Rare Initial Manifestation of Lupus as Lobular Panniculitis of the Breast-A Case Report and Review of the Literature.

The American Journal of Dermatopathology
Anurag SharmaMiglena K Komforti

Abstract

Lupus mastitis is a rare complication of systemic or discoid lupus erythematosus with an uncommon initial presentation when limited to the breast. In this article, we report a 42-year-old woman who presented with constant pain and tenderness in her breasts. Ultrasound imaging of the left breast revealed a 14-mm oval mass, suspicious for malignancy; a needle core biopsy was performed. Sections showed necrosis of the fat lobules with associated mixed nodular lymphoplasmacytic aggregates. Karyorrhectic debris, fibrinoid necrosis of small vessels, and microcalcifications were all present while the background breast parenchyma was unremarkable. The diagnosis of lupus mastitis was rendered. Subsequent serology showed negative dsDNA but positive antinuclear antibodies, C4, and anti -Sjögren';s-syndrome-related antigen A antibodies. Clinical features of active systemic disease were not identified at the patient's follow-up dermatology appointment 1 month after the biopsy, and she elected management for her nodules with steroids. To the best of our knowledge, only 40 other cases of lupus mastitis have been reported in the English literature, of which 25 presented as a mass and only in 6 lupus mastitis of the breast was the initial prese...Continue Reading

References

Feb 27, 2007·The Breast Journal·Sancar BayarMurat Turgay
Dec 23, 2008·Advances in Anatomic Pathology·Thomas A SummersMichael C Royer
Apr 23, 2010·The American Journal of Surgical Pathology·Christopher KinonenVijaya B Reddy
Nov 30, 2012·Annals of Diagnostic Pathology·Marilin Rosa, Amir Mohammadi
Jun 19, 2017·European Journal of Radiology·Béatrice VoizardIsabelle Trop
Nov 30, 2018·Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry·Abdel Masieh MetrySuad Hannawi
Sep 21, 2019·The Breast Journal·Yumiko TanakaYoshihumi Komoike
Apr 3, 2020·Journal of Clinical Medicine·Radjiv GoulabchandPhilippe Guilpain

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