Sclerosing lobular hyperplasia: sonographic pathologic correlation

The objective was to evaluate the sonographic findings of sclerosing lobular hyperplasia (SLH) of the breast and to correlate the sonographic findings and the pathologic features. This study consisted of 9 patients with pathologically proven sclerosing lobular hyperplasia who had undergone a preoperative imaging study. We retrospectively reviewed 9 ultrasonograms and 6 mammograms. In each patient mammographic findings including, shape and margin, and ultrasonographic findings including the size, length-to-anteroposterior ratio, shape, margin, internal echo pattern, and the presence and location of internal echogenic septum, were evaluated. Histopathologic correlations focused on characteristic imaging findings. Of the 6 mammograms, 4 cases showed a lobular (3 of 6) or an oval shaped mass (1 of 6) with a partly obscured margin (4 of 6). The remaining 2 cases showed heterogeneously dense breast without visible mass. Ultrasonograms showed a lobular (5 of 9) or an oval (4 of 9) shaped mass with a circumscribed margin (9 of 9). The mean length/anteroposterior ratio was 1.98. Intratumoral echogenic septum was present in 8 cases. Six cases had a peripherally arising septum. Histopathologic review revealed that this septum was correlated to interlobular sclerosis. A peripherally arising intratumoral echogenic septum on ultrasonography seen in SLH might be explained by the interlobular sclerosis.