Sarcoidosis may involve the female breast and may mimic breast carcinoma.


Clinical features:

(1) The condition occurs in adult women.

(2) The patient may have other manifestations of sarcoidosis at the time of presentation.

(3) The condition may present as a primary breast mass (measuring up to 5 cm in diameter) with or without regional lymphadenopathy, suggesting primary breast carcinoma. Rarely the woman may have bilateral breast disease.

(4) The breast mass is firm to hard and typically lacks calcifications. It may or may not be tender.

(5) Serum angiotensin converting enzyme (ACE) is often elevated.


Histologic features:

(1) noncaseating granulomas

(2) negative workup for other conditions (sarcoidosis may co-exist with breast cancer, and noncaseating granulomas may be found in lymph nodes draining a breast tumor)


Differential diagnosis:

(1) tuberculosis, deep fungal or bacterial infection

(2) foreign body reaction (may show polarizable material)

(3) rheumatoid nodules

(4) granulomatous lobular mastitis

(5) breast carcinoma


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