FUNGAL INFECTION OF THE BREAST: TWO REPORTED CASES DIAGNOSED BY FINE NEEDLE ASPIRATION (FNA) CYTOLOGY
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Date
2009-09-21
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Chiang Mai Medical Journal
Abstract
Objective: To report two cases of fungal infection, zygomycosis and aspergillosis, of the breast, diagnosed by fine needle aspiration (FNA) cytology. In most reports, these fungal species are not frequently encountered in immunocompetent hosts. Both of our patients were in healthy condition.
Materials and methods: All breast FNA cases obtained over a 5 year period in Maharaj Nakorn Chiang Mai Hospital were reviewed. Only two cases of fungal infections were found. The FNA and histologic slides were reviewed.
Results: Case 1: A 42-year-old healthy woman presented with a 1.5 cm ill-defined mass at the left breast. FNA showed fungal hyphae, morphologically consistent with zygomycosis. The histologic study of a subsequent biopsy revealed fungal hyphae with broad and irregular branching, identified by Gomori methenamine silver and Periodic Acid Schiff stains.
Case 2: A 59-year-old woman with a history of intraductal carcinoma and treated with post-lumpectomy and chemotherapy, seven years before, presented with newly developed mass at the right breast. The cytology revealed multiple septate hyphae with dichotomous branching; a feature of aspergillus. The patient was treated by wide excision. Histologic examination showed abscesses containing septate hyphae.
Conclusion: Fungal infection of the breast is uncommon even in patients with immunocompromised status. Both of our patients were healthy, though one was previously diagnosed as having breast cancer and treated seven years before. Our study also emphasized the usefulness of FNA study in diagnosing fungal infection of the breast.
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Chiang Mai Medical Journal; Vol.48 No.2 June 2009 (pages 43 - 76); 65 - 70