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Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 323-325

Image-guided fine-needle aspiration cytology or core biopsy – A key to definitive diagnosis of tuberculous mastitis

Department of Pathology, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India

Correspondence Address:
Shirish Sahebrao Chandanwale
No. 75/1 + 2/1, Krishna Appt, New Sangvi Pune - 411 027, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmy.ijmy_98_22

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Despite advances in the treatment, tuberculosis (TB) is still a global health problem. The diagnosis of extrapulmonary TB in their primary form is very challenging. Breast TB is very uncommon and accounts for < 0.1% of all breast lesions. Due to rarity of the disease and difficulty in diagnosis, we report a case of a 40-year-old female who had a hard lump in the right breast. Full-field digital mammography suggested the lesion as American College of Radiology Breast Imaging Reporting and Data System-5 (ACR BIRADS-5) (highly suggestive of carcinoma). Histopathological examination of multiple cores of the breast tissue showed lymphocytic inflammatory infiltrates confined to breast lobules. Fungal stains and Ziehl–Neelsen (ZN) stain were negative. A diagnosis of chronic mastitis with the possibility of autoimmune lobular mastitis was suggested. Subsequent image-guided fine needle aspiration smears showed epithelioid granulomas mixed with lymphocytes. Areas of amorphous-to-granular eosinophilic material (caseous necrosis) were seen at places. ZN stain showed acid-fast bacilli. A diagnosis of tuberculous mastitis was given.

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