A 50-year-old woman has a painless 1.5 cm breast lump two months after seatbelt injury to the chest. Mammography shows pleomorphic microcalcifications suspicious for malignancy. Biopsy shows anucleate ghost adipocytes, foamy histiocytes, foreign body giant cells and cholesterol clefts. What is the correct interpretation?
- A Inflammatory carcinoma requiring immediate chemotherapy
- B Fat necrosis, a benign lesion that can mimic carcinoma radiologically ✓
- C Liposarcoma of the breast
- D Granular cell tumor
Correct answer: B. Fat necrosis, a benign lesion that can mimic carcinoma radiologically
Explanation
Fat necrosis follows trauma, surgery or radiation and presents as a painless mass whose dystrophic calcifications mimic malignancy on mammography. Histology shows necrotic adipocytes without nuclei, lipid-laden foamy macrophages, multinucleated giant cells and cholesterol clefts. Liposarcoma is excluded because the atypical lipoblasts and sarcomatous stroma expected there are absent, and the lesion is entirely reactive.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.