UTILITY OF FINE-NEEDLE ASPIRATION IN THE DIAGNOSIS OF GRANULOMATOUS LESIONS OF THE BREAST

Fourteen cases of granulomatous mastitis (GM) studied by fine-needle a spiration (FNA) are reviewed and nine cytologic features (necrosis, ne utrophil granulocytes, foamy cells, plasma cells, granulomas, epithelo id cells, multinucleated giant cells of foreign body type and Langhans ' type, duct cells, and the presence of acid-fast bacilli) are reappra ised in a semiquantitative manner. The main objective of this study wa s to find out if one or more of these features would permit the variou s granulomatous entities identified in surgical pathology to be separa ted cytologically. The results suggest that FNA does not permit the va rious granulomatous lesions identified in surgical pathology to be dif ferentiated, since in this series different entities share a common cy tologic pattern. Only the presence of acid fast bacilli in smears woul d enable a tuberculous etiology to be diagnosed. The opinion is put fo rward that the term GM should be avoided in the cytologic report and s ubstituted by the noncommitted term ''granulomatous lesion of the brea st.'' (C) 1997 Wiley-Liss, Inc.