Primary Actinomycosis of the Breast Masquerading as Malignancy: Diagnosis by Fine Needle Aspiration Cytology

Gupta, C R Das; Singh, Prem Kumar; Bedi, Sanjay; Kapur, Kalyani

doi:10.1159/000337774

Cited by 9 publications

(7 citation statements)

References 4 publications

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“…Thambi et al noted fluffy areas on FNAC smears . Gupta et al described the colonies on FNAC as giving “bales of wool” appearance . Special stains and culture help to arrive at the correct diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Primary actinomycosis of breast—A diagnosis on cytology

Gosavi

Anvikar

Sulhyan

et al. 2016

Diagnostic Cytopathology

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Primary actinomycosis of breast is a rare disease with only a few cases reported in the literature. We present a case of a 25-year-old lactating woman with primary actinomycosis of breast which was diagnosed on cytology. The patient presented with lump in left breast with dull aching pain. Fine-needle aspiration cytology smears showed acute suppurative inflammation with presence of fluffy basophilic colonies on Hematoxylin and Eosin staining and branched, Gram positive filamentous bacilli on Gram staining. The bacilli were non-acid fast with 1% Zeihl Neelsen stain. A diagnosis of actinomycosis was suggested on cytology. Histopathological examination revealed an abscess with few Gram positive basophilic granules surrounded by eosinophilic Splendore-Hoeppli material thus confirming the diagnosis of actinomycosis. Meticulous search for microorganisms with the aid of special stains should be done on cytology smears before labeling an inflammatory lesion as nonspecific. Diagn. Cytopathol. 2016;44:693-695. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

“…2 Gupta et al described the colonies on FNAC as giving "bales of wool" appearance. 7 Special stains and culture help to arrive at the correct diagnosis. Cell block technique with histochemistry has also been effectively used for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Primary actinomycosis of breast—A diagnosis on cytology

Gosavi

Anvikar

Sulhyan

et al. 2016

Diagnostic Cytopathology

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“…Multinucleated giant cells or granulomas may be seen in some cases. The filamentous bacterial aggregates have been described as ‘a cotton ball', ‘a bale of wool', ‘dust bunny' or ‘Gupta body' in the literature [17,18]. On Papanicolaou stain, the club-shaped structures seen in SHP appear yellow.…”

Section: Discussionmentioning

confidence: 99%

Cytopathology of Hepatobiliary-Related Actinomycosis

Xing

Rodrı́guez²,

Pantanowitz

2016

Acta Cytologica

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Background: The clinical diagnosis of hepatobiliary-related actinomycosis can be challenging owing to its rarity and variable presentation. Moreover, actinomycotic pseudotumors may mimic malignancy and result in unnecessary surgical resection. Herein, we present the clinical and cytopathological features of 3 cases with hepatobiliary-related actinomycosis. Cases: The first patient was a 73-year-old man who presented with an exophytic liver lesion. The second patient was a 78-year-old woman who presented with a biliary stricture. The third patient was an 88-year-old woman with a right flank mass extending to the liver. The aspirate smears in these 3 cases demonstrated ‘cotton ball' clusters of filamentous microorganisms and abscesses. The cell blocks of 2 of the patients showed sulfur granules with peripheral filamentous microorganisms positive with a Gram stain but negative with an acid fast stain, consistent with Actinomyces species. All patients were elderly and shared a past surgical history of laparoscopic cholecystectomy. Conclusion: These casesdemonstrate the complementary role of cytology in the diagnosis of hepatobiliary actinomycosis. A cytologic diagnosis of actinomycosis is minimally invasive and quick. It can prompt proper culture medium selection and avoid unnecessary or extensive surgery. Based on our experience, laparoscopic cholecystectomy may be a precipitating factor for the subsequent development of hepatobiliary-related actinomycosis.

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“…With either group of bacteria, the potential for serious infections exists, and these microorganisms often demonstrate overlap in their clinical presentations . Both can present as infections within the lung, soft tissue, bone, joint, or central nervous system (CNS) as well as a number of less frequent anatomic sites including the nipple and the skin . Additionally, both are capable of systemic dissemination, typically through hematogenous routes …”

Section: Introductionmentioning

confidence: 99%

“…Sinus tracts commonly form, and macroscopically visible sulfur granules may drain from these tracts. On imaging, actinomycosis may appear as a lesion that is directly spreading through tissues without respect for physical planes or barriers . Because of this radiological appearance, Actinomyces infections may be clinically mistaken for malignancy .…”

Section: Introductionmentioning

confidence: 99%

The cytopathology of Actinomyces, Nocardia, and their mimickers

McHugh

Sturgis

Procop

et al. 2017

Diagnostic Cytopathology

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Nocardia species and Actinomyces species are 2 of the most commonly diagnosed filamentous bacteria in routine cytopathology practice. These genera share many overlapping cytomorphologic features, including their thin, beaded, branching, Gram-positive, GMS-positive filamentous structures that fragment at their peripheries into bacillary- and coccoid-appearing forms. Features that help distinguish between these 2 microorganisms include the width of their filamentous structures, the angles at which they branch, and their ability or lack thereof to retain a modified acid-fast stain. In addition to cytomorphologic overlap, overlap in clinical presentation is frequent with pulmonary and mucocutaneous presentations seen in both. Differentiating between Nocardia and Actinomyces is essential because patients with these infections require different approaches to medical management. Both antibiotic susceptibilities and the need for early surgical intervention as part of the treatment plan vary greatly among these 2 groups. This review focuses on the clinical presentation, cytomorphology and staining characteristics that can be useful in identifying and distinguishing between Nocardia and Actinomyces infections, as well as their mimickers.

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Primary Actinomycosis of the Breast Masquerading as Malignancy: Diagnosis by Fine Needle Aspiration Cytology

Cited by 9 publications

References 4 publications

Primary actinomycosis of breast—A diagnosis on cytology

Primary actinomycosis of breast—A diagnosis on cytology

Cytopathology of Hepatobiliary-Related Actinomycosis

The cytopathology of Actinomyces, Nocardia, and their mimickers

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