Unilateral Primary Localised Cutaneous Nodular Amyloidosis of the Nipple Nipple amyloidosis

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Hamish Walker https://orcid.org/0000-0003-4798-5444
Dearbhail Reid
Richard Hunt
Hannah Wainman


Amyloidosis, case report, nipple, skin changes


Background: Amyloidosis is characterised by extracellular accumulation of an amorphous fibrillary protein and can affect any organ. It is classified into systemic and localised disease according to its sites of presentation and as primary or secondary according to aetiology. Breast amyloid was first described in 1973 and is extremely rare.
Case Presentation: A 61-year-old woman presented in 2020 with a 1-year history of an enlarging tender left nipple with some associated bleeding. Clinical differential diagnoses included a nipple adenoma and an intraductal carcinoma; therefore, a punch biopsy was taken. A full set of screening blood tests were undertaken which were normal, showing no evidence of a plasma cell dyscrasia.
The biopsy showed diffuse replacement of the dermis by acellular eosinophilic material showing fracturing. Congo Red stain was positive showing apple-green birefringence under polarised light. A diagnosis of primary localised cutaneous nodular amyloidosis of the nipple was made.
Conclusion: We present a rare documented case of isolated primary localised cutaneous nodular amyloidosis of the nipple. This can be considered as a differential diagnosis for patients with a new nipple lesion alongside nipple adenoma and intraductal carcinoma.


1. Fernandez BB, Hernandez FJ. Amyloid tumor of the breast. Arch Pathol. 1973;95(2):102–5
2. Yılmaz E, Yılmaz A, İnan İ, Gündoğar Ö, Uçar N, Parlakkılıç ÜT, et al. Localized breast amyloidosis. Eur J Breast Health. 2019;15(1):63. doi: 10.5152/ejbh.2018.4104.
3. Liu SW, Hung CT, Gao HW, Chiang CP, Chen CY, Chen YH, et al. Primary localized cutaneous nodular amyloidosis on areola. Indian J Dermatol Venereol Leprol. 2022;(Epub ahead of print). doi: 10.25259/ijdvl_491_2021.
4. Ganor S, Dollberg L. Amyloidosis of the nipple presenting as pruritus. Cutis. 1983;31:318
5. Gluck BS, Cabrera J, Strauss B, Ricca R, Brancaccio W, Tamsen A. Amyloid deposition of the breast. AJR Am J Roentgenol. 2000;175(6):1590. doi: 10.2214/ajr.175.6.1751590.
6. Tsuji W, Takeuchi E, Oka S, Yamashita T, Yotsumoto F. Localized primary amyloidosis of the breast: a case report and review of the literature. BMC.Surg. 2016;16(1):62. doi: 10.1186/s12893-016-0178-6.
7. Charlot M, Seldin DC, O’Hara C, Skinner M, Sanchorawala V. Localized amyloidosis of the breast: a case series. Amyloid. 2011;18(2):72–75. doi: 10.3109/13506129.2011.570817.
8. Berk JL, O’Regan A, Skinner M. Pulmonary and tracheobronchial amyloidosis. Semin Respir Crit Care Med. 2002;23:155–165. doi: 10.1055/s-2002-25304.
9. Biewend ML, Menke DM, Calamia KT. The spectrum of localized amyloidosis: a case series of 20 patients and review of the literature. Amyloid. 2006;13:135–142. doi: 10.1080/13506120600876773.
10. Said SM, Reynolds C, Jimenez RE, Chen B, Vrana JA, Theis JD, et al. Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders. Mod Pathol. 2013;26(2):232–238. doi: 10.1038/modpathol.2012.167.
11. O’Brien J, Aherne S, McCormack O, Jeffers M, McInerney D. MRI features of bilateral amyloidosis of breast. Breast J. 2013;19(3):338–339. doi: 10.1111/tbj.12110.
12. Paccalin M, Hachulla E, Cazalet C, Tricot L, Carreiro M, Rubi M, et al. Localized amyloidosis: a survey of 35 French cases. Amyloid. 2005;12:239–245. doi: 10.1080/13506120500351174.
13. M Mori, H Kotani, M Sawaki, M Hattori, A Yoshimura, N Gondo, et al. Amyloid tumor of the breast Surg Case Rep. 2019;5(1):31. doi: 10.1186/s40792-019-0591-z.
14. Huerter ME, Hammadeh R, Zhou Q, Weisberg A, Riker AI. Primary amyloidosis of the breast presenting as a solitary nodule: case report and review of the literature. Ochsner J. 2014;14(2):282–286.
15. Woollons, A. and Black, M. Nodular localized primary cutaneous amyloidosis: a long-term follow-up study. Br J Dermatol. 2001;145(1):105-109. doi: 10.1046/j.1365-2133.2001.04291.x.

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