis is a systemic granulomatous disease of unknown cause that most commonly affects the lungs, lymph nodes, skin, eyes, spleen, bone, and glandular tissue. The diagnosis is made when characteristic histologic findings are demonstrated and other granulomatous processes are excluded. It can be an acute or chronic debilitating disease, but in patients with acute disease the process can be self-limited. Multiple therapeutic options have been described both for the cutaneous and systemic lesions of sarcoidosis. Steroids, however, remain the cornerstone of therapy.
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Affiliation(s)
- T J Giuffrida
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136, USA
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17
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Abstract
UNLABELLED Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin. The cutaneous manifestations of sarcoidosis often enable the dermatologist to be the first physician to make the diagnosis. This article reviews essential sarcoidosis pathophysiology, clinical polymorphisms, systemic evaluation, and treatment modalities for cutaneous sarcoidosis to further enhance the dermatologist's understanding of this disease entity. LEARNING OBJECTIVE At the conclusion of this learning activity, participants should be familiar with the theories of the pathogenesis of sarcoidosis, its cutaneous manifestations, its various syndromes and associations, and its presentation in children. Participants should also be more knowledgeable about diagnostic evaluation, measurement of disease progression, treatment modalities, and the prognosis and mortality data of sarcoidosis.
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Affiliation(s)
- J C English
- Department of Dermatology, University of Virginia, Charlottesville, USA
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18
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Abstract
Sarcoidosis is a multisystemic disease that may involve the breast parenchyma and can be confused with benign or malignant tumors. A recent case of sarcoidosis of the breast treated in our institution prompted us to review the world literature on the topic. From 1921 to 1997, 45 cases relating to sarcoidosis of the breast were reported; 10 of these cases were excluded from our review because of the lack of histological proof of sarcoidosis. The data were organized according to clinical presentation, diagnostic studies, treatment plan, and follow-up care. The mean age at presentation was 47 years (range 20–72 years) and all patients were female. Seven patients (20%) had a breast mass as primary presentation of sarcoidosis without any clinical evidence of systemic sarcoidosis. Thirty-one patients (89%) presented with a self-detected mass and three patients (8%) demonstrated skin dimpling and peau d'orange appearance mimicking cancer. The size of the breast lesions ranged from 0.25 to 5 cm in diameter. One patient presented with bilateral breast lesions and one with more than one lesion in the same affected breast. A single breast mass was found in the rest of the patients. Of the seven patients evaluated by mammography, only one revealed changes suspicious for malignancy. Fine-needle aspiration was used only in four cases; the results of two were compatible with sarcoidosis and two required an excisional biopsy as a result of inconclusive results. Seventeen cases reported excisional biopsy as the diagnostic procedure. In 11 patients the type of biopsy was not stated. In two cases of radical mastectomies for breast adenocarcinoma, sarcoidosis was an incidental finding, either in the remaining breast tissue or in the axillary nodes. One patient underwent a partial mastectomy revealing sarcoidosis as the definitive diagnosis. Ultrasound was used in two cases; one revealed a suspicious lesion and one was inconclusive. Although sarcoidosis of the breast constitutes a rare entity it should be considered in the differential diagnosis of breast cancer even in patients without clinical evidence of systemic sarcoidosis. These patients should undergo a biopsy to rule out malignancy because clinical findings, mammography, and ultrasound results can be misleading or inconclusive.
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Affiliation(s)
- Herminio Ojeda
- Department of Surgery, St. Agnes Health Care, Baltimore, Maryland
| | - Armando Sardi
- Department of Surgery, St. Agnes Health Care, Baltimore, Maryland
| | - Adil Totoonchie
- Department of Surgery, St. Agnes Health Care, Baltimore, Maryland
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Abstract
A 67-year-old woman sought medical treatment of cardiomyopathy, which had been diagnosed 2 years earlier; the causative factor was sarcoidosis. A screening mammogram revealed multiple spiculated masses in both breasts. A review of previous films obtained elsewhere showed that these masses had been increasing in prominence during the past 3 years. The patient had no visible axillary nodal abnormalities. Sarcoidosis was considered a diagnostic possibility, and a large-core needle biopsy was done with stereotactic guidance. The histological diagnosis was non-necrotizing granulomatous inflammation, consistent with sarcoidosis.
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Affiliation(s)
- J J Gisvold
- Department of Diagnostic Radiology, Mayo Clinic Rochester, MN 55905, USA
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