A case series on tuberculous mastitis
Journal Title: IP Archives of Cytology and Histopathology Research - Year 2016, Vol 1, Issue 1
Abstract
Background: Although Tuberculosis is a very common disease in developing countries like India but tuberculous mastitis is not very common as breast tissue is remarkably resistant to tuberculosis as the environment there is quite infertile for the growth and multiplication of Mycobacterium tuberculi. Aim: Fine needle aspiration (FNAC) is the most widely used investigation of choice and its accuracy varies from 73% to 100%. The demonstration of a caseating granuloma is conclusive of tuberculosis and it is not always mandatory to find a demonstration of acid fast bacilli (AFB). In endemic countries, finding a granuloma in the FNAC studies warrants empirical treatment for tuberculosis. However, an excision biopsy is strongly advocated, to rule out other diagnoses such as sarcoidosis, fungal infection and for excluding breast malignancies that may be coexisting with it. Materials & Methods: A retrospective study was done on patients coming to Patna Medical College and hospital for breast lesions. Out of 796 patients, 16 patients proved to be suffering from tuberculous mastitis. In our series, among the 14 patients FNAC was conclusive in 12 patients, which showed caseating granulomas and AFB was not demonstrated. Though the mycobacterium culture remains the gold standard for the diagnosis of tuberculosis, the time which is required for it and the frequent negative results which are seen with the paucibacillary specimens are important limitations of it. Conclusion: FNAC is a one of the accurate methods for diagnosing tuberculous mastitis. Finding of caseous necrosis, granulomas, epithelioid cell clusters, macrophage and lymphocytes point towards a tuberculous lesion. AFB demosnstration proves it to be of tuberculous origin.
Authors and Affiliations
Iffat Jamal
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