A rare case of xanthogranulomatous mastitis with intraductal papilloma

Abstract

Xanthogranulomatous inflammation is rare and has been described most commonly in kidney and gallbladder. It is extremely rare in breast. We report here a case of a 42-year-old female who came with firm painless lump in the left breast. Mammography suggested suspicious neoplastic retroareolar lesion. Fine-needle aspiration (FNA) smears suggested a benign cystic lesion and excision of the cyst was advised. Histopathological examination revealed breast tissue infiltrated with polymorphonuclear leukocytes, lymphoplasmacytic inflammatory cells, few giant cells, and sheets of foamy histiocytes (xanthoma cells) with a focus of intraductal papilloma. A diagnosis of xanthogranulomatous mastitis with intraductal papilloma was made. Chronic inflammatory lesions are known to produce firm lesions which may mimic neoplastic lesion. Definitive diagnosis could not be achieved in FNA smears due to the absence of adequate number of xanthoma cells. Final diagnosis was made on histopathology examination. Xanthogranulomatous mastitis is an extremely rare entity. Clinical presentation is quite variable. Imaging modalities and FNA are inadequate for definitive diagnosis.