J Rheum Dis.  2014 Aug;21(4):219-222. 10.4078/jrd.2014.21.4.219.

A Case of Antineutrophil Cytoplasmic Antibody-negative Granulomatosis with Polyangiitis Presenting as Breast Mass

• Kim MG
• Huh JH
• Cheon YH
• Cho SY
• Ko GH
• Kim HO
• Kim JE
• Choi HY
• Lee SI

• KMID: 2222966
• DOI: http://doi.org/10.4078/jrd.2014.21.4.219

Abstract

Granulomatosis with polyangiitis (GPA) is a disease characterized by a granulomatous necrotizing vasculitis of the small vessels, along with the presence of antineutrophil cytoplasmic antibody (ANCA), serologically. GPA is a multisystem disease, in which the diagnosis is frequently based on respiratory and renal manifestations, with rare breast invasion. To date, several cases of breast invasion by GPA have been published, and most cases have been positive for ANCA. However, ANCA-negative forms of breast invasion by GPA are extremely rare and have not been reported in Korea thus far. Therefore, we report a case of ANCA-negative GPA in a 70-year-old woman, who was initially presented with a localized palpable mass in the left breast.

Keyword

Granulomatosis with polyangiitis; Antibodies; Antineutrophil cytoplasmic; Breast

MeSH Terms

Aged
Antibodies
Antibodies, Antineutrophil Cytoplasmic
Breast*
Cytoplasm*
Diagnosis
Female
Humans
Korea
Vasculitis
Antibodies
Antibodies, Antineutrophil Cytoplasmic

Figure

• 

  Figure 1. (A) Breast ultrasonography shows the lesion which is the prominent superficial vessels with diffuse wall thickening (arrows) and increased echogenicity of subcutaneous fat, surrounding them (arrow heads). (B) Follow-up breast ultrasonography after treatment shows the lesion is replaced by normal vessel conditions and does not obtain increased echogenicity of subcutaneous fat anymore.

• 

  Figure 2. Histopathologic specimen of the breast demonstrates granulomatous inflammation in the small artery, media (arrow) and fibrinoid necrosis with neutrophilic infiltration in small artery, intima (arrow heads) (Hematoxylin and eosin, original magnification ×200).

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