Red nodule on the breast.

Area of Science:

• Medical Case Study
• Infectious Diseases
• Dermatology

Background:

• Borrelial lymphocytoma, a manifestation of Lyme borreliosis, can present atypically.
• Clinical diagnosis is challenging without classic signs like lymphadenopathy or erythema migrans.
• Rural residency and nodular breast lesions warrant consideration of tick-borne illnesses.

Purpose of the Study:

• To report a case of borrelial lymphocytoma presenting as a breast nodule.
• To emphasize the diagnostic challenges and importance of Lyme borreliosis investigation in specific patient populations.

Main Methods:

• Clinical presentation analysis of a 63-year-old woman with a breast nodule.
• Histological examination and immunohistochemical analyses.
• Serological evaluation using ELISA and Western blot.

Main Results:

• A diagnosis of borrelial lymphocytoma was confirmed through integrated clinical, histological, and serological findings.
• The absence of typical Lyme disease indicators (tick bite, erythema migrans) complicated initial diagnosis.
• Specific factors including rural residence and nodule presentation in September aided diagnosis.

Conclusions:

• Lyme borreliosis should be investigated in rural patients presenting with unexplained breast nodules, particularly the nipple-areola region.
• Integrated diagnostic approaches combining clinical, histological, and serological data are crucial for atypical presentations.
• This case underscores the need for heightened awareness of tick-borne diseases in endemic areas.