We saw skin lesion at the contact site. LAP biopsy specimens reevaluated by pathologist.

It was reported as micro abscess and necrotizing granulomatous lymphadenitis. He was diagnosed as Cat-Scratch Disease (CSD) and treatment with Doxycycline was started. A 40-year-old female without any complaint admitted to a general surgery clinic for routine clinical breast examination. She had no history of childbirth, nursing, oral contraceptive SCH 900776 cell line use, hyperprolactinemia within 2 years. Breast US showed punctate microcalcification in left upper-middle zone and mammography showed nodulary density in left middle zone. Excisional biopsy of breast tissue revealed noncaseating lobular granulomas composed of epithelioid histiocytes and multinuclear giant cells and intraductal papilloma, with no evidence of malignancy. She was

referred to our clinic with presumptive diagnosis of TB. Tissue sample was negative for AFB. Chest radiography was normal (Fig. 3). Three sputum smears AFB and TB cultures were negative. Fiberoptic bronchoscopy was normal and bronchial lavage AFB and TB culture was negative. PPD was negative. ESR was 9 mm/h. Serum ACE, calcium and urinary calcium levels were within normal range. Serum tumour marker levels were normal. All other laboratory findings were selleck compound normal. Abdominal and neck US examinations were normal. Despite of all examinations, there could not be found any finding related with TB, fungal disease, parasitary disease, and other diseases causing granulomatous lesions. This case was suggested idiopathic granulomatous mastitis (IGM). Diagnosis of granulomatous inflammation is a common practice in pathology. The common causes of granulomatous reaction are infective agents like mycobacteria, fungi, parasites, etc. and non-infective aetiologies like sarcoidosis, foreign bodies, Wegener’s granulomatosis,

Crohn’s disease, etc. In addition, certain neoplasms are also known to be associated with a granulomatous response in the parenchyma e.g. Hodgkin’s disease.1, 2 and 3 Differential diagnosis Bay 11-7085 and management demand a skilful interpretation of clinical findings and histology. Infections are the commonest causes of disseminated granulomatous disease. Some experts regard an infection as the root cause of all such disorders but that it still remains undetected in some; over the past decade advances in molecular diagnostic techniques have allowed identification of causal organisms that were previously unrecognised.4 Tularemia is caused by bacterium Francisella tularensis. It occurs naturally in rabbits, hares and rodents. F. tularensis can be transmitted to humans via various mechanisms: Bites by infected arthropods, direct contact with infected animals, handling of infectious animal tissues or fluids, direct contact with contaminated soil or water, ingestion of contaminated food, water, or soil, inhalation of infectious aerosols. 5, 6, 7 and 8 Because of the difficulty in culturing F.