Diagnostic challenges of tubercular lesions of breast

Zeeba Shamim Jairajpuri; Sujata Jetley; Safia Rana; Shaan Khetrapal; Sabina Khan; Mohammad Jaseem Hassan

doi:10.4103/JLP.JLP_26_17

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(02): 179-184
DOI: 10.4103/JLP.JLP_26_17

Original Article

Diagnostic challenges of tubercular lesions of breast

Zeeba Shamim Jairajpuri

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

,

Sujata Jetley

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

,

Safia Rana

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

,

Shaan Khetrapal

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

,

Sabina Khan

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

,

Mohammad Jaseem Hassan

Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi, India

› Author Affiliations

Abstract

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ABSTRACT

INTRODUCTION: Tuberculosis (TB) in the developing countries presents with both pulmonary and extrapulmonary manifestations. Breast TB, however, remains a rare presentation. Its importance lies in the fact that it may mimic malignancy or present as inflammatory lump/abscess.

AIMS AND OBJECTIVE: The aim of the present study is to highlight the importance of breast TB and its diagnostic challenges.

MATERIALS AND METHODS: It was a retrospective study conducted at a tertiary care hospital, over 2 years between 2013 and 2015 during which eight cases of breast lesions were diagnosed as of tubercular origin.

RESULTS: Granulomas were seen in five cases while three cases revealed only few epithelioid cells, and necrosis was seen in all cases on fine-needle aspiration cytology. Histopathological evaluation was available in six out of the eight cases, while acid–fast bacilli were positive in three cases, the characteristic granulomas were seen in all the six cases evaluated.

CONCLUSION: Significance of TB breast lies in the fact that it may masquerade as breast malignancy or pyogenic abscess. India is a developing country where TB is endemic, a high index of suspicion should be expressed in evaluating breast masses, and TB should be considered in the differential diagnosis.

Keywords

Abscess - breast lump - cytology - malignancy - tuberculosis

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References

References
1 Nirhale DS, Athavale VS, Kishore K, Goenka GG. Is primary tuberculosis of breast a forgotten entity? Series of three cases. Med J DY Patil Univ 2014;7:62-4.
2 Bhosale AA, Joshi AR, Ashturkar AV, Pathak GS. Primary tuberculosis of breast: A case series. Ann Trop Med Public Health 2012;5:262-4.
3 Sharma PK, Babel AL, Yadav SS. Tuberculosis of breast (study of 7 cases). J Postgrad Med 1991;37:24-6, 26A.
4 Morino GF, Rizzardi G, Gobbi F, Baldan M. Breast tuberculosis mimicking other diseases. Trop Doct 2007;37:177-8.
5 Borens-Fefer B, Engohan-Aloghe C, Nosël JC, Simon P, Bucella D, Boutemy R, et al. Primary mammary tuberculosis presenting as a voluminous abscess. JBR-BTR 2008;91:54-7.
6 Fadaei-Araghi M, Geranpayeh L, Irani S, Matloob R, Kuraki S. Breast tuberculosis: Report of eight cases. Arch Iran Med 2008;11:463-5.
7 da Silva BB, Dos Santos LG, Costa PV, Pires CG, Borges AS. Primary tuberculosis of the breast mimicking carcinoma. Am J Trop Med Hyg 2005;73:975-6.
8 Marinopoulos S, Lourantou D, Gatzionis T, Dimitrakakis C, Papaspyrou I, Antsaklis A, et al. Breast tuberculosis: Diagnosis, management and treatment. Int J Surg Case Rep 2012;3:548-50.
9 Maroulis I, Spyropoulos C, Zolota V, Tzorakoleftherakis E. Mammary tubercu-losis mimicking breast cancer: A case report. J Med Case Rep 2008;2:34.
10 Zandrino F, Monetti F, Gandolfo N. Primary tuberculosis of the breast. A case report. Acta Radiol 2000;41:61-3.
11 Kervancioğlu S, Kervancioğlu R, Ozkur A, Sirikçi A. Primary tuberculosis of the breast. Diagn Interv Radiol 2005;11:210-2.
12 Jetley S, Jairajpuri ZS, Pujani M, Khan S. Exotic associations and presentations of an age old disease: Spectrum of tuberculosis in a developing country. Int J Res Med Sci 2016;4:2379-87.
13 Cooper A. Illustrations of the Diseases of the Breast: Part 1. London: Longman, Rees Orme, Brown and Green; 1829. p. 73.
14 Madhusudhan KS, Gamanagatti S. Primary breast tuberculosis masquerading as carcinoma. Singapore Med J 2008;49:e3-5.
15 Tuli R, O’Hara BJ, Hines J, Rosenberg AL. Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: A case report and review of the literature. Int Semin Surg Oncol 2007;4:21.
16 Kedar GP, Bophate SK, Kherdekar M. Tuberculosis of breast. Indian J Tuberc 1985;32:146.
17 Elsiddig KE, Khalil EA, Elhag IA, Elsa ME, Suleiman GM, Elkhidir IM, et al. Granulomatous mammary disease: Ten years’ experience with ne needle aspiration cytology. Int J Tuberc Lung Dis 2003;7:365.
18 Sen M, Gorpelioglu C, Bozer M. Isolated primary breast tuberculosis: Report of three cases and review of the literature. Clinics (Sao Paulo) 2009;64:607-10.
19 Wılson TS, Macgregor JW. The diagnosis and treatment of tuberculosis of the breast. Can Med Assoc J 1963;89:1118-24.
20 Singal R, Bala J, Gupta S, Goyal S, Mahajan N, Chawla A, et al. Primary breast tuberculosis presenting as a lump: A rare modern disease. Ann Med Health Sci Res 2013;3:110-2.
21 Vassilakos P. Tuberculosis of breast: Cytological findings with fine needle aspiration. Acta Cytol 1973;17:160-5.
22 Gulpinar KS, Ozis E, Ozdemir S, Korkmaz A. Primary breast tuberculosis: Report of a case. Surg Sci 2013;4:68-71.
23 Kervancioglu S, Kervancioglu R, Ozkur A, Sirikci A. Diagn Interv Radiol 2005;4:210-2.
24 Chandanwale SS, Buch AC, Gore CR, Ramanpreet KC, Jadhav P. Fine needle aspiration cytology in breast tuberculosis: Diagnostic difficulties – Study of eleven cases. Indian J Tuberc 2012;59:162-7.
25 Tauro LF, Martis JS, George C, Kamath A, Lobo G, Hegde BR, et al. Tuberculous mastitis presenting as breast abscess. Oman Med J 2011;26:53-5.
26 Shinde SR, Chandawarkar RY, Deshmukh SP. Tuberculosis of the breast masquerading as carcinoma: A study of 100 patients. World J Surg 1995;19:379-81.
27 Kakkar S, Kapila K, Sing MK, Verma K. Tuberculosis of the breast. A cytomorphological study. Acta Cytol 2000;44:292-6.
28 Jadhav PS, Pagaro PM, Verma A, Deshpande A. Tubercular breast abscess. Med J DY Patil Univ 2013;6:206-7.
29 De Sousa R, Patil R. Breast tuberculosis or granulomatous mastitis: A diagnostic dilemma. Ann Trop Med Public Health 2011;4:122-5.
30 Mehrotra R. Fine needle aspiration diagnosis of tuberculous mastitis. Indian J Pathol Microbiol 2004;47:377-80.
31 Tewari M, Shukla HS. Breast tuberculosis: Diagnosis, clinical features and management. Indian J Med Res 2005;122:103-10.
32 Gupta PP, Gupta KB, Yadav RK, Agarwal D. Tuberculous mastitis – A review of seven consecutive cases. Indian J Tuberc 2003;50:47-50.
33 Mudduwa LK, Nagahawatte Ade S. Diagnosis of tuberculous lymphadenitis: Combining cytomorphology, microbiology and molecular techniques – A study from Sri Lanka. Indian J Pathol Microbiol 2008;51:195-7.