Sclerosing Lymphocytic Lobulitis / Diabetic Mastopathy
Key points
- Sclerosing lymphocytic lobulitis may occur in patients with insulin-dependent diabetes mellitus.
- Patients classically present with a firm to hard, irregular, palpable, breast mass that can be difficult to differentiate from carcinoma.
- Mammography There are a variety of nonspecific appearances, varying from asymmetrical densities to ill-defined mass lesions and distortion.
- Macroscopic Appearance The lesions are ill-defined, firm, rubbery, gray-white masses.
Sclerosing lymphocytic lobulitis may occur in patients with insulin-dependent diabetes mellitus.
Clinical Features
Patients classically present with a firm to hard, irregular, palpable, breast mass that can be difficult to differentiate from carcinoma.
Radiology
Radiologic features may mimic malignancy.
Mammography
There are a variety of nonspecific appearances, varying from asymmetrical densities to ill-defined mass lesions and distortion.
Ultrasound
Ultrasound reveals areas of distortion with acoustic shadowing.
Pathology
Macroscopic Appearance
The lesions are ill-defined, firm, rubbery, gray-white masses.
Microscopic Appearance
The lesions are characterized by fibrosis and varying degrees of lobulocentric and perivascular lymphoid infiltrates. There is concomitant lobular atrophy of varying degree. In earlier lesions the inflammation is prominent and predominantly lobulocentric, whereas in more long-standing cases there is dense fibrosis, marked lobular atrophy and focal small-lymphoid infiltrates, which are perivascular in location.
Management
If an unequivocal histologic diagnosis has been obtained on core biopsy no further treatment is required.
A.D. Purushotham, P. Britton and L. Bobrow
A prospective study of benign breast disease and the risk of breast cancer. JAMA 2002
Written and revised by
David Cohen, M.D.
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