title: Necrobiotic palisading granulomas associated with breast carcinoma.
abstract: OBJECTIVE
  The presence of granulomas within the stroma of carcinomas and in the lymph nodes draining carcinomas has been well described. To date, however, there have been few studies examining the occurrence and relevance of necrobiotic granulomas occurring in association with breast carcinoma.
  
  
  RESULTS
  Four cases of breast carcinoma with necrobiotic granulomas were examined using periodic acid Schiff and Ziehl Neelsen stains for fungi and tubercle bacilli and with immunohistochemistry using CAM 5.2, cytokeratin 7, and cytokeratin AE1/3 for tumour cells. In one case the stroma was involved, in the other three cases the lymph nodes contained necrobiotic granulomas. In two of the cases, one with stromal and one with lymph node involvement, the necrobiotic granulomas contained necrotic tumour cells.
  
  
  CONCLUSIONS
  In this study the features of four cases of breast carcinomas with necrobiotic granulomas are examined and their relevance explored. Close scrutiny of such granulomas is necessary to avoid underdiagnosis of metastatic disease.
authors.affiliation: Department of Pathology, Wythenshawe Hospital, Wythenshawe, Manchester, M23 9LT, UK. Johnnycoyne@doctors.org.uk
authors.forename: J D
authors.initials: JD
authors.lastname: Coyne
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000150:complications* / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D017441:Necrobiotic Disorders / Q000209:etiology* / Q000473:pathology