Coryneform Bacteria in Granulomatous Lobular Mastitis: Morphological Diagnosis in Breast Biopsies

Int J Surg Pathol. 2019 Jun;27(4):380-386. doi: 10.1177/1066896918815580. Epub 2018 Nov 29.


Granulomatous lobular mastitis is a rare disease whose origin is still unknown and shows an increase in its frequency. Morphological, microbiological, and molecular biology studies have linked this disease to lipophilic and fastidious corynebacteria, suggesting its possible infectious etiology. This series describes and reviews in detail the distinctive morphological characteristics of the bacteria present in the granulomas of this disease, the usefulness of histochemical techniques for their identification, and our proposal for a tissue quantification score for the bacteria. The MacCallum-Goodpasture method of Gram's stain turned out to be the gold standard for examination, but we also highlight the efficiency of hematoxylin and eosin stain when it is exhaustively examined as well as the Grocott stain to evaluate the bacterial pleomorphism method, which is often underutilized.

Keywords: Gram and Grocott stains; breast inflammation; coryneform lipophilic bacteria; granulomatous lobular mastitis; pathological diagnosis.

MeSH terms

  • Actinomycetales / isolation & purification*
  • Actinomycetales Infections / diagnosis*
  • Actinomycetales Infections / microbiology
  • Actinomycetales Infections / pathology
  • Adult
  • Aged
  • Biopsy
  • Breast / microbiology
  • Breast / pathology*
  • Coloring Agents / chemistry
  • Eosine Yellowish-(YS) / chemistry
  • Female
  • Gentian Violet
  • Granulomatous Mastitis / diagnosis*
  • Granulomatous Mastitis / microbiology
  • Granulomatous Mastitis / pathology
  • Hematoxylin / chemistry
  • Humans
  • Middle Aged
  • Phenazines
  • Young Adult


  • Coloring Agents
  • Gram's stain
  • Phenazines
  • Gentian Violet
  • Eosine Yellowish-(YS)
  • Hematoxylin