*Corresponding author: Dr. Ankit Kaushik, B-19 Mahesh Park, Modinagar, Ghaziabad, UP, India Email: Kaushikankit30@yahoo.co.in, Phone. +91-9953816240. Date of Submission: May 30, 2014 Date of Acceptance: Sept 28, 2014 Date of Publishing: Jan #, 2015 Case Report This work is licensed under the Creative Commons Attribution 4.0 License. Published by Pacific Group of e-Journals (PaGe) Radio-cytological diagnosis of nodulocaseous tubercular lymphadenitis: a clinical dilemma Keywords: Tubercular lymphadenitis, Ultrasound, FNAC, Breast Abstract Ankit Kaushik*, Disha Arora, Sachin Kolte, Kusum Gupta, A K Mandal Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Nodulocaseous tubercular lymphadenitis is a rare entity presenting with ill-defined breast lump, accompanied by non-specific systemic presentation. We present a case report of a young female patient presenting with breast lump and no definitive clin- ical diagnosis. The radiological investigation like ultrasound breast revealed mul- tiple enlarged nodulocaseous lymph nodes in all four quadrants of breast. The pres- ence of epitheloid cell granuloma with necrosis on fine needle aspiration cytology established primary diagnosis of intramammary tubercular lymphadenitis. Nodulocaseous tubercular lymphadenitis breast often presents with atypical presen- tation and primary diagnosis is often difficult to establish. The case establishes the role of ultrasound breast and fine needle aspiration cytology being rapid and cost effective way of diagnosing this lesion.