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Delayed involution of lactation presenting as a non-resolving breast mass: a case report.

Kumar Y, Chahal A, Garg M, Bhatia A, Mahajan NC, Ganju A - J Med Case Rep (2008)

Bottom Line: Histopathology, however, revealed involuting lactational changes.To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature.The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Maharshi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala Haryana, India. ykabh@hotmail.com

ABSTRACT

Introduction: Involution of lactation is a physiological process. Rarely, it may be delayed and troublesome for the lactating woman. Though lactation-induced changes in breast are well known, morphological features of delayed involution are not clear.

Case presentation: We report a case of a 22-year-old lactating mother who presented with a painful, non-resolving breast mass 5 months after delivery. Clinically, it simulated an inflammatory carcinoma. Histopathology, however, revealed involuting lactational changes.

Conclusion: To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature. The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.

No MeSH data available.


Related in: MedlinePlus

Haematoxylin and eosin stained sections showing: (A) Sheets of macrophages infiltrating the lobules and extending into the adjacent stroma. (B) High power view depicting macrophages destroying one of the breast lobules. Only a few acini are preserved. (C) Lymphocytic aggregate within the lobule.
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Figure 3: Haematoxylin and eosin stained sections showing: (A) Sheets of macrophages infiltrating the lobules and extending into the adjacent stroma. (B) High power view depicting macrophages destroying one of the breast lobules. Only a few acini are preserved. (C) Lymphocytic aggregate within the lobule.

Mentions: Microscopic examination revealed two types of lobules separated by an extensively hyalinized stroma (Figure 2A). Some of these lobules showed classical lactational changes comprising many hyperplastic and dilated acini filled up with pink, eosinophilic secretions. These acini were lined with round to oval cells with fine chromatin and conspicuous nucleoli. Many of these cells had granular eosinophilic cytoplasm. Others had abundant, clear vacuolated cytoplasm with the nucleus pushed to the periphery (Figure 2B). The ducts were also dilated and filled up with milk (Figure 2C). The second type of lobules depicted ongoing involutional changes in the form of sheets of macrophages replacing and destroying the acini (Figure 3A and 3B). In places, the phagocytic cells showed prominent admixture with lymphocytes some of which were also found infiltrating into the acinar epithelium. A few lymphoid aggregates were also noted around the individual ducts and acini (Figure 3C). Based on all these findings, a diagnosis of lactating breast with delayed involution was offered.


Delayed involution of lactation presenting as a non-resolving breast mass: a case report.

Kumar Y, Chahal A, Garg M, Bhatia A, Mahajan NC, Ganju A - J Med Case Rep (2008)

Haematoxylin and eosin stained sections showing: (A) Sheets of macrophages infiltrating the lobules and extending into the adjacent stroma. (B) High power view depicting macrophages destroying one of the breast lobules. Only a few acini are preserved. (C) Lymphocytic aggregate within the lobule.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2572069&req=5

Figure 3: Haematoxylin and eosin stained sections showing: (A) Sheets of macrophages infiltrating the lobules and extending into the adjacent stroma. (B) High power view depicting macrophages destroying one of the breast lobules. Only a few acini are preserved. (C) Lymphocytic aggregate within the lobule.
Mentions: Microscopic examination revealed two types of lobules separated by an extensively hyalinized stroma (Figure 2A). Some of these lobules showed classical lactational changes comprising many hyperplastic and dilated acini filled up with pink, eosinophilic secretions. These acini were lined with round to oval cells with fine chromatin and conspicuous nucleoli. Many of these cells had granular eosinophilic cytoplasm. Others had abundant, clear vacuolated cytoplasm with the nucleus pushed to the periphery (Figure 2B). The ducts were also dilated and filled up with milk (Figure 2C). The second type of lobules depicted ongoing involutional changes in the form of sheets of macrophages replacing and destroying the acini (Figure 3A and 3B). In places, the phagocytic cells showed prominent admixture with lymphocytes some of which were also found infiltrating into the acinar epithelium. A few lymphoid aggregates were also noted around the individual ducts and acini (Figure 3C). Based on all these findings, a diagnosis of lactating breast with delayed involution was offered.

Bottom Line: Histopathology, however, revealed involuting lactational changes.To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature.The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Maharshi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala Haryana, India. ykabh@hotmail.com

ABSTRACT

Introduction: Involution of lactation is a physiological process. Rarely, it may be delayed and troublesome for the lactating woman. Though lactation-induced changes in breast are well known, morphological features of delayed involution are not clear.

Case presentation: We report a case of a 22-year-old lactating mother who presented with a painful, non-resolving breast mass 5 months after delivery. Clinically, it simulated an inflammatory carcinoma. Histopathology, however, revealed involuting lactational changes.

Conclusion: To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature. The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.

No MeSH data available.


Related in: MedlinePlus