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Case Reports
- Granulomatous(Lobular) Mastitis in a Pregnant Woman: A case report.
- Kyu Rae Kim, Hee Sung Kim, Yeon Lim Suh, Jung Hyun Yang, Howe Jung Ree
- Korean J Pathol. 1996;30(3):261-265.
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- 44 Download
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Abstract
PDF - Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
- Fine Needle Aspiration Cytology of Bilateral Granulomatous Mastitis: A Cese Report.
- Seung Sam Paik, Seok Hoon Jeon, Eun Kyung Hong, Moon Hyang Park
- Korean J Cytopathol. 1995;6(2):174-178.
- 1,536 View
- 16 Download
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Abstract
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- Granulomatous mastitis is a rare inflammatory breast lesion, usually presented with rapidly enlarging palpable mass in young parous women and can simulate carcinoma. Unnecessary surgical procedure can be avoided if the nature of the lesion were defined by fine needle aspiratio(FNA) cytology. We experienced a case of bilateral granulomatous mastitis diagnosed by FNA cytology. The patients was a 31-year-old woman with one month history of a rapidly enlarging mass in the left breast. considered clinically to be malignant. After 4 years. she presented with a palpable mass in the right breast. The FNA cytology smears contained numerous aggregates of epithelioid histiocytes admixed with Langhans' and foreign body giant cells, lymphoytes, neutrophils and apoptotic debris leading to a diagnosis of granulomatous mastitis. The subsequent lumpectomy of the left breast confirmed the diagnosis of granulomatous mastitis. The FNA cytology smears from right breast showed identical cytologic findings.
Original Articles
- Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis.
- Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sung Hye Park, Byung Ju Song
- Korean J Cytopathol. 2006;17(1):27-31.
- 3,645 View
- 96 Download
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Abstract
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- Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.
- Clinicopathologic Features of Granulomatous Mastitis.
- Yee Jeong Kim, Yoon Jung Choi, Ji Young Kim, Hee Jung Kim, Yang Soon Park, Soon Won Hong, Chanil Park, Doyil Kim, Hyde Lee, Woo Hee Jung
- Korean J Pathol. 2005;39(3):181-186.
- 1,963 View
- 24 Download
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Abstract
PDF
- BACKGROUND
Granulomatous mastitis (GM) is a rare chronic inflammatory condition that clinically mimics a carcinoma. The diagnosis of idiopathic GM depends on the exclusion of other granulomatous inflammations. The purpose of this study is to correlate the clinicopathological features of GM with etiologies.
METHODS
We reviewed the clinical records of 58 cases that were histologically diagnosed as GM. We performed special stains for microorganisms such as Ziehl-Neelsen, periodic acid Schiff and gram stains, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis (TB PCR).
RESULTS
The mean age of patients was 35.3 years. Most patients were parous except three. Seven patients (12.1%) were related with pregnancy or lactation. TB PCR was positive in nine patients (15.5%). Five patients (8.6%) had gram positive bacilli that were recognizable as coryneform bacteria. Culture study demonstrated Staphylococcus aureus in only one case. Infectious GM had a greater tendency to form abscesses. Fat necrosis was more likely to be present in idiopathic GM, but other histological features were similar to each other. Twenty-two cases (37.9%) showed recurrence.
CONCLUSIONS
We suggest that TB PCR and gram stain are essential tests for the differential diagnosis of GM, because the histologic features considerably overlap irrespective of the various etiologies.
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