Primary breast amyloidosis presenting as microcalcifications only

Abstract

Amyloidosis is a rare disease characterized by the formation of pathological protein deposits in organs or tissues. It is typically a systemic disease which can occur in a localized form. Amyloidosis of the breast is uncommon. Common mammographic findings of breast amyloidosis are multiple nodules with or without calcifications. We report a case of primary localized breast amyloidosis presenting suspicious microcalcifications on mammography without associated masses. Mammography in a 72-year-old woman displayed multiple, linearly distributed, irregular and rod-like calcifications in the subareolar area of the left breast. The patient underwent surgical excision under mammo-guided needle localization and the pathology was confirmed to be breast amyloidosis.

Keywords: Amyloidosis; Breast; Microcalcification.

Fig. 1

Seventy two-year-old woman was diagnosed with primary breast amyloidosis presenting as only microcalcifications. Initial mammography (A) of left breast showing multiple, irregularly linear or rod-like calcifications at upper right, outer quadrant and subareolar area. Follow-up mammography after surgical excisions (B) show unchanged multiple irregular linear calcifications and post-operative architectural distortion. C. Specimen mammogram confirming presence of microcalcification. D. Photomicrograph showing calcification deposition in lobule (arrow) and multiple giant cells at periductal space (arrowhead) (Hematoxylin and Eosin stain, × 200). E. Congo-red stain showing multiple apple-green birefringence under polarized light.