Breast Carcinoma Masquerading as Granulomatous Mastitis on Fine Needle Aspiration Cytology lessons to learn!

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Breast Carcinoma Masquerading as Granulomatous Mastitis on Fine Needle Aspiration Cytology lessons to learn!

Anwar Ul Haque, Abdaal Munir and Hajra Farooq
Department of Pathology, Azad Jammu & Kashmir Medical College, AJK University, Muzaffarabad, Azad Kashmir Pakistan

Abstract

Chronic granulomatous mastitis is not an uncommon entity. It mimics breast carcinoma on physical, gross & microscopic examinations; both on histopathological and fine needle aspiration cytology. At other times invasive ductal carcinoma may suggest granulomatous mastitis. A case is presented here where ductal carcinoma was misinterpreted as granulomatous mastitis on fine needle aspiration cytology smears in a 48 yr old woman who presented with large painful lump in her left breast. The mass was subsequently excised and the histopathological examination revealed infiltrating ductal carcinoma. Reexamination of the cytology smears did show some atypical cells commensurate with the ductal carcinoma. We here discuss various reasons and factors responsible for over and under interpretation of cytological atypia.
Key words: Granulomatous mastitis, Breast disease, Ductal carcinoma, Cytological atypia, Fine Needle Aspiration Cytology, FNAC, False positive cytology, False negative cytology, Laboratory error.

         

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