International Journal of Clinical Case Reports 2017, Vol.7, No.18, 81-85
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Demott met the same difficulties; in fact, out of a total of nine cytological punctures, seven are acellular and the
other two cases are very poor in cells to allow interpretation.
In the rare cases where the cytological puncture contains cellular material there is often an abundant fibrous tissue
hyalinized. This fibrous tissue is about ten times more abundant than in normal epithelial tissue. Cytological
puncture in our case was very poor in cells and considered uninterpretable.
The biopsy is the unavoidable examination that allows the diagnosis.
The histological study highlights three kinds of elementary, non-specific, variously associated lesions:
Lymphocyte lobulitis: mononuclear inflammatory infiltrate, more or less dense, associating small
lymphocytes especially B, plasma cells and histiocytes. She sits primarily in the breast lobules but also and
less marked in perivascular and sometimes in peri-canalar;
A fibrosis of the pallial tissue, always found, is homogeneous and dense;
Inconsistently, stromal epithelioid cells homogeneously distributed.
Immunohistochemistry has no diagnostic indication. It can be useful in differential diagnosis with:
Invasive lobular carcinoma (anti-keratin antibodies) in cases where epithelioid cells are particularly many
(Boutéet al., 2003; Murakami et al., 2009);
Low-grade non-Hodgkin's lymphoma when lymphoid infiltrate appears suspect (Hadj et al., 2002);
After surgery excision, evolution is marked by a high rate of recurrence of lesions ranging from 20% according to
Hunfeld and Bassler (1997) to 100% according to Lammie (2003). Our patient presented rapid recurrence after
four months of the procedure. A new tumor excision is practiced.
By the way, when the diagnosis is made by microbiopsy, radical surgery is not necessary. A Simple monitoring is
recommended, it includes an annual clinical examination and a mammogram both years, it is possible that the
(DM) affects a healing process (Murakami et al., 2009).
No direct relationship between (DM) and breast cancer has been reported in the literature and the risk of
developing breast cancer later joined that of the general population (Hadj et al., 2002; Boutéet al., 2003).
3 Conclusions
Diabetic mastopathy is a rare condition that is benign mainly occurring in young patients with type I diabetes,
having multiple degenerative complications. She simulates clinically breast cancer. Mammography is informative
and the diagnosis of certainty is based on histological examination. Its evolution is dominated by risk of
recurrence. After exclusion of a neoplastic pathology by microbiopsy, its management is limited toa simple
surveillance.
Authors’ contributions
R.H: editing and supervision, read and approved the final manuscript; A.A: participated in the drafting of the discussion, read and
approved the final manuscript; D.A: participated in the drafting of the observation, read and approved the final manuscript.
All
authors read and approved the final manuscript.
Acknowledgments
We thank the anatomopathology department of Ibn El Jazzar Hospital, Kairouan.
References
Andrews-Tang D., Diamond A.B., Rogers L., and Butler D., 2000, Diabetic mastopathy: adjunctive use of ultrasound and utility of core biopsy in diagnosis,
Breast J, 6:183-188
PMid:11348362
BoutéV., Denoux Y., Feilel V., Lemery S., Lacroix J., Peffault De Latour M. et al., 2003, La mastopathie diabétique: complication peu commune du diabète de
type I. J Le Sein, 13:261-269
