Korean J Radiol.  2009 Oct;10(5):515-518. 10.3348/kjr.2009.10.5.515.

Inflammatory Pseudotumor of the Breast: a Case Report with Imaging Findings

• Kim SJ
• Moon WK
• Kim JH
• Cho N
• Chang CM

• KMID: 1093968
• DOI: http://doi.org/10.3348/kjr.2009.10.5.515

Abstract

Inflammatory pseudotumor, also known as inflammatory myofibroblastic tumor and plasma cell granuloma, is an uncommon low-grade lesion composed of spindle cells admixed with mature plasma cells and other inflammatory cells, such as histiocytes, lymphocytes, and eosinophils. Here, we describe the mammographic and ultrasonographic findings of a case of an inflammatory pseudotumor of the breast in a 60-year-old woman. With the suspicion of malignancy, core needle biopsy and surgical excision confirmed the mass as being an inflammatory pseudotumor of the breast.

Keyword

Breast; Inflammatory pseudotumor

MeSH Terms

Biopsy
Breast Diseases/pathology/*radiography/*ultrasonography
Diagnosis, Differential
Female
Granuloma, Plasma Cell/pathology/*radiography/*ultrasonography
Humans
Mammography
Middle Aged
Ultrasonography, Mammary

Figure

• 

  Fig. 1 Inflammatory pseudotumor of breast in 60-year-old woman. A, B. Left craniocaudal (A) and mediolateral oblique (B) mammograms reveal 1.5-cm-sized ill-defined, high-density mass (arrows) in axillary tail area of left breast. C. Transverse US scan reveals irregular shaped, ill-defined homogeneous hypoechoic mass with echogenic halo in left axillary tail region. We found nodule surrounded by fat lobules and mass appearing to infiltrate around fat lobules. D. Color Doppler study reveals moderate vascularity in peripheral halo portion of mass. E. Upon gross pathology, we observed ill-defined pinkish-white mass (arrowheads) without necrosis or hemorrhage. F. For microscopic findings at high magnification, proliferating spindle cells had bland-looking nuclei and nucleoli were inconspicuous. There were occasional mitoses (up to 3 of 10 per high-power field), but atypical mitoses were not found (Hematoxylin & Eosin staining, ×200). G. Following immunohistochemical assay, spindle cells were found to be reactive for anti-SMA (smooth muscle actin), which demonstrates myofibroblastic differentiation (×200).

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