Breast nonmalignant
Giant cell arteritis

Topic Completed: 1 January 2009

Revised: 30 May 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Giant cell arteritis [title] breast

Hind Warzecha, M.D.
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Cite this page: Nassar H Giant cell arteritis. website. Accessed August 18th, 2019.
Definition / general
  • Vascular disorder that may have systemic manifestations but no temporal artery involvement (Hum Path 1987;18:1186)
  • Usually postmenopausal women with firm mass that mimics carcinoma
Clinical features
  • Nodules or pain in the breast, with or without tenderness
  • Associated with significant constitutional symptoms that resemble polymyalgia rheumatica (Breast Cancer 2010;17:225)
Case reports
  • Possibly prednisone therapy
Microscopic (histologic) description
  • Involvement of small and medium sized arteries with transmural and perivascular infiltrate of lymphocytes, histiocytes and giant cells
  • Elastic stain shows fragmentation of elastic fibers in vessel wall
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick

Elastic stain

Intramammary arterial lumen
is mostly obliterated by
subintimal and mural inflammation,
including giant cells (arrows)

Transmural necrotizing inflammation
of medium sized mammary vessels,
with elastic stain showing partial
destruction of elastic layer

Differential diagnosis
  • Polyarteritis nodosa: transmural necrotizing vasculitis without giant cells; often prominent eosinophils, fibrinoid necrosis
  • Granulomatosis with polyangiitis (Wegener's): acute and chronic inflammation of breast parenchyma and fat; may resemble an abscess; vessels in necrotic areas and in surrounding breast exhibit fibrinoid necrosis; granulomatous foci in blood vessels and at peripheral of breast infarcts
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