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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 1701909010.5144/0256-4947.2006.403asm-5-403What's Your Diagnosis?A 52-year-old woman with a subcutaneous, slightly movable and painless nodule in the left breast Bezić Joško *Vrbičić Branka †Guberina Paško ‡Alfier Vinko §Projić Petar *Marović Zlatko ||
* Department of Pathology, Clinical Hospital Split, Croatia
† Department of Pathology, Regional Hospital Šibenik, Croatia
‡ Department of Radiology, Regional Hospital Šibenik, Croatia
§ Department of Surgery, Regional Hospital Šibenik, Croatia
|| Medical School, University of Split, CroatiaCorrespondence and reprint requests: Joško Bezić, MD, Institute of Pathology, Cytology and Forensic Medicine, Clinical Hospital Split, Spinčićeva 1; 21 000, Split, Croatia, jb@mefst.hrSep-Oct 2006 26 5 403 404 Copyright © 2006, Annals of Saudi Medicine2006This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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A 52-year-old woman from Šibenik, Southern Croatia, presented in March 2004 to her clinician with the subcutaneous, slightly movable and painless nodule in the left breast, noticed one month before. The rest of clinical examination was normal and laboratory findings were within normal limits without eosinophilia. She had not travelled abroad in recent years.

Left breast mammography was normal while an ultrasonographic examination showed an oval, well circumscribed hypoechogenic structure measuring 16×4 mm, located in subcutaneous tissue (Figure 1). The initial diagnosis was inflamed atheroma, and surgical excision of the nodule was performed. On gross examination the specimen was a nodular subcutaneous mass of 1.6 cm in greatest diameter, with a soft yellow-white cut surface. The histological slides were stained with haematoxylin and eosin. Histologically, the nodule was composed of a suppurative centre with a few transverse sections of structure surrounded by a granulomatous inflammatory infiltrate composed of histiocytes admixed with polymorphous leucocytes and lymphocytes (Figures 2, 3).

What is the structure seen in the histological slides?

What is the diagnosis?

Answers on page 414.

Figure 1 Ultrasonographic picture of the well-circumscribed, hypoechogenic subcutaneous breast structure.

Figure 2 Transverse section of the subcutaneous structure, surrounded by a granulomatous inflammatory reaction (H&E section, × 40).

Figure 3 Transverse section of the subcutaneous structure (H&E section, × 200).