Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis

관주위유방염 (유륜하 농양)의 세침흡인 세포소견 및 세포진단의 중요성

  • Joo, Mee (Department of Pathology, Inje University Ilsan Paik Hospital) ;
  • Chang, Sun-Hee (Department of Pathology, Inje University Ilsan Paik Hospital) ;
  • Kwak, Ji-Eun (Department of Pathology, Inje University Ilsan Paik Hospital) ;
  • Park, Sung-Hye (Department of Pathology, Seoul National University College of Medicine) ;
  • Song, Byung-Ju (Department of General Surgery, Kang Nam St. Mary's Hospital) ;
  • Kim, Han-Seong (Department of Pathology, Inje University Ilsan Paik Hospital)
  • 주미 (인제대학교 의과대학 일산백병원 병리과) ;
  • 장선희 (인제대학교 의과대학 일산백병원 병리과) ;
  • 곽지은 (인제대학교 의과대학 일산백병원 병리과) ;
  • 박성혜 (서울대학교 의과대학 병리학교실) ;
  • 송병주 (가톨릭의대 강남성모병원 일반외과) ;
  • 김한성 (인제대학교 의과대학 일산백병원 병리과)
  • Published : 2006.03.31

Abstract

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.

Keywords

References

  1. Lester SC, Cotran RS. The Breast. In: Cotran RS, Kumar V, Collins T. Robbins Pathologic Basis of Disease. 6th ed. Philadelphia: W.B. Saunders Co., 1999;1096-7
  2. Galblum LI, Oertel YC. Subareolar abscess of the breast: Diagnosis by fine needle aspiration. Am J Clin Pathol 1983;80:496-9 https://doi.org/10.1093/ajcp/80.4.496
  3. Habif DV, Perzin KH, Lipton R, Latter R. Subareolar abscess associated with squamous metaplasia of lactiferous ducts. Am J Surg 1970;119:523-6 https://doi.org/10.1016/0002-9610(70)90167-4
  4. Patey DH, Thackray AC. Pathology and treatment of mammary-duct fistula. Lancet 1958;2:871-3
  5. Rosenthal LJ, Greenfield DS, Lesnick GJ. Breast abscess: Management in subareolar and peripheral disease. NY State J Med 1981;81:182-3
  6. Zuska JJ, Crile G Jr, Ayres WW. Fistulas of lactiferous ducts. Am J Surg 1951;81:312-7 https://doi.org/10.1016/0002-9610(51)90233-4
  7. Meguid MM, Oler A, Numann PJ, Khan S. Pathogenesisbased treatment of recurring subareolar breast abscesses. Surgery 1995;118:775-82 https://doi.org/10.1016/S0039-6060(05)80049-2
  8. Versluijs-Ossewaarde FN, Roumen RM, Goris RJ. Subareolar breast abscesses: characteristics and results of surgical treatment. Breast J 2005;11:179-82 https://doi.org/10.1111/j.1075-122X.2005.21524.x
  9. Silverman JF, Lannin DR, Unverferth M, Norris HT. Fine needle aspiration cytology of subareolar abscess of the breast: spectrum of cytomorphologic findings and potential diagnostic pitfalls. Acta Cytol 1986;30:413-9