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A rare and unusual cause of mammographic calcification in the breast
  1. Andrew Robinson1,
  2. Abeer M Shaaban2
  1. 1Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital, Birmingham, UK
  2. 2Department of Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  1. Correspondence to Dr Abeer M Shaaban, Department of Cellular Pathology, Queen Elizabeth Hospital and University of Birmingham, B15 2GW, Birmingham, UK; a.shaaban{at}nhs.net

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Clinical question

A 45-year-old woman is found, on family history screening, to have calcification within the upper outer quadrant of her right breast. A diagnostic mammotome biopsy was performed. Review the interactive digital slide and consider your diagnosis and appropriate management.

What is your diagnosis?

  1. Collagenous spherulosis

  2. Flat epithelial atypia with psammomatous calcification

  3. Liesegang rings with lactational changes

  4. Parasitic infection

  5. Spheroid type amyloid

Discussion

Answer: C

Histologically, there are focal collections of dilated ducts and microcysts lined by vacuolated epithelium showing lactational change. Many rounded concentric calcifications of various sizes are seen within the ductal lumina. These show characteristic appearances of Liesegang rings. In some ducts, the rings surround amorphous material with histologically identifiable calcific deposits. A mild chronic inflammatory infiltrate is seen in-between ducts.

Liesegang rings are spherical, ring-like …

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    BMJ Publishing Group Ltd and Association of Clinical Pathologists