case_images: PMC11283659_01
case_images: Craniocaudal (A) and mediolateral oblique views (B) of the right breast show an area of increased density along the outer slightly lower quadrant of the right breast. Ultrasound (C) of this region showed an area of decreased echogenicity with areas of low-level internal echoes. Aspiration of the areas with low-level internal echoes revealed pus, which was sent for cytology and culture. Ultrasound of the right axillary region (D) showed a borderline 2 x 1 cm lymph node with 5 mm cortical thickening.
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case_images: Mammography and breast ultrasound revealed a 7-cm nodular and irregular area involving the right breast at 8 o'clock (Figure 1A and B). In addition, there was a suspicious right axillary lymph node 21 mm (Figure 1 C and D).
case_images: Acute inflammation consisting of neutrophils with prominent vessels. Scattered eosinophils and lymphocytes are also seen. (Hematoxylin and Eosin stain, original magnification 40x).
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case_images: Biopsy of the breast mass showed widespread acute inflammation, abscess formation, and fat necrosis (Figure 2).
case_images: Raised erythematous spots on the anterior shins bilaterally.
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case_images: Notably, the appearance of abscesses was accompanied by flares of fever, myalgias, and polyarthritis, involving the right ankle, hands, and feet, and erythematous and tender bumps were noticed symmetrically on the shins (Figure 3), diagnosed as erythema nodosum.