Study of the clinical and cytological spectrum of Granulomatous Mastitis: A Retrospective Study in Bundelkhand Medical College Sagar MP


  • Shikha Agarwal Assistant Professor, Department of Pathology, BMC, Sagar, MP,India
  • Atul Jain Associate Professor, Department of Pathology, BMC, Sagar, MP,India
  • Amar Gangwani Professor & HOD, Department of Pathology, BMC, Sagar, MP,India


FNAC, cytological presentations, childbirth, breast.


Background: Granulomatous mastitis (GM) is a benign condition, and therefore its early diagnosis is essential to avoid invasive surgery. The fine needle aspiration cytological (FNAC) features of GM have rarely been discussed in the literature.Aims and objectives: To study the various clinical and cytological presentations of GM and its differentiation from neoplastic lesions of the breast, thus avoiding time-consuming histopathological workup of cases.Materials and methods: Fifty-two cases of GM diagnosed on FNAC were studied between 2017 to 2021 retrospectively. The patient history, clinical findings, and the cytology slides of all the cases were retrieved and studied. Patient details including age, sex, presenting symptoms, obstetrics and lactational history, relevant past medical history, and treatment history were collected. The radiological diagnoses when present were also recorded. The patient's age, sex, history of recent childbirth or lactation, duration of symptoms, laterality of lump,nature of lump whether well-defined or diffuse, presence of discharging sinus,presence or absence of nipple retraction, and axillary lymph nodes were noted and analyzed. Cytological findings include the presence of epithelioid cells, as granulomas or in singles, multinucleated giant cells and their morphology, necrosis, caseous and non-caseous, and type of background inflammation of neutrophils, lymphocytes, and macrophages were also studied from the cytology slides.Results: All patients with GM except one were females (98.08%) with a mean age of 38 years. The majority had left side lump (69.23%) and the size of lump <5 cm (88.46%). 48 (92.3%) patients had a palpable lump, and 8 (15.38%) had axillary lymphadenopathy. In USG, 28.85% had an abscess, 21.15% had irregular hypoechoic mass, and 15.38% had increased vascularity. On fine needle aspiration, blood mixed aspirate was obtained in 65.38% cases, whereas in 34.62% cases, pus was aspirated. On cytological smears, 30.77% of patients showed the presence of ill-formed granulomas, one case had scattered epithelioid histiocytes, and the rest of the cases had well-formed granulomas. Multinucleated giant cells, containing nuclei ranging from 5 to 8, were present in 2 (3.85%) cases, 27 (51.92%) cases also had a predominance of neutrophils among other inflammatory cells forming microabscesses, and 8 (15.38%) cases showed the presence of benign ductal cells of the breast.Conclusion: The common clinical findings include a positive history of recent childbirth or lactation along with results of the firm to hard unilateral palpable lump associated with skinulceration, sinus formation with or without discharge, nipple eversion, or retraction with any associated axillary lymphadenopathy. Epithelioid histiocytes, singly scattered or present as granulomas, multinucleated giant cells along with the background of caseationnecrosis, or neutrophils present in the background are the common cytological features. However, a confident diagnosis requires a multidisciplinary approach based on microbiological investigations, radiological correlation, and histopathological confirmation.




How to Cite

Shikha Agarwal, Atul Jain, & Amar Gangwani. (2021). Study of the clinical and cytological spectrum of Granulomatous Mastitis: A Retrospective Study in Bundelkhand Medical College Sagar MP. International Journal of Health and Clinical Research, 4(18), 135–137. Retrieved from