J Breast Cancer.  2007 Dec;10(4):278-281. 10.4048/jbc.2007.10.4.278.

Localized Polyarteritis Nodosa of the Breast with Mammary Duct Ectasia: A Case Report

• Hong YO
• Kang J
• Gong GY
• Suh JH
• Kim YM
• Choi HJ
• Jeong AK
• Cha HJ

• KMID: 2286598
• DOI: http://doi.org/10.4048/jbc.2007.10.4.278

Abstract

We describe here a case of localized polyarteritis nodosa that involved the unilateral breast in a 69-yr-old woman. She presented with a tender breast mass and had suffered for two months. On physical examination, an ill-defined 2 cm sized, firm mass was palpated. Ultrasonographic examination revealed a mass like lesion that contained microcalcifications. The mass was excised because of the suspicion of carcinoma. The histologic findings were vasculitis involving medium and small sized-arteries that showed marked neutrophilic and lymphocytic infiltrations with intimal fibroplasias and fragmentation of the internal elastic lamina. The patient progressed well after surgical excision. The discussion includes the importance of differential diagnosis between localized polyarteritis nodosa and other vasculitis, and review of previously reported cases of vasculitis of the breast. Only 13 cases of polyarteritis nodosa of the breast have been reported and this is the first case of polyarteritis nodosa with mammary duct ectasia.

Keyword

Polyarteritis nodosa; Breast; Vasculitis

MeSH Terms

Breast*
Diagnosis, Differential
Dilatation, Pathologic*
Female
Humans
Neutrophils
Physical Examination
Polyarteritis Nodosa*
Vasculitis

Figure

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  Fig 1 Ultrasonogram: An ill-defined heterogenous and irregular shaped mass-like lesion is present. Multifocal microcalcification is apparent (arrows).

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  Fig 2 Small to medium sized-artery show vasculitis in a background of ductal ectasia (Hematoxilin-Eosin stain, ×100).

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  Fig 3 The blood vessel wall is partly obliterated by the inflammatory cells with fibrin thrombi (Hematoxilin-Eosin stain, ×400).

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  Fig 4 Marked necrotizing vasculitis with fragmentation of internal elastic lamina and calcification are identified in the vessel wall (Elastic stain, ×400).

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