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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Insulin-dependent diabetics may manifest evidence of autoimmune diseases involving endocrine or other organs. Rare cases of a peculiar fibrous and inflammatory lesion of the breast in diabetic patients have been previously described; however, the pathologic and clinical features that uniquely characterize these cases have not been defined or distinguished from other chronic inflammatory and fibrosing conditions in the breast. We studied eight patients with breast masses and longstanding insulin-dependent diabetes and compared them with 36 nondiabetic or short-duration diabetic patients with fibrosis and chronic mastitis. The longstanding diabetic patients presented with clinical breast masses ranging in size from 2 to 6 cm. Six of the eight patients had documented diabetic nephropathy, retinopathy, or neuropathy. Pathologically, these lesions showed lymphocytic lobulitis and ductitis, lymphocytic vasculitis (predominantly B cell), and dense keloid-like fibrosis that in many cases (six of eight) contained peculiar epithelioid cells embedded in dense fibrous stroma. We have provisionally labeled these cells "epithelioid fibroblasts" (EFBs). Although the features of lymphocytic lobulitis, ductitis, and/or vasculitis may occasionally be encountered in nondiabetic breast biopsies, EFBs appear to be unique to the diabetic condition. Control cases of chronic mastitis in nondiabetic or short-duration diabetes patients failed to show the complete constellation of lymphocytic lobulitis and ductitis, vasculitis, keloidal fibrosis, and EFBs. Diabetic mastopathy may represent an immune reaction to abnormal matrix accumulation. A hypothesis is presented.
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PMID:Diabetic mastopathy: a distinctive clinicopathologic entity. 161 78

Diabetic mastopathy is a distinct clinicopathologic entity with specific histopathologic characteristics which include keloidal fibrosis, epithelioid fibroblasts, widespread periductal/lobular lymphocytic infiltration, and widespread perivascular lymphocytic infiltration. We report the clinical and histopathologic breast tissue findings of 20 patients with diabetes mellitus as compared to 20 age-matched controls. The control patients also were matched for diseases other than diabetes mellitus. All patients with diabetes mellitus showed at least one of the histologic findings of diabetic mastopathy: 13 patients (65%) showed all four histopathologic characteristics; one patient showed three; one patient showed two; and five patients showed one feature. The 20 control patients did not demonstrate any of the four histopathologic features of diabetic mastopathy. We confirm previously reported findings of diabetic mastopathy presenting as palpable breast masses in insulin-dependent diabetics. However, we also suggest that diabetic mastopathy should be expanded to include the histopathologic findings characteristic in diabetic patients with nonpalpable mammographic abnormalities and breast tissue distant to the site of involvement by carcinoma.
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PMID:Diabetic mastopathy: a clinicopathologic study in palpable and nonpalpable breast lesions. 756 29

Diabetic mastopathy is a recently described collection of histopathological features found in dense fibrous breast masses in insulin-requiring diabetics. Fifty-seven breast biopsy specimens showing nonspecific benign disease were examined in a blinded fashion from 21 diabetics (seven insulin-requiring, 14 non-insulin-requiring), 30 age-matched controls and six patients with thyroid disease. Five diabetics had the constellation of extensive keloidal fibrosis, mononuclear perivasculitis, and mononuclear ductitis and/or lobulitis, whereas none of the controls or patients with thyroid disease had all of these features. All five patients with diabetic mastopathy were insulin-requiring (two type I, three type II). Epithelioid fibroblasts in the stroma, a previously described component of this constellation, were present in three of the five cases but do not appear to be essential in making the diagnosis. Four of the five diabetics were hypertensive, and three had secondary diabetic complications. The mean duration of diabetes in the five patients was greater than 13 years. Based on a previous report and the current study, this constellation of histological features appears to be relatively specific for insulin-requiring diabetes mellitus. The single clinical factor common to all patients with diabetic mastopathy in this article and in a previous study was exogenous insulin use.
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PMID:Mastopathy in insulin-requiring diabetes mellitus. 805 24

Diabetic mastopathy represents less than 1% of benign breast diseases, but is more frequent (13%) in insulin-dependent diabetics. We report on 10 cases (eight females and two males) of this rare lesion of the breast in patients with additional diabetes mellitus type I. All cases showed a marked B-lymphocytic mastitis in combination with a homogenous fibrosis of the breast and with presence of epithelioid fibroblasts. In the male patients, diabetic mastopathy simulated gynecomastia. A comparative examination of 12 cases of lymphocytic mastitis without long-standing type-I-diabetes mellitus revealed a more heterogeneous pattern with lower degrees of inflammation and fibrosis. From the pathophysiologic point of view, lymphocytic mastitis in diabetic mastopathy is thought to be a diabetes-induced reaction probably of autoimmune origin. Moreover, lymphocytic mastitis with or without diabetes mellitus may represent a lymphoepithelial lesion of the MALT-type which, under certain circumstances, is considered to bear a prelymphomatous potential.
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PMID:Lymphocytic mastitis and fibrosis of the breast in long-standing insulin-dependent diabetics. A histopathologic study on diabetic mastopathy and report of ten cases. 926 8

Diabetic mastopathy is a recently described collection of radiographical and histological features found in dense fibrous masses of the breast in long standing Type I diabetes. We describe the first case of bilateral disease with the alternate progression and regression of the disease over a 5 year period. A 45-year-old woman has been affected of insulin dependent diabetes mellitus (IDDM) for 21 years. She developed palpable mass retromamillar of the right side, indistinguishable radiographically from cancer. The histology showed a diabetic mastopathy (DMP) with B-lymphocytic ductitis and lobulitis, a discrete monocellular vasculitis and a keloid-like fibrosis. After 22 months she developed a suspicious palpable mass contralateral on the left side. The FNAB presented an identical morphology on histology. Additionally 10 months later there were no palpable masses of both mammae. Mammographically no suspect alterations were observed. One year later the clinical and mammographical examination showed similar findings, mentioned before. The pathogenesis is still obscure and includes the hypothesis of extracellular accumulation, secondary to prolonged hyperglycemia in IDDM, production of alternated non-enzymatic glycosylated end products with neoantigen formation, B cell predominant inflammation with autoimmune response against neoantigens and cytokine release secondary to the autoimmune response.
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PMID:Bilateral, tumorlike diabetic mastopathy-progression and regression of the disease during 5-year follow up. 958 50

Diabetic mastopathy, an uncommon form of lymphocytic mastitis and stromal fibrosis, typically occurs in longstanding type 1 diabetes. Nineteen cases meeting predetermined histopathologic criteria for diabetic mastopathy were correlated as to clinical history and disease recurrence. Physical examination revealed palpable discrete masses or diffuse nodularity, both predominantly in the subareolar region. One nonpalpable lesion was detected incidentally during reduction mammoplasty. All cases contained lymphocytic ductitis and lobulitis with varying degrees of keloidal fibrosis, vasculitis, epithelioid fibroblasts, and lymphoid nodule formation. Single mammary lesions were found in 11 patients with type 1 diabetes, 1 with type 2 diabetes, and 3 without diabetes. Four cases were bilateral (3 patients with type 1 and 1 patient with type 2 diabetes). Six of 19 cases recurred (3 ipsilateral, 2 contralateral, and 1 bilateral). We confirm the histopathologic constellation for diabetic mastopathy. However, we question the specificity of these features because of identical findings in patients with type 2 diabetes and nondiabetic patients. We found diabetic mastopathy in men and women, as a solitary mass or bilateral disease, and recurrence in either breast, sometimes multiple. Recognition of potential recurrence is important because it might spare patients with documented diabetic mastopathy from repeated breast biopsies.
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PMID:Diabetic mastopathy. A clinicopathologic review. 1076 56

Diabetic mastopathy is a source of confusion with breast carcinoma. The association between mastopathy and Type I diabetes of long duration has been reported, but this clinical condition is poorly recognized since breast examination is not routinely performed in young diabetic patients. Radiologists' awareness of the constellation of findings in diabetic mastopathy may spare patients from undergoing unwarranted surgical biopsies.
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PMID:Case report: diabetic mastopathy. 1268 35

Diabetic mastopathy, although reported since 1984, is a poorly recognized diabetes complication. It more frequently affects pre-menopausal women with Type 1 diabetes mellitus and microvascular complications. The pathogenesis of this condition is believed to involve mammary tissue autoimmune reaction to the accumulation of abnormal matrix proteins, caused by hyperglycemia. The lesion often simulates breast cancer; its recognition, therefore, is important to avoid unnecessary diagnostic procedures and surgical treatments. We now report a case of diabetic mastopathy which clinically simulated breast cancer in a young pre-menopausal diabetic woman who, after sonography and mammography, was suggested surgery under suspicion of breast cancer. Histopathological examination by core-biopsy ruled out malignancy.
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PMID:Diabetic mastopathy: a case report. 1459 23

Diabetic mastopathy can mimic cancer. We report 2 cases of diabetic mastopathy in patients with long-standing type II diabetes. One was insulin-dependent, and the other had never been treated with insulin. These 2 patients had classical acoustical shadow on ultrasonograms. Breast core biopsies showed constellations of morphological features resembling diabetic mastopathy, including sclerotic changes of the fibrous stroma with keloid-like collagen fibers, few epithelioid fibroblasts, perivascular and interlobular mononuclear cell infiltrates, and focal atrophic changes of the ductal-lobular units. Both patients were free of malignancy at 3 and 4 years of follow-up, respectively. There are limited data on diabetic mastopathy in insulin-naive type II diabetes mellitus patients. Better awareness of this entity and its sonographic features may allow more patients to be spared from excisional biopsy.
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PMID:Diabetic mastopathy in type II diabetes mellitus. 1566 Jan 77

Diabetic mastopathy is a rare, benign clinico-pathological entity strongly associated with type I diabetes. X-ray mammography and ultrasonography are inadequate to distinguish this lesion from malignancy, leading to unnecessary excision biopsies. Dynamic contrast enhanced MRI and MR spectroscopy, powerful tools in the investigation of breast disease, can help solve this problem.
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PMID:Dynamic contrast enhanced magnetic resonance imaging and magnetic resonance spectroscopy in diabetic mastopathy. 1569 85


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