Intraductal papilloma

case1 revised

Clinical History:

A 52 year old female patient with right sided nipple discharge. The mammogram was classified as ACR4 without any abnormal findings.

Diagnosis:
Intraductal papilloma

MR Technique: 
1.5-T system (Magnetom Avanto, Siemens Healthcare, Erlangen, Germany) using a standard bilateral breast coil. (A) Native T1-weighted 3D gradient-echo sequence (1.6 mm axial slices, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms every 50 s) (B) T1-weighted 3D gradient-echo sequences (1.6 mm axial slices, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms every 50 s) after bolus injection of 0.2 mmol of Gd-DOTA per kilogram of body weight, 6th of 8 series (C) Corresponding subtracted T1-weighted 3D gradient-echo post contrast images. (D) T2-weighted turbo spin-echo sequence (3 mm axial slices, field of view 320 mm, matrix 512×512, TR/TE 4400/104 ms). (E) Signal-intensity curve of the lesion.

Imaging Findings:
A 1.2 cm lobulated lesion with sharp margins and strong homogeneous contrast enhancement with a type II signal-intensity curve (rapid signal increase followed by a plateau) and hyperintense in T2 weighted images could be detected in the right medial lower quadrant retroareolar. The diagnosis of a papilloma was confirmed by a core cut biopsy in a second-look ultrasound.