Martínez-Parra D, Nevado-Santos M, Meléndez-Guerrero B, García-Solano J, Hierro-Guilmain C C, Pérez-Guillermo M
Department of Pathology, Valme University Hospital, Seville University, Spain.
Diagn Cytopathol. 1997 Aug;17(2):108-14. doi: 10.1002/(sici)1097-0339(199708)17:2<108::aid-dc5>3.0.co;2-c.
Fourteen cases of granulomatous mastitis (GM) studied by fine-needle aspiration (FNA) are reviewed and nine cytologic features (necrosis, neutrophil granulocytes, foamy cells, plasma cells, granulomas, epitheloid cells, multinucleated giant cells of foreign body type and Langhans' type, duct cells, and the presence of acid-fast bacilli) are reappraised in a semiquantitative manner. The main objective of this study was to find out if one or more of these features would permit the various granulomatous entities identified in surgical pathology to be separated cytologically. The results suggest that FNA does not permit the various granulomatous lesions identified in surgical pathology to be differentiated, since in this series different entities share a common cytologic pattern. Only the presence of acid fast bacilli in smears would enable a tuberculous etiology to be diagnosed. The opinion is put forward that the term GM should be avoided in the cytologic report and substituted by the noncommitted term "granulomatous lesion of the breast.
回顾了14例经细针穿刺活检（FNA）研究的肉芽肿性乳腺炎（GM）病例，并以半定量方式重新评估了9个细胞学特征（坏死、中性粒细胞、泡沫细胞、浆细胞、肉芽肿、上皮样细胞、异物型和朗汉斯型多核巨细胞、导管细胞以及抗酸杆菌的存在）。本研究的主要目的是确定这些特征中的一个或多个是否能在细胞学上区分手术病理学中识别的各种肉芽肿性实体。结果表明，FNA无法区分手术病理学中识别的各种肉芽肿性病变，因为在本系列中不同实体具有共同的细胞学模式。涂片上仅抗酸杆菌的存在可诊断结核病因。有人提出，在细胞学报告中应避免使用GM一词，而用非特定术语“乳腺肉芽肿性病变”代替。
