Sclerosing lymphocytic lobulitis (SLL): a diagnostic challenge

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SLL is a relatively rare condition first described in 1984. The clinical presentation, ultrasonographic and mammographic appearances and histology in 10 patients have been reviewed. The median age was 47 years (range 23-70 years). Eight patients presented with a hard mass (mean size 2.0 cm) and two patients had ill-defined thickening. Ultrasonography showed an irregular hypoechoeic area in four cases. There was non-visualisation of the lump in three cases, a discrete mass in two cases and an area of distortion in another. Mammography was performed in six patients which showed an appearance suggestive of carcinoma in two, increased density with distortion in one, dense glandular tissue in two and an increased density with a lucent mass in another. Fine needle aspiration cytology was performed in nine cases and reported as C1 in two, C2 in three, C3 in two and C4 in two patients. Core biopsy in eight cases showed SLL in four and B2 in four cases. Surgical biopsy confirmed the diagnosis of SLL in nine patients.

SLL can mimic carcinoma both clinically and radiologically. A wide variation in radiological appearances means that following triple assessment surgical biopsy to confirm the diagnosis may be required.