European Journal of Breast Health
Original Article

Cytomorphological Spectrum of Granulomatous Mastitis: A Study of 33 Cases

1.

Department of Pathology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pimpri Pune, India

Eur J Breast Health 2020; 16: 146-151
DOI: 10.5152/ejbh.2020.5185
Read: 251 Downloads: 128 Published: 01 April 2020

Objective: Granulomatous mastitis is an uncommon benign breast disease. Varied aetiologies such as tuberculosis, foreign body reactions, sarcoidosis, fungal and parasitic infections and autoimmunity have been suggested. Pre-operative definitive diagnosis is essential for proper treatment. In developing countries like India, fine needle aspiration is still widely used as a reliable technique for preoperative evaluation of palpable breast lumps. The objective of this study is to study the cytomorphological features of different forms of granulomatous mastitis and correlate with other clinical findings including histological features.

 

Materials and Methods: A total of 33 cases of granulomatous mastitis were reviewed. The patients underwent fine needle aspiration. Cytomorphological features were studied in detail and correlated with histopathological features and other clinical findings.

 

Results: All the 33 patients showed varied cytomorphological features which included epithelioid cells/granuloma with lymphocytes/plasma cells/ polymorphs with or without necrosis/caseous necrosis and with or without giant cells. Ziehl Nelson stain showed acid fast bacilli in 13 smears. Out of 17 cases, the eight cases showed positive acid fast bacilli culture. Fungal stain such as Grocott- Gommeri Methane amine did not show fungi. Based on cytomorphological features in aspiration smears, they were grouped into  4 Groups. A total of 27 breast lesions were diagnosed as tuberculous mastitis, the four lesions were diagnosed as idiopathic granulomatous lobular mastitis and two lesions were diagnosed as foreign body granulomatous mastitis. Grocott- Gommeri Methane amine did not showed fungi. Based on cytomorphological features in aspiration smears, they were grouped into  4 Groups. A total of 27 breast lesions were diagnosed as tuberculous mastitis, the four lesions were diagnosed as idiopathic granulomatous lobular mastitis and two lesions were diagnosed as foreign body granulomatous mastitis.

 

Conclusion: Epithelioid granulomas with caseous necrosis with or without acid fast bacilli in cytology smears are diagnostic of tuberculosis. Cytology smears showing epithelioid granulomas with predominant polymorphs without necrosis and acid fast bacilli, a diagnosis of idiopathic granulomatous lobular mastitis must be considered. Histopathological examination is essential for definitive diagnosis in these cases.

 

Cite this articles as: Chandanwale S, Naragude P, Shetty A, Sawadkar M, Raj A, Bhide A, et al. Cytomorphological Spectrum of Granulomatous Mastitis:  A Study of 33 Cases. Eur J Breast Health 2020; 16(2): 146-151.

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