Utility of fine-needle aspiration in the diagnosis of granulomatous lesions of the breast

Abstract

Fourteen cases of granulomatous mastitis (GM) studied by fine‐needle aspiration (FNA) are reviewed and nine cytologic features (necrosis, neutrophil granulocytes, foamy cells, plasma cells, granulomas, epitheloid cells, multinucleated giant cells of foreign body type and Langhans' type, duct cells, and the presence of acid‐fast bacilli) are reappraised in a semiquantitative manner. The main objective of this study was to find out if one or more of these features would permit the various granulomatous entities identified in surgical pathology to be separated cytologically. The results suggest that FNA does not permit the various granulomatous lesions identified in surgical pathology to be differentiated, since in this series different entities share a common cytologic pattern. Only the presence of acid fast bacilli in smears would enable a tuberculous etiology to be diagnosed. The opinion is put forward that the term GM should be avoided in the cytologic report and substituted by the noncommitted term “granulomatous lesion of the breast.” Diagn. Cytopathol. 17:108–114, 1997. © 1997 Wiley‐Liss, Inc.

Granulomatous Mastitis Complicated by Arthralgia and Erythema Nodosum Successfully Treated with Prednisolone and Methotrexate

“…Because these symptoms are also seen in breast cancer and because granulomatous mastitis has no specific radiological appearance (6), it is difficult to clinically distinguish granulomatous mastitis from breast cancer. A histological examination is therefore essential for a proper diagnosis (7). The characteristic histological findings are lobular non-caseous granulomas with epithelioid histiocytes, giant cells and neutrophils and a negative microbiological investigation.…”

Tuberculosis of breast: a rare case report

“…Approximately 73% of the cases can be diagnosed on FNAC when both epithelioid cell granulomas and necrosis are present. 15,16 At ultrasonography, a hypoechogenic mass is found in 60% of patients and the method may sometimes identify a fistula or a sinus tract which can be seen in cases of tuberculosis mastitis. 13 The gold standard for the diagnosis of breast tuberculosis is detection of M. tuberculosis by Ziehl Neelsen staining or by culture.…”

Tuberculosis of the Female Breast and Reproductive Organs: A Diagnostic Dilemma

“…The nodular variant is the commonest presentation in 60% of cases and thus may be misdiagnosed as a neoplastic lesion as also seen in our patients while, the abscess variant is often seen in young females and accounts for 30% of cases [20]. Diagnosis can be achieved with Fine Needle Aspiration Cytology (FNAC) though tissue biopsy is still advocated to differentiate from other causes of granulomatous diseases of the breast [24][25][26]. Granuloma centering round breast ducts and not lobules is diagnostic in tissue biopsy and the demonstration of acid fast bacilli is not mandatory [11].…”