PMC2718101_01
61-year-old woman with foreign body granuloma of the breast.. A. Bilateral mediolateral oblique mammograms show ill-defined masses with some spiculation in the central posterior portion of both breasts (arrows).. B. Sonogram of the right breast shows a markedly lobulated, heterogeneously hypoechoic mass in the subareolar portion (large arrows) and extending into the pectoralis muscle (small arrows). A sonogram of the left breast revealed similar features (not shown) (M: retroglandular portion of the mass; P: pectoralis muscle; RF: retromammary fat).. C. Axial, fat-saturated, T2-weighted fast spin-echo images (TR/TE, 4383/102, upper), two-dimensional spoiled gradient-echo images before (76/3.3, middle) and 1 min aftar gadolinium enhancement (lower) show bilateral, spiculated, low-signal intensity masses with early enhancement (arrows) in the posterior central portion of the breasts (arrows).. D. Sagittal T1-weighted images with fat saturation 8 mins after gadolinium enhancement (550/10) show spiculated masses in both breasts (large arrows) extending into the pectoralis muscle (small arrows). Note the delayed peripheral enhancement of the masses.. E. Photomicrograph of histologic specimen shows cholesterol clefts, seen as needle-like empty spaces (large arrows), secretory materials in luminal structures (small arrows) and perivascular fibrosis (arrowheads) (H and E, x100).
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F1
Mammography demonstrated that in the central posterior portion, bilateral ill-defined masses were present (Fig. 1A), and sonography revealed that in both subareolar portions, 2-cm masses, each showing posterior shadowing and heterogeneous echogenicity, extended into the pectoralis muscle (Fig. 1B). Fat-suppressed T2- and T1-weighted spin-echo images demonstrated low signal intensity, and 1 min after the administration of gadolinium-DTPA (0.1 mmol/kg body weight; Schering, Berlin, Germany), diffuse enhancement was noted (Fig. 1C). Eight minutes after contrast enhancement, a peripherally enhanced mass extending into the pectoralis muscle was noted in both breasts (Fig. 1D). Pathologically, the mass was found to consist primarily of granulomatous tissue containing cholesterol clefts and collagen (Fig. 1E), and the final pathologic diagnosis was foreign body granuloma.
PMC2718101_02
64-year-old woman with foreign body granuloma of the breast.. A, B. Bilateral mediolateral oblique (A) and craniocaudal (B) mammograms show high-density spiculated masses in the posterior portion of each breast. Microcalcifications are seen within the masses (arrows).. C. Sonogram of the left breast reveals an ovoid hypoechoic mass with suspicious fine spiculation at its posterior portion (RF: retromammary fat).
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F2
Mammography, however, demonstrated the bilateral presence of spiculated masses with microcalcifications at the left upper central and right upper inner quadrant (Figs. 2A, B). The masses were located in the posterior portion of the breasts near the pectoralis muscle, and sonography revealed that both were hypoechoic and posterior shadowing (Fig. 2C).