Fine needle aspiration cytology in the diagnosis of tuberculous mastitis

OBJECTIVE: To study the relationship between granulomas in the breast and t uberculous mastitis. STUDY DESIGN: Retrospective analysis of 22 breast aspirates that showed epi thelioid cell granulomas. The aspirates were reviewed and the cytomorpholog ic findings summarized. RESULTS: Aspiration cytology revealed epithelioid cell granulomas along wit h giant cells, necrosis and inflammatory cell infiltrate. Overall acid-fast bacillus (AFB) positivity was 22.7%. AFB positivity was greater in the pre sence of necrosis when epithelioid cells were absent. CONCLUSION: In a country like India, the diagnosis of granulomatous mastiti s must be made with caution, even in the abscence of AFB. Only after a suff icient trial of antituberculosis treatment hits been given and the patient fails to respond should an alternative diagnosis be suggested.