Periductal mastitis in a male breast masquerading as lobular carcinoma on fine needle aspiration cytology

Abstract

Fine needle aspiration cytology (FNAC) is quite successful in identifying specific benign and malignant breast lesions, but its role in the categorization of proliferative breast lesions has not been well defined. Mastitis/ breast abscess can lead to intense inflammatory response; however, its association with epithelial hyperplasia is rarely reported. At times, it may be difficult to differentiate dense lymphoplasmacytic infiltrate from non-Hodgkin's lymphoma. We present a case of periductal mastitis associated with epithelial hyperplasia, presenting as a subaerolar swelling in a male breast, which was misinterpreted as lobular carcinoma on FNAC.

Plasma Cell Mastitis In Men: A Single-center Experience and Review of the Literature

“…It allows a differential diagnosis between mastitis, gynecomastia and malignant neoplasia, and steers the clinician towards a correct therapeutic approach. In fact, as it can be seen from clinical case number 11 (Table II), fineneedle aspiration cytology does not allow differential diagnosis between plasma cell mastitis and lobular carcinoma, leading to overtreatment, consisting of radical surgery, compared to that to the correct disease (18).…”

“…Rarely is a total mastectomy indicated, when the differential diagnosis between mastitis and carcinoma is uncertain (18).…”

“…In 2005, Reddy et al described the case of a man with a retroareolar breast lump who underwent a fine-needle aspiration and, subsequently, an excisional biopsy (17). In 2011, Gupta et al treated a man with a breast lump, which was initially thought to be a lobular carcinoma, after cytological examination by means of fine-needle aspiration, and therefore treated with a simple mastectomy (18). The definitive histological examination, however, showed the presence of plasma cell mastitis, as in all of the previous cases.…”