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. 2013:2013:190856.
doi: 10.1155/2013/190856. Epub 2013 Feb 4.

Amyloidosis of the Breast with Multicentric DCIS and Pleomorphic Invasive Lobular Carcinoma in a Patient with Underlying Extranodal Castleman's Disease

David Chiang  1 , Michael Lee, Pauline Germaine, Lydia Liao
Affiliations

Amyloidosis of the Breast with Multicentric DCIS and Pleomorphic Invasive Lobular Carcinoma in a Patient with Underlying Extranodal Castleman's Disease

David Chiang et al. Case Rep Radiol. 2013.

Abstract

We present an interesting case of focal amyloidosis of the left breast which was intermixed with ductal carcinoma in situ (DCIS). On subsequent staging bilateral breast magnetic resonance imaging (MRI), the patient was found to have an additional suspicious enhancing mass with spiculated borders within the left breast. This mass was biopsy proven to represent pleomorphic invasive lobular carcinoma. A pulmonary nodule within the lingula was also noted on the staging bilateral breast MRI and was biopsy proven to represent extranodal Castleman's disease. Therefore, it is believed that our patient had secondary amyloidosis due to Castleman's disease.

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Figures

Figure 1
Figure 1
Craniocaudal (CC) and mediolateral oblique (MLO) projections of the left breast demonstrate suspicious pleomorphic calcifications in a segmental distribution within the superior-medial quadrant, spanning approximately 2.3 cm. These calcifications were biopsy proven to represent amyloidosis and DCIS.
Figure 2
Figure 2
Subtraction MRI demonstrates a 0.9 cm enhancing mass with spiculated borders within the posterior left breast with no involvement of the left chest wall. This posterior mass was not appreciated on mammography. Under MRI guidance, this mass was biopsy proven to represent invasive pleomorphic lobular carcinoma.
Figure 3
Figure 3
Subtraction MRI demonstrates a 2.1 cm × 1.2 cm enhancing mass within the lingula, biopsy proven to represent extranodal Castleman's disease. Incidental note is made of a postbiopsy hematoma/seroma within the medial left breast from stereotactic biopsy of the pleomorphic calcifications demonstrated in Figures 1(a) and 1(b).
See this image and copyright information in PMC

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