Fine needle aspiration cytology of inflammatory breast lesions

Department of Pathology & Laboratory Medicine, King Abdul Aziz Specialist Hospital, Taif, K.S.A.
Journal of the Pakistan Medical Association (Impact Factor: 0.41). 04/2009; 59(3):167-70.
Source: PubMed


To study the characteristics of inflammatory breast aspirate by Fine Needle Aspiration, performed by pathologist.
Inflammatory breast aspirates reported at two hospitals in Taif area (King Abdul Aziz Specialist Hospital and Al Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia (KSA) from January 2000 till September 2007 were reviewed. The cytopathology reports, slides, clinical information, microbiology culture results, Tuberculosis; Polymerase Chain Reaction (TB; PCR) and histology were reviewed. The aspirates were identified as inflammatory based on presence of inflammatory cells and/or granulomas with occasional benign ductal epithelial cells. Cases of inflammatory carcinoma or duct ectasia were excluded.
Forty-nine cases of inflammatory breast aspirates were included in the study. The aspirates were categorized into: Acute mastitis/Abscess 13 (26.5%), Granulomatous Mastitis 15 (30.6%), Fat Necrosis / Organized Haematoma 8 (16.4%) and Inflammation, not otherwise specified (NOS) 13 (26.5%), based on morphologic criteria combined with clinical impression. The Granulomatous Mastitis cases were subcategorized into Idiopathic and Infection related which included Brucellosis, Tuberculosis, and fungal mastitis.
FNA of inflammatory breast lesions is a useful tool if performed by a pathologist and combined with further workup including microbiologic culture correlation. It helps in management and treatment of the patient and avoiding unnecessary surgery.

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    • "There were 85 (20%) cases of benign inflammatory lesions, and the majority of these were of acute and chronic mastitis. “Granulomatous mastitis is a rare chronic inflammatory breast lesion that mimics carcinoma clinically and radiologically” [19–21]. There were 2 (2.3%) cases of tuberculosis; definitive diagnosis of the tuberculous mastitis was based on identification of typical histological features under microscopy and detection of tubercle bacilli on Ziehl-Neelsen stain. "
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