Breast involvement in mixed connective tissue disease

Area of Science:

• Rheumatology
• Radiology
• Pathology

Background:

• Mixed connective tissue disease (MCTD) is a rare autoimmune disorder.
• Mammographic manifestations in MCTD have not been previously documented.
• Panniculitis has been reported in only two prior MCTD cases.

Observation:

• A patient with MCTD exhibited bilateral coarse sheet-like calcifications on mammography.
• These calcifications progressed over time, correlating with elevated anti-double-stranded DNA (anti-dsDNA) antibody levels.
• Histopathological analysis revealed fat necrosis, chronic inflammation, fibrosis, vasculitis, and T and B cell infiltration.

Findings:

• The mammographic and histological findings were consistent with "lupus mastitis."
• This case suggests a potential link between MCTD and specific mammographic changes.
• The observed changes correlated with disease activity markers.

Implications:

• This report expands the understanding of potential extraskeletal manifestations of MCTD.
• It highlights the importance of considering MCTD in differential diagnoses for patients presenting with similar mammographic findings.
• Further research is warranted to explore the prevalence and significance of these mammographic changes in MCTD patients.