Radio-cytological diagnosis of nodulocaseous tubercular lymphadenitis: a clinical dilemma

  • Ankit Kaushik VMMC and Safdarjung Hospital, GGSIPU
  • Disha Arora
  • Sachin Kolte
  • Kusum Gupta
  • A K Mandal
Keywords: Tubercular lymphadenitis, Ultrasound, FNAC, Breast

Abstract

Nodulocaseous tubercular lymphadenitis is a rare entity presenting with ill-defined breast lump, accompanied by non-specific systemic presentation. We present a case report of a young female patient presenting with breast lump and no definitive clinical diagnosis. The radiological investigation like ultrasound breast revealed multiple enlarged nodulocaseous lymph nodes in all four quadrants of breast. The presence of epitheloid cell granuloma with necrosis on fine needle aspiration cytology established primary diagnosis of intramammary tubercular lymphadenitis.Nodulocaseous tubercular lymphadenitis breast often presents with atypical presentation and primary diagnosis is often difficult to establish. The case establishes the role of ultrasound breast and fine needle aspiration cytology being rapid and cost effective way of diagnosing this lesion.

References

1. Kalac N, Ozkan B, Bayiz H, Dursun AB, Demirag F. Breast tuberculosis. Breast. 2002;11:346-9.
2. Al-Marri MR, Almosleh A, Almoslmani Y. Pri-mary tuberculosis of the breast in Qatar: ten year experience and review of the literature. Eur J Surg. 2000;166:687-90.
3. Dharkar RS, Kanhere MH, Vaishya ND, Baisarya AK. Tuberculosis of the breast. J Indian Med Assoc. 1968;50:207-9.
4. Mukerjee P, George M, Maheshwari HB, Rao CP. Tuberculosis of the breast. J Indian Med Assoc. 1974;62:410-2.
5. Green RM, Ormerod LP. Mammary tuberculosis: rare but still present in the United Kingdom. Int J Tuberc Lung Dis. 2000;4:788-90.
6. Sehgal S, Goyal P, Ghosh S, Mittal D, Singh S. Malignancy and Granulomatosis: Causality or Coincidence? Narrative Systematic Review. Ira-nian Journal of Pathology. 2014;9: 237-244
7. Mckeown KC, Wilkinson KW. Tuberculous dis-eases of the breast. Br J Surg. 1952;39:420.
8. Vassilakos P. Tuberculosis of the breast: cyto-logical findings with fine-needle aspiration. A case clinically and radiologically mimicking car-cinoma. Acta Cytol. 1973;17:160-5.
9. Alagaratnam TT, Ong GB. Tuberculosis of the breast. Br J Surg.1980;67:125-6.
10. Shukla HS, Kumar S. Benign breast disorders in nonwestern populations: Part II - Benign breast disorders in India. World J Surg.1989;13:746-9.
11. Shukla HS, Tewari M. Breast tuberculosis: diag-nosis, clinical features & management. Indian J Med Res. 2005;122:103-10.
12. Popli MB. Pictorial essay: tuberculosis of the breast. Indian J Radiol Imag.1999;9:127-32.
13. Kakkar S, Kapila K, Singh MK, Verma K. Tu-berculosis of the breast. A cytomorphologic study. Acta Cytol.2000;44:292-6.
14. Pagel W, Simmonds FAH, Macdonald J, Nassan E. Pulmonary Tuberculosis, 4th edition. London: Oxford University Press; 1964. p. 245.
Published
2015-01-30
Issue
Vol 2 No 1 (2015)
Section
Case Report

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).

 

Most read articles by the same author(s)

1 2 > >>