Figure 6c. Necrobiotic xanthogranulomatosis diagnosed with screening mammography in a 68-year-old woman. (a) Bilateral mammograms show multiple ill-defined asymmetric densities involving both breasts (arrows). (b) Bilateral US images demonstrate multiple solid hypoechoic masses with a teardrop or wavelike configuration. (c) Photomicrographs (original magnification, x400 [left, upper right] and x200 [lower right]; H-E stain) show an extensive area of central necrosis (*) surrounded by an inflammatory process with xanthic cells (arrows) and giant Touton cells (arrowhead).