Breast involvement in panniculitis: report of 7 cases with literature review / 中华风湿病学杂志

ABSTRACT

Objective To analyze the clinical characteristics of patients with panniculitis who had breast involvement and to expand the understanding of the organ involvement of panniculitis.Methods The data of panniculitis patients with breast involvement were collected from our hospital during 2012.1.1 to 2017.7.1,including sex,age,clinical manifestations,laboratory tests,imaging examinations and treatments.Results A total of 7 panniculitis patients were included who had breast involvement.All patients were female,aged 28 to 45 years [mean,(35±6) years].Clinical manifestations included hypothermia (4/7),arthralgia (4/7),limb subcutaneous nodules (7/7) and breast nodules (7/7).Breast nodules occurred 1 to 4 months earlier than the limbs subcutaneous nodules in 6 cases and 11 years later than the limbs subcutaneous in 1 case.For laboratory testsall patients had increased of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (7/7) while only 2 patients had elevation of white blood cell count (2/6).One patient had breast enhanced magnetic resonance imaging (MRI) scanning.Seven patients underwent biopsy of limb subcutaneous nodules.The pathological findings were all consistent with the pathological characteristics of panniculitis.Three cases had breast nodules biopsy,which showed inflammation and decrease of fat tissue,several kinds of cells infiltration and granuloma formation.Treatment with antibiotic failed while glucocorticoid and immunosuppressive agents treatment was effective.Conclusion Pancreatitis can have breast involvement,mostly in young women,with breast painful nodules in most patients early than limb subcutaneous nodules.Breast enhancement MRI scanning and nodules biopsy have important value in the diagnosis of breast panniculitis.For patients with breast nodules as the first symptom and fail to response to antibiotic treatment,clinicians need to be alert to breast panniculitis and perform pathological biopsy to reduce the chance of misdiagnosis.