Profile of patients with granulomatous mastitis presenting to a university teaching hospital in UAE: a case series

To highlight the profile of five patients diagnosed as having granulomatous mastitis by histopathological examination. This presentation is a case series of patients, diagnosed as idiopathic granulomatous mastitis by histopathological examination of excised specimens. The total number of cases included in the report was five females over a 4-year period from 2005 to 2009. The mean age of the patients was 29.6 years and the duration of symptoms varied from three weeks to four months. All the patients presented with a palpable mass in the breast, and two patients had associated pain and one had a bloody nipple discharge. The average size of the excised masses was 3.8 cm x 3.1 cm. Four out of the five patients diagnosed to have breast abscess or segmental mastitis had taken a course of antibiotics. One patient had a persistent wound sinus which subsided with ATT and the rest of the patients had no post-operative complications. Idiopathic Granulomatous Mastitis [IGM] is a relatively rare disease which mimics the common breast disorders in the reproductive age group including malignancy

P53 and carcinoembryonic antigen [CEA] as immunocytochemical markers to differentiate malignant from benign serous effusions

Serous effusions occur as a manifestation of a variety of different diseases of a benign and malignant nature. Cytological diagnosis of serous effusions is based upon the distinction between benign and malignant cells at the light microscope level. This differentiation is not easy to perform in all cases due to the fact that benign reactive mesothelial cells may resemble the cells derived from adenocarcinoma or mesotheliomas. This study is an attempt to improve the diagnostic accuracy of the cytological diagnosis of malignant effusions by investigating cytologic and immunocytochemical changes in cells exfoliated in those effusions. A total of [50] inpatients with effusions [pleural and ascitic], and having a high risk of malignancy were included in this study. Effusion fluids were aspirated. All of the 50 specimens obtained were processed and examined by conventional cytologic technique and immunocytochemical technique using 2 monoclonal antibodies [p53 and CEA]. All of the cases were followed up and the final clinical diagnosis were recorded that included various other investigations done including histopathology and the final clinician's opinion. The final clinical diagnosis was regarded then as the gold standard for comparative statistical work of this study. The final clinical diagnosis revealed that 36 [72%] cases were malignant and 14 [28%] were benign. The sensitivity of cytology was 86.1%; specificity was 92.85%, with an overall accuracy of 88%. While the sensitivity, specificity, and accuracy of p53 were [63.8%, 92.8%, 72%] and of CEA were [72.22%, 85.7%, 76%] respectively. combined p53 and CEA results showed a sensitivity of 83.33%, specificity of 85.71%, and an accuracy of 84%. And when both cytology and immunocytochemistry were combined in parallel the sensitivity was 91.66%, specificity was 85.7%, and the accuracy was 90%. Adenocarcinoma of lung followed by that of breast were the most frequent primary tumors metastasizing to the pleural cavity. While adenocarcinoma of the ovary and stomach were the most frequent primary tumors metastasizing to the peritoneal cavity. It is concluded that using 2 or more [panel] selected monoclonal antibodies will surely enhance the accuracy of immunocytochemical technique for malignancy detection while combined cytology and immunocytochemistry have higher accuracy than each of them alone