Phyllodes Tumour of the Breast Associated with Concomitant Tuberculous and Sarcoid Like Lesions in the Axillary Lymph Nodes: A Case Report

The concomitant presence of tuberculous and sarcoid like lesions in the lymph nodes, which drain a neoplasm, is very rare. The case which is reported here is that of a 40 years old female patient who presented with a history of a right sided breast mass of 5 years duration. Fine needle aspiration cytology (FNAC) of the breast lump suggested the features of a phyllodes tumour of questionable malignant potential. She underwent a simple mastectomy with axillary lymph node clearance. The histo­ pathological examination of the tumour revealed the features of a borderline phyllodes tumour of the breast. The axillary lymph nodes revealed a florid, sarcoid like, granulomatous reaction and caseating granulomas with acid fast bacillus positivity. There was no clinical, radiological or immunological evidence of systemic sarcoidosis. No metastatic deposits were seen in the lymph nodes. The occurrence of the sarcoid like reaction and tuberculosis concomitantly in the lymph nodes, which drain a breast neoplasm, has been described and discussed. Phyllodes Tumour of the Breast Associated with Concomitant Tuberculous and Sarcoid Like Lesions in the Axillary Lymph Nodes: A Case Report