ABSTRACT
Diabetic mastopathy is an unusual fibroinflammatory breast lesion that is characteristically presented in premenopausal women with long-standing diabetes with multiple microvascular complications. This patient was a 49-year-old postmenopausal woman with diabetic nephropathy, neuropathy, and retinopathy. Although palpable mass was detected on the left breast, an ultrasonography could not distinguish it from breast cancer. Excisional biopsy was conducted. Histological findings indicated diabetic mastopathy with keloid-like fibrosis, perivascular lymphocytic infiltration, and lymphocytic lobulitis without evidence of malignancy. After excision, there has been no recurrence until now.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Breast , Breast Neoplasms , Diabetic Nephropathies , Fibrosis , RecurrenceABSTRACT
Objective: To retrospectively analyze the clinical records and imaging data of patients with diabetic mastopathy according to pathological findings of samples obtained by histological puncture with ultrasound guidance. Methods: Between 2002 and 2007, six patients were diagnosed with diabetic mastopathy, and their medical records and MR images were assessed. All patients underwent both mammography and ultrasound examination. One of them was additionally submitted to MRI. Results: The patients' mean age was 36.6 years. Mammograms showed asymmetric tissue densifications without micro calcifications, while ultrasound examination evidenced ill-defined solid nodular or pseudonodular areas greater than 2 cm, with posterior sonic attenuation. Magnetic resonance imaging revealed a nodular area with poorly defined contours with enhancement similar to normal breast tissue. By performing eco-guided biopsy, it was possible to establish the differential histological diagnosis of breast carcinoma and to confirm diabetic mastopathy. Conclusion: Diabetic mastopathy presents mammographic and ultrasound imaging features indistinguishable from breast cancer. Since MRI does not reveal pathological stromal enhancement it can be helpful for a differential diagnosis. The echo-guided biopsy allows the diagnosis of this condition.
Objetivo: Analizar retrospectivamente las historias clínicas e imágenes de pacientes conmastopatía diabética, según hallazgos en anatomía patológica de muestras obtenidas por punción histológica con guía ecográfica. Material y Métodos: Entre los años 2002 y 2007, se diagnosticaron 6 pacientes con mastopatía diabética, evaluándose sus historias clínicas e imágenes. A todas las pacientes se le efectuó mamografía y ecografía; a una paciente se realizó además resonancia magnética. Resultados: La edad promedio de las pacientes fue de 36,6 años. Las mamografías mostraron densificaciones tisulares asimétricas sin microcalcificaciones; las ecografías evidenciaron áreas sólidas nodulares o seudonodulares mal definidas, mayores a 2 cm, con atenuación sónica posterior y la resonancia magnética: un área nodular de contornos mal delimitados con realce similar al tejido mamario normal. La punción biopsia ecoguiada pudo establecer el diagnóstico histológico diferencial con carcinoma mamario y confirmar mastopatía diabética. Conclusión: La mastopatía diabética presenta características imaginológicas en mamografía y ecografía que pueden ser similares al carcinoma. La resonancia magnética, al no presentar realce patológico estromal, puede colaborar en el diagnostico diferencial. La biopsia eco-guiada permite el diagnóstico de esta patología.
Subject(s)
Humans , Carcinoma/diagnosis , Diabetes Mellitus, Type 1/complications , Fibrocystic Breast Disease/diagnosis , Breast Neoplasms/diagnosis , Biopsy, Needle , Carcinoma/pathology , Diagnosis, Differential , Retrospective Studies , Magnetic Resonance Imaging , Mammography , Breast Neoplasms/pathologyABSTRACT
A mastopatia diabética acomete mulheres na pré-menopausa com diabetes mellitus tipo 1 de longa data. Seu diagnóstico é feito associando achados clínicos (espessamento ou nódulo mamário endurecidos, uni ou bilateral), radiológicos (aumento da densidade mamária), ultra-sonográficos (acentuada sombra acústica posterior) e histopatológicos (fibrose e infiltrado linfocítico perivascular e periductal). Pode simular carcinoma. Neste artigo relata-se um caso de paciente com mastopatia diabética.
Diabetic mastopathy affects premenopausal women with longstanding type 1 diabetes mellitus. The diagnosis is based on clinical findings (uni or bilateral hardened, palpable mass) associated with radiological (increase in breast density), sonographic (marked posterior acoustic shadowing), and histopathological (fibrosis and perivascular and periductal lymphocytic infiltration) findings. This disease may clinically simulate a breast carcinoma. The case of a patient with diabetic mastopathy is reported.
Subject(s)
Humans , Female , Adult , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 1/complications , Fibrocystic Breast Disease/etiology , Breast Diseases/diagnosis , Breast Diseases/pathology , Breast/pathology , Breast Neoplasms/diagnosis , Biopsy, Fine-Needle , Diagnosis, DifferentialABSTRACT
Fibrous mastopathy, also known as diabetic mastopathy and lymphocytic mastopathy, may mimic breast cancer at the physical examination, mammography, and ultrasound. We report a case of a woman who presented a non-tender mass clinically suggestive of breast carcinoma; however, the fine-needle aspiration cytology indicated atypia and the core needle biopsy revealed lymphocytic mastopathy. The magnetic resonance imaging of the breast showed a lesion with benign features. It was not demonstrated diabetics mellitus and autoimmune diseases. The patient got pregnant, breastfed, and it was observed the progressive regression of the lesion, with complete disappearance of the solid mass. Three years and three months later, there was no palpable mass at the clinical examination and ultrasound. In conclusion, fibrous mastopathy shall be considered for all breast lesions, regardless of the diagnosis of diabetes mellitus. Once a definitive diagnosis of this pathology is reached, it is recommended clinical, imaging studies and fine-needle aspiration biopsy follow-up of the patient, avoiding unnecessary surgical procedures.
A mastopatia fibrótica, também conhecida como mastopatia diabética e mastopatia linfocítica, pode, ao exame clínico, mamografia e ultra-som, simular um carcinoma mamário. Descrevemos o relato de uma mulher na qual o nódulo foi inicialmente suspeito de carcinoma mamário, mas o diagnóstico pela punção aspirativa com agulha fina foi de atipia, e o com biópsia com agulha grossa foi de mastopatia linfocítica. A ressonância magnética da mama mostrou a lesão com características de benignidade. Não foram demonstradas diabetes mellitus e doenças auto-imunes. A paciente engravidou, amamentou e foi observada regressão progressiva da lesão, com desaparecimento da mesma. A paciente persiste sem lesão na mama ao exame clínico e de ultra-som após acompanhamento de três anos e três meses. Em conclusão, a mastopatia fibrótica deve ser considerada para todas as lesões de mama, mesmo em pacientes sem diabetes mellitus. Quando o diagnóstico definitivo da patologia for realizado, é recomendável o acompanhamento da paciente com estudos clínicos e de imagem e biópsia com agulha fina, evitando-se procedimentos cirúrgicos desnecessários.
Subject(s)
Adult , Female , Humans , Breast Neoplasms/pathology , Breast/pathology , Carcinoma, Lobular/pathology , Fibrocystic Breast Disease/pathology , Biopsy, Needle , Breast Feeding , Breast Neoplasms/surgery , Breast/surgery , Carcinoma, Lobular/surgery , Diagnosis, Differential , Diabetes Mellitus/diagnosis , Fibrocystic Breast Disease/surgery , Mammography , Ultrasonography, MammaryABSTRACT
Objetivo: relatar um caso de mastopatia diabética bilateral, um tipo incomum e raro de doença inflamatória da mama. A associação entre mastopatia e diabete insulino-dependente é uma condição não muita conhecida. Relato do caso: paciente do sexo feminino, trinta e dois anos de idade, com diagnóstico de diabete desde os doze anos. A investigação clínica se baseou na anamnese e exame físico; realizada, também, ultra-sonografia e histopatologia. Considerações finais: o caso apresentado demonstra a importância do diagnóstico precoce das doenças que afetam a mama e a gravidade da mastopatia diabética, quando detectada tardiamente.
Objective: to report a case of diabetic mastopathy, an uncommon type of inflammatory breast pathology. The bilateral form is more rare. The association between mastopathy and insulin-dependent diabetes is a not very known condition. Case report: patient of female sex, thirtytwo years old, with diagnoses of diabetes at age of twelve. Final considerations: in the case reported above the authors emphasize the importance of early diagnosis in breast diseases.
Subject(s)
Humans , Female , Adult , Diabetes Mellitus, Type 1/complications , Breast Diseases/diagnosis , Breast/pathologyABSTRACT
Diabetic mastopathy is a rare disease that occurs in long-term insulin-dependent diabetic patient. It manifests as a hard palpable breast mass that may be clinically indistinguishable from a breast carcinoma. Mammography shows a non-specific, dense, heterogenous glandular opacity in both breasts. Sonography shows a markedly hypoechoic, ill-marginated mass with a posterior acoustic shadowing. We present the mammography, ultrasonography and MRI findings of a 54-year-old woman with diabetic mastopathy.