Fine needle aspiration biopsy of mastitis secondary to empyema necessitatis - A report of two cases

BACKGROUND: Empyema necessitatis is a relatively rare entity. Two instances of mastitis secondary to empyema necessitatis, diagnosed by fine needle as piration biopsy are reported. CASES: One case was tuberculous in etiology and was initially recognized by cytologic findings of epithelioid and granulomatous cellular reactions and thr presence of acid-fast bacilli, which were subsequently cultured and sp eciated as Mycobacterium tuberculosis. nle other case was due to coexisting Actinomyces and Actinobacillus. These organisms were cytologically suggest ed by "sulfur" granules of filamentous, gram-positive bacilli, admixed gram -negative coccobacilli and Splendore-Hoeppli phenomenon in an exudative cel l background and were confirmed by microbiologic culture as Actinomyces isr aelii and Astinomyces actinomycetemcomitans, respectively. CONCLUSION: The usefulness of fine needle aspiration cytology ill the diagn osis of empyema necessitatis, supported by ancillary microbial culture, his tochemistry, ann radiographic imaging, is well illustrated by these two cas es.