Korean J Radiol.  2001 Jun;2(2):113-116. 10.3348/kjr.2001.2.2.113.

Foreign Body Granulomas of the Breast Presenting as Bilateral Spiculated Masses

• Han BK
• Choe YH
• Ko YH
• Nam SJ
• Yang JH

• KMID: 754114
• DOI: http://doi.org/10.3348/kjr.2001.2.2.113

Abstract

In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.

Keyword

Breast, abnormalities; Breast radiography

MeSH Terms

Breast Neoplasms/radiography
Case Report
Cholesterol
Diagnosis, Differential
Esthetics
Female
Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography
Human
Injections/adverse effects
Mammography
Middle Age
Paraffin

Figure

• 

  Fig. 1 61-year-old woman with foreign body granuloma of the breast. A. Bilateral mediolateral oblique mammograms show ill-defined masses with some spiculation in the central posterior portion of both breasts (arrows). B. Sonogram of the right breast shows a markedly lobulated, heterogeneously hypoechoic mass in the subareolar portion (large arrows) and extending into the pectoralis muscle (small arrows). A sonogram of the left breast revealed similar features (not shown) (M: retroglandular portion of the mass; P: pectoralis muscle; RF: retromammary fat). C. Axial, fat-saturated, T2-weighted fast spin-echo images (TR/TE, 4383/102, upper), two-dimensional spoiled gradient-echo images before (76/3.3, middle) and 1 min aftar gadolinium enhancement (lower) show bilateral, spiculated, low-signal intensity masses with early enhancement (arrows) in the posterior central portion of the breasts (arrows). D. Sagittal T1-weighted images with fat saturation 8 mins after gadolinium enhancement (550/10) show spiculated masses in both breasts (large arrows) extending into the pectoralis muscle (small arrows). Note the delayed peripheral enhancement of the masses. E. Photomicrograph of histologic specimen shows cholesterol clefts, seen as needle-like empty spaces (large arrows), secretory materials in luminal structures (small arrows) and perivascular fibrosis (arrowheads) (H and E, ×100).

• 

  Fig. 2 64-year-old woman with foreign body granuloma of the breast. A, B. Bilateral mediolateral oblique (A) and craniocaudal (B) mammograms show high-density spiculated masses in the posterior portion of each breast. Microcalcifications are seen within the masses (arrows). C. Sonogram of the left breast reveals an ovoid hypoechoic mass with suspicious fine spiculation at its posterior portion (RF: retromammary fat).

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