PMC6884983_01
A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (a) Spot compression-magnification craniocaudal view of the left breast demonstrates a small circumscribed oval mass in the upper outer quadrant of the left breast. The mass contains multiple small l dystrophic calcifications. (b) Spot compression-magnification mediolateral oblique view of the left breast demonstrates a small circumscribed oval mass in the upper outer quadrant of the left breast. The mass contains multiple small dystrophic calcifications. (c) Digitally magnified mediolateral oblique view of the left breast focusing on the lesion, better demonstrating the oval shape, circumscribed margins and multiple small dystrophic calcifications (white arrow).
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F1
Diagnostic mammography demonstrates an oval-shaped, circumscribed mass in the upper outer left breast, with smooth borders, and multiple pleomorphic calcifications [Figure 1].
A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (a) A color doppler ultrasound image of the lesion shows internal vascularity. (b) A grayscale ultrasound image pre-biopsy better demonstrating the small hyperechoic foci of calcifications (white arrow) observed on the mammogram.
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F2
Gray-scale ultrasound examination revealed a 1.0 cm x 0.8 cm x 0.6 cm superficial isoechoic circumscribed oval mass, parallel to the skin and chest wall, with internal vascularity, and multiple hyperechoic foci corresponding to the calcifications seen on mammogram [Figure 2].
A 36-year-old HIV positive male presented with a painless hard palpable "pea-size" lump in the left breast, upper outer quadrant, present for many years, increased in size over the most recent 6 months. (a) Low power core biopsy specimen of a predominantly keratinizing neoplasm. (Hemotoxylin and eosin, 20 ). (b) Eosinophilic keratin debris with the characteristic finding of "ghosted" nuclei (orange arrow) that is diagnostic and classically seen in pilomatrixoma. (Hematoxylin and eosin, 100 ). (c) Basaloid cells with abrupt trichilemmal keratinization towards the center forming the characteristic "ghost cells." (Hematoxylin and eosin, 100 ).
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F3
Pathologic diagnosis revealed a pilomatrixoma [Figure 3].