J Korean Soc Radiol.  2017 May;76(5):354-357. 10.3348/jksr.2017.76.5.354.

Breast Amyloidosis in a Female Patient with Multiple Myeloma: Ultrasonographic and Mammographic Findings

• Woo AR
• Kim JM
• Nam SJ

• KMID: 2377039
• DOI: http://doi.org/10.3348/jksr.2017.76.5.354

Abstract

Amyloidosis is a rare disease characterized by pathological protein deposits in organs or tissues. Breast involvement by amyloidosis is rare. We report a female patient with amyloidosis in the breast, with underlying multiple myeloma, which presents as a focal asymmetry on a screening mammogram and a low suspicious mass lesion by ultrasonography.

MeSH Terms

Amyloidosis*
Breast*
Female*
Humans
Mammography
Mass Screening
Multiple Myeloma*
Rare Diseases
Ultrasonography

Figure

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  Fig. 1 Amyloidosis of the breast in a 56-year-old woman with multiple myeloma. A, B. Mammograms with craniocaudal (A) and mediolateral oblique (B) views show focal asymmetry (arrows) at the outer central portion of the right breast without microcalcification or masses. C. Ultrasonogram shows oval shaped, isoechoic mass with microlobulated margin and parallel orientation, which is located at the 9 o'clock position of the right breast and 5 cm away from the nipple (the largest diameter: 1.1 cm). D-F. Microscopic examination of 14-gauge core biopsy specimens of breast amyloidosis (D) shows amyloid deposition (arrow) in the periductal stroma of the breast. (H&E, × 200). Congo red stain (× 100) (E) reveals diffuse orange red coloring (arrow) consistent with a strong positive identification of amyloid. Polarizing microscopy (× 100) (F) reveals the characteristic apple-green birefringence (arrow) of amyloid.

• 

  Fig. 2 Chest CT of same patient. Contrast enhanced CT scan shows an irregular enhancing mass in the left lower lung. The lesion was diagnosed as plasma cell myeloma forming amyloid tumor by surgical wedge resection.

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