Granulomatous mammary disease: ten years' experience with fine needle aspiration cytology.
OBJECTIVE
To determine the aetiological types of granulomatous disease of the breast in women presenting with mammary complaints in the Sudan.


METHODS
Clinical history and physical examination, complete blood counts, Mantoux test, histopathology and fine needle aspiration cytology (FNAC).


RESULTS
Granulomatous mastitis was seen in 11/2500 (0.44%) patients with mammary disease over a 10-year period. All were of childbearing age (mean 26.0 +/- 5.9 years). Common presentations were diffuse swelling, well-circumscribed masses, nipple retraction, multiple sinuses and superficial skin ulcers. Lymphadenopathy was seen in more than 60% of the patients. Diagnosis was based on cytomorphological features in 10/11 cases and histopathology in one. Nine were diagnosed with tuberculous mastitis and two with idiopathic granulomatous mastitis. Acid-fast bacilli (AFB) could not be demonstrated in any of the cytology smears. Tuberculous mastitis responded to empirical anti-tuberculosis treatment, with a minimum follow-up of 2 years in seven women.


CONCLUSIONS
Tuberculous mastitis is a rare entity in women with mammary disease in the Sudan. Alternative diagnoses such as idiopathic granulomatous mastitis should be made only after failure of an adequate trial of anti-tuberculosis treatment. FNAC is a useful diagnostic tool even if AFB cannot be demonstrated.
Department of Surgery, Faculty of Medicine, Khartoum, Sudan.
K E
KE
Elsiddig
E A G
EA
Khalil
I A
IA
Elhag
M E M O
ME
Elsafi
G M
GM
Suleiman
I M
IM
Elkhidir
A M
AM
Hussein
A M
AM
El-Hassan
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D001707:Biopsy, Needle; D002908:Chronic Disease; D003581:Cytodiagnosis; D005260:Female; D006099:Granuloma / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008413:Mastitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013397:Sudan / Q000453:epidemiology
D000995:Antitubercular Agents