• 대한세포병리학회지
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• 제6권2호
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• pp.174-178
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• 1995

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 patient 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.

• 대한세포병리학회지
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• 제6권2호
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• pp.156-162
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• 1995

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively. Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2 Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.

• 대한수의학회지
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• 제24권2호
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• pp.183-193
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• 1984

In this study lactating female rabbits and strains of coliforms previously isolated from the cases of acute and chronic mastitis in dairy cattle were employed. The pathological changes were observed on the mastitis experimentally induced with the coliform strains and the mamary glands after infusions of E. coli suspension together with dexamethasone, dextran iron or transferrin were grossly and microscopically observed. From the results reported, the following points are concluded. In the bacterial suspension-infused groups by E. coli, K. pneumoniae and Ent. aerogenes, respectively, the affected quarters of udder showed grossly swelling, hyperemia, hemorrhage, focal necrosis and firmness. The microscopic findings of early stage of the mastitis were appearance of large numbers of heterophils in the glandular lumina and ducts accompanied by degeneration, necrosis and desquamation of epithelial cells and also infiltration of heterophils, hemorrhage and edema in the interstitial tissue and destruction of alveoli. Later, proliferation of fibroblasts, plasma cells, lymphocytes, eosinophils and macrophages appeared in the glandular tissue and with these cells necrotic foci of glandular tissue were surrounded by highly proliferated connective tissue. In addition, granulomatous inflammatory changes could be observed in the glandular tissue from the 7th day after infusion. The difference of the inflammatory response among the groups did not recognized. In the groups infused with dexamethasone and E. coli suspension the inflammatory response was slighter at the inflammatory change with alveolar destruction and hemorrhage was more rapid and severer than E. coli alone. Also in the groups infused with dextran iron and E. coli suspension the inflammatory change was more rapid and severer than E. coli alone and the histological changes were not recognized in the groups infused with dextran iron alone. Reaction of the iron staining was diffusely strong positive within the glandular alveolar lumina in the groups of dextran iron alone, hut was slightly positive toward epithelial cells in the groups of dextran iron and E. coli infusion. In the group infused with transferrin and E. coli suspension, the inflammatory response was tighter, but the peroxidase activity of the heterophils in the glandular lumina was more or less stronger than E. coli alone.

• 대한세포병리학회지
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• 제8권2호
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• pp.120-128
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• 1997

Fine needle aspiration cytology of breast lesion is well known as a simple, economic and effective diagnostic modality. For the evaluation of cytohistologic correlation, 256 cases of cytologic smears and subsequent histologic sections during 2-year period from Jan. 1995 to Dec. 1996 were reviewed. 1. Fifteen cases(5.9%) were proven as insufficient for evaluation, and 13 of them were fibrocystic change histologically. One case of carcinoma exhibiting sufficient amount of aspirates with no malignant cells on smear was regarded as inadequate. 2. Cytohistologic correlation of 240 cases revealed sensitivity 87.0%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 97.0%, false positive rate 0.0% and false negative rate 13.0%. Total diagnostic accuracy is 95.7%. 3. Total 6 cases of negative were due to small amount of aspirates containing scantiness of malignant cells in two and underestimation in four. 4. Diagnostic concordance rates of fibrocystic change and fibroadenoma were 95.5% and 80.0%, respectively. Diagnostic discrepancies were noted in 7 cases of fibrocystic change and 6 cases of fibroadenoma, however, cytologic discrimination of two entities was not easy in seven of them. 5. In a case of phyllodes tumor and a case of duct ectasia, the discrepancy was due to targeting error. Other three cases(lymphoma, adenomyoepithelioma and granulomatous mastitis) were misinterpreted because of poor acquaintance with those entities. Diagnostic accuracy of fine needle aspiration cytology of breast lesions are relatively high. However, good technique on aspiration and adequate interpretation are necessary to reduce the false negative rate and the discrepancy between cytologic and histologic diagnoses.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7257-7260
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• 2013

To determine the pattern of disease in patients presenting with breast lumps and to determine the sensitivity and specificity of fine needle aspiration cytology of benign and malignant diseases as a diagnostic tool by correlating with histopathology findings. This retrospective study was carried out in the Department of Pathology, Maharaja Agrasen Medical College, Agroha, from Jan 2008 to April 2012. Fine needle aspiration cytology was performed on 370 cases and out of these 52 cases were received in the Department for histopathological examination. Fibroadenoma was the most common disease encountered, in 88 (24%), with a peak incidence in second and third decade of life. Fibrocystic disease was second, being common in the third and fourth decades of life. Peak incidences of duct ectasia, granulomatous and tubercular mastitis were seen in the third decade. Gynaecomastia showed two peak incidences in second and sixth decades of life. Out of total 370 cases undergoing fine needle aspiration, benign cases were 316 (85.4%), malignant and suspicious were 54 (14.6%) and 10 (2.70%) respectively. Out of total 22 histological confirmed malignant lesions 19 were interpreted as malignant cytologically while two as suspicious and one as benign. All thirty histologically confirmed benign cases were diagnosed as benign cytologically. The sensitivity, specificity, positive and negative predictive values were 98%, 100%, 100% and 96.4% respectively. FNA cytology is highly accurate for diagnosis of breast masses. However, the clinician should correlate FNA cytological results with physical examination and imaging findings to prevent false negative and false positive events and to obtain optimal management of their patients.