Waqar S N, Khan H, Mekan S F, Kayani N.
Cystic Breast Lymphangioma.
J Pak Med Assoc Jan ;54(10):531-3.
A 24-year-old lactating woman presented with a 1 month history of high grade fever, chills and rigors along with painful enlargement of a pre-existing right breast lump. The lump had been present since birth and had gradually enlarged over time. On examination, the right breast and axillary tail were diffusely enlarged. On palpation the mass was firm, nodular and mobile with respect to underlying tissues but attached to overlying skin which was edematous (peau d` orange) with prominent veins. On the under surface of the breast were grouped thick-walled vesicles, not conforming to any dermatomal distribution. Some of these vesicles contained brownish hemorrhagic fluid. Preliminary diagnosis of a congenital breast mass with superimposed acute mastitis was made. Ultrasound of the right breast showed heterogenous echotexture, with irregular, multiple cystic areas and increased soft tissue vascularity. No abscess collection was seen. MRI further revealed a mixed solid and cystic lesion infiltrating the breast parenchyma. Incisional biopsy revealed cystic lesions, lined by flat endothelium, with lymphocytes in the interstitium, consistent with the diagnosis of lymphangioma.
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