Fat Necrosis of the Breast: A Pictorial Review of the Mammographic, Ultrasound, CT, and MRI Findings with Histopathologic Correlation

Figure 1

49-year-old female with history of left modified radical mastectomy with transverse rectus abdominis myocutaneous (TRAM) flap reconstruction. Left TRAM flap reconstruction craniocaudal and mediolateral oblique projections ((a) and (b)) demonstrate a large mass of dystrophic calcification and fat. MRI breast T1-weighted nonfat saturation (c), T1-weighted fat saturation after gadolinium (d), and T2-weighted fat saturation images (e) demonstrate a mass in the central left TRAM which follows fat signal on all pulse sequences with a thin rim of enhancement (arrow). The biopsy ((f); H&E, 400x) demonstrating dense fibrotic tissue with foamy histiocytes (left) and hemosiderin-laden macrophages (upper and right). Rebiopsy ((g); H&E, 400x) demonstrating fibrous paucicellular cyst wall (left) surrounded by massive accumulation of foamy histiocytes (center and right).

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