Ultrasonographic manifestations and pathologic study of fat necrosis of the breast
FENG Jian, LI Quan-shui, ZHANG Jia-ting, TIAN Ping, ZHANG Chan, ZHU Guo-xian, HE Jin-song
Department of Ultrasonography, the Second People’s Hospital of Shenzhen, Affiliated Shenzhen Hospital, Southern Medical University, Shenzhen Guangdong 518035, China
Abstract：Objective: To discuss mammographic findings and pathologic basis of fat necrosis of the breast. Methods: The ultrasonographic findings in 33 cases with pathologically proved breast fat necrosis were analyzed retrospectively, of which 4 cases were bilateral breast fat necrosis, and a comparison with pathological results was made． Results: The sonographic findings included: isoechoic masses(n=5, 13.5％), hypoechoic masses(n=16, 43.2％), anechoic nodules(n=10, 27．0％), complex with mural nodules(n=6, 16.2％). Doppler sonography did not show vascularity in all lesions, some demonstrated sonographic ill-defined margins and calcification. Posterior acoustic shadowing and posterior acoustic enhancement could also be found in hypoechoic masses and anechoic nodules. Seven lesions lying in subcutaneous fatty tissues of breast, and 30 lesions located in the breast parenchyma. The pathologic interpretations: ①There is local adipose cell destruction and the development of vacuoles filled with necrotic lipid material, which surrounded by phagocytic lipid-laden histiocytes(“foam cells”), with an accumulation of multinucleared giant cells at the edges of the lesion and accompanied by an inflammatory cell infiltrate; ②Fibroblasts proliferate at the periphery of the lesion, surrounding areas of necrotic fat and cellular debris, calcifications may appear; ③Fibrosis may replace the areas of necrotic fat and debris or leave persistent cavities. Loculated and degenerated fat may persist within a fibrotic scar. These histopathologic appearances also can occur simultaneously with various degrees of intensity. The imaging features of fat necrosis of the breast reflect the intensity of each of these histological events at the time of the imaging study. Conclusion: Sonography is very helpful for making the diagnosis of breast fat necrosis．
2008, Vol. 19 
