Abstract

Azna WH, Jayaram G, Yip CH
Department of Pathology, Putrajaya Hospital, Putrajaya. Departments of Pathology and Surgery, University of Malaya Medical Centre, Kuala Lumpur.

Granulomatous mastitis (GM) is a rare, idiopathic, chronic inflammatory condition of the breast lobules that can simulate breast carcinoma both clinically and radiologically. Fine needle aspiration (FNA) cytology often provides a definitive diagnosis in this lesion. This study is a clinicocytologic analysis of GM diagnosed at the University Malaya Medical Centre (UMMC), Kuala Lumpur.

83/7357 FNAs of breast, (1.13%), done at UMMC during the period 1995-2005 were diagnosed as GM. FNA cytology was performed at the surgical outpatient clinic by the cytopathologist. In all cases, bedside Diff-Quick staining was performed on one smear to ensure adequate cellularity and to determine the necessity for ancillary staining.

All patients were female with ages ranging from 25 to 61 years (mean 37). 46 women were Malay (55.42%), 27 were Chinese (32.53%) and 10 were Indian (12.05%). One woman was pregnant at the time of initial presentation while three were lactational. The most common clinical presentation was a unilateral indurated, firm, discrete mass. In 51 patients (61.45%) there was a clinical suspicion of malignancy. Smears stained with May-Grünwald-Giemsa showed numerous degenerating and viable neutrophils, epithelioid granulomas, clusters of foamy histiocytes and scattered multinucleated giant cells. Fragments of small blood vessels surrounded by leucocytes were often present and in a few cases, multinucleated giant cells were seen in juxtaposition to the vessels. No acid fast bacilli or fungi were identified in smears stained with Ziehl Neelsen and Grocott Methenamine Silver stains.