title: Xanthogranulomatous reaction to a ruptured galactocele.
abstract: We describe a case of a 34-year-old, healthy, lactating female with a 2-month history of breast pain and an enlarging, tender mass on her right nipple. Her right breast was firm and mildly engorged without mass, warmth or erythema. A tender, yellow nodule was located on the superior aspect of the nipple, obstructing the flow of milk from this portion of the nipple. A biopsy showed epidermal erosion, sheets of cells with massively distended, foamy cytoplasm in the dermis, and a hypertrophied and occluded glandular duct, consistent with reactive squamous metaplasia. Immunostaining for CD68 confirmed the foamy cells were macrophages, and anti-human milk fat globulin-1 (HMFG1) labeled the substance within the macrophages consistent with human breast milk. Therefore, the lesion could be identified as a xanthogranulomatous reaction to a ruptured galactocele.
authors.affiliation: Department of Dermatology, National Naval Medical Center, Uniformed Services University of the Health Sciences and National Naval Medical Center, Bethesda, MD 20889, USA. erin.adams@med.navy.mil
authors.forename: Erin G
authors.initials: EG
authors.lastname: Adams
authors.forename: Jean D
authors.initials: JD
authors.lastname: Kemp
authors.forename: Katherine Z
authors.initials: KZ
authors.lastname: Holcomb
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Sperling
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D047688:Breast Cyst / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D001942:Breast Feeding; D005260:Female; D006099:Granuloma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007775:Lactation Disorders / Q000378:metabolism / Q000473:pathology*; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D012422:Rupture, Spontaneous; D014973:Xanthomatosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; C469215:pemtumomab