Vitkovski Taisia, Marder Galina S, Filardi Dominic A, Gupta Ekta, Breuer Frank
1 Department of Pathology and Laboratory Medicine, Hofstra Northwell Health, New Hyde Park, NY, USA.
2 Department of Internal Medicine Division of Rheumatology, Hofstra Northwell Health, New Hyde Park, NY, USA.
Int J Surg Pathol. 2017 Dec;25(8):711-715. doi: 10.1177/1066896917714324. Epub 2017 Jun 14.
IgG4-related sclerosing disease of the breast is a rare entity with 10 reports in the literature. We report the first case in a male patient. A 48-year-old male presented with 4-week history of palpable right upper outer quadrant breast mass associated with skin puckering. He reported a family history of breast cancer in his aunt. Ultrasound and mammography showed a spiculated 2.5-cm mass associated with skin retraction with extension to the pectoralis muscle. Ultrasound-guided core biopsy was performed. The findings were interpreted as acute and chronic inflammatory process. The patient subsequently denied improvement of the mass, and an excisional biopsy was performed. Histologic examination showed fibrosis and dense lymphoplasmacytic inflammation in the breast mass and muscle biopsy. Focal obliterative phlebitis was noted. IgG4-positive plasma cells were increased with counts of over 50 per high-power field. The diagnosis was confirmed as sclerosing IgG4-related disease of breast.
IgG4相关性乳腺硬化性疾病是一种罕见疾病，文献中仅有10例报道。我们报告了首例男性患者病例。一名48岁男性，右乳外上象限可触及肿块，伴有皮肤皱缩，病程4周。他报告其姑姑有乳腺癌家族史。超声和乳腺钼靶检查显示一个2.5厘米的毛刺状肿块，伴有皮肤回缩，并延伸至胸大肌。进行了超声引导下的粗针活检。检查结果被解释为急性和慢性炎症过程。该患者随后否认肿块有所改善，遂进行了切除活检。组织学检查显示乳腺肿块和肌肉活检中有纤维化和密集的淋巴浆细胞炎症。可见局灶性闭塞性静脉炎。IgG4阳性浆细胞增多，每高倍视野计数超过50个。诊断为IgG4相关性乳腺硬化性疾病。
