Localized Breast Amyloidosis

Abstract

Localized amyloidosis in the breast is a very rare disease and may mimic malignant lesions. A 60-year-old woman who had a history of breast-conserving surgery presents with a new a well-defined oval opacity accompanied by many round tight clustered micro- and macrocalcifications on mammograms. It could not be visualized sonographically due to the intense posterior acoustic shadowing of the fat necrosis areas and contrast enhancement was not detected in this area on the dynamic contrast enhanced magnetic resonance images. At pathological examination breast amyloidosis was detected. Amyloidosis of the breast is a rare disease, but it can mimic malignancy and should be included in the differential diagnosis.

Keywords: Amyloidosis; breast carcinoma; localized amyloidosis.

Figure 1. a, b

Mammogram of the left breast on CC projection reveals the oval opacity belongs to the amyloid accumulation (white arrow) accompanied by micro- and macro-calcifications (a). The mammogram obtained during the wire localization is demonstrated (b)

Figure 2. a–d

The lesion is observed as isointense both in axial fat suppressed T1 weighted (black arrow) (a) and T2 weighted (white arrow) images (b). No contrast enhancement was observed in post-contrast fat suppressed T1-weighted (c) and subtracted images (d) obtained 60 second after intravenous gadolinium injection

Figure 3. a, b

Amorphous eosinophilic amyloid deposition on terminal ductal lobular unit walls (a) and in the breast stroma (b) (H&E x200)

Figure 4

Amyloid deposition on terminal ductal lobular unit walls (H&E, x400) (a) and Congo-red stained amyloid deposits in breast parenchyma (Congo-red x200)