Cases reported "Breast Diseases"

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1/29. Radial scar with microcalcification mammographic-pathologic correlation: case report.

    Radial scar, a descriptive term for a pathologic lesion, is composed of central area of fibroelastosis and distorted ducts, and peripheral zone of intraductal hyperplasia. This lesion often presents as a spiculated lesion, sometimes with microcalcifications, on mammography which may mimic malignancy such as tubular carcinoma. We report a case of radial scar with clustered microcalcifications incidentally found in the screened mammogram.
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2/29. Fine needle aspiration cytology of mammary pseudoangiomatous stromal hyperplasia. A case report.

    BACKGROUND: Pseudoangiomatous stromal hyperplasia (PASH) is an unusual benign breast lesion that may occasionally present as a palpable mass. CASE: This report describes the fine needle aspiration cytology (FNAC) features of a case of mammary PASH that presented as a palpable mass. This is the second description of the FNAC features of this lesion and the first reported case in which a diagnosis of phyllodes tumor was considered. The aspirate was cellular and contained cohesive groups of cells in which there was a dual population of epithelial and myoepithelial cells. Occasional cellular stromal fragments were present, as were typical, bipolar, bare nuclei. Admixed with the bare nuclei were large numbers of plump, spindle-shaped cells, some with intact cytoplasm. Histologic examination of the excised mass showed features typical of PASH. CONCLUSION: Mammary PASH may present as a palpable mass and is likely to be encountered in FNAC specimens. This diagnosis should be considered when one is confronted with an aspirate containing cohesive epithelial groups, cellular stromal fragments and large numbers of single, spindle-shaped cells. These features on FNAC may result in consideration of a phyllodes tumor. The single, spindle-shaped cells may be a characteristic cytologic feature of PASH.
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keywords = hyperplasia
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3/29. Extralymphonodal Castleman's disease. A case report.

    Castleman's disease is a rare lymph node pathology characterized by angiofollicular hyperplasia. There are two forms of the disease: localized and systemic, with different features, symptoms and prognosis. Three are the histological types of disease: plasma cell, hyaline-vascular and mixed variants. We report the case of a 65-year-old female affected by localized plasma cell variant of Castleman's disease. The singularity of our case lies in its localization on the breast and monoclonal plasma cell proliferation inside the nodule.
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4/29. A patient with congenital hypertrichosis, gum hyperplasia and macromastia.

    A syndrome of congenital hypertrichosis, hirsutism, gum hyperplasia and macromastia is described. The patient was demonstrated to have mild hyperinsulinemia with normal oral glucose tolerance test. This is the second such patient reported in the literature.
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keywords = hyperplasia
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5/29. angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the breast: report of a case.

    We report herein the unusual case of a 35-year-old woman found to have angiolymphoid hyperplasia with eosinophilia (ALHE) of the breast. The patient was initially referred to our hospital for investigation of a well-circumscribed breast lump, 2.5 cm in diameter, and a clinical diagnosis of fibroadenoma was made. However, fine-needle aspiration cytology of the lump revealed an admixture of lymphocytes and eosinophils. Therefore, the lump was excised and microscopic examination showed features of ALHE. No evidence of recurrence of the lump has been seen in the 2 years since this excision. To the best of our knowledge, this is the first case to be documented of ALHE arising in the breast.
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keywords = hyperplasia
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6/29. Virginal breast hypertrophy.

    Macromastia is the massive enlargement of the breast, unilateral or bilateral, disproportional to growth in the remainder of the body. Most patients seen with macromastia have breasts that develop normally at puberty but simply reach excessive size. Virginal breast hypertrophy is a rare and distinct disorder with the rapid onset of macromastia at the onset of puberty. Although the disorder has been reported in the surgical, pediatric, and gynecologic literature, virginal breast hypertrophy has not been reported in dermatologic journals. We report two cases of virginal breast hypertrophy. Patient 1 is a 14-year-old girl who developed macromastia 6 months after a liver transplant for alpha 1-antitrypsin deficiency. She had intense erythema as well as verrucous hyperplasia overlying the breasts. Patient 2 was a 12-year-old girl who experienced severe bilateral breast enlargement 4 months after beginning treatment for thyrotoxicosis. She had extreme tenderness, erythema, and edema of the breasts and was treated with tamoxifen citrate, with improvement of her symptoms. Although virginal breast hypertrophy is a rare disorder, the dermatologist may be asked to consult on the associated skin changes in these cases and should be aware of its existence. The definitive therapy is surgical, but until breast growth is stabilized, cutaneous manifestations need to be managed.
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keywords = hyperplasia
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7/29. gynecomastia-like changes of the female breast.

    OBJECTIVES: gynecomastia-like changes of the female breast are only sparsely reported and are not well defined in the literature to our knowledge. Our objectives were to determine the incidence, clinical presentation, mammographic findings, and the medical background of patients with these changes. DESIGN: Two thousand seven hundred nine female breast surgical cases from 1995 to 1999 were searched by SNOMED. Three observers further reviewed all cases with gynecomastia-like changes. Strict criteria were developed and cases that fulfilled the criteria were analyzed further. RESULTS: We found the incidence of female gynecomastia-like changes to be 0.15% (4/2709) of all female breast lesions, which represents an underestimation. patients were usually young and had an average age of 32 years. The usual clinical presentation was a palpable mass with a size ranging from about 3.5 x 2 x 2 cm to 5 x 4 x 2.5 cm. mammography showed either negative findings or a nonspecific density. Gross examination of these specimens revealed no distinct lesions. Histologically, the lesions consisted of ductal hyperplasia with periductal stromal fibrosis or edema. They were associated with fibrocystic changes in the adjacent breast. The patients had no significant medical history. CONCLUSION: We propose that the gynecomastia-like change is a specific benign entity within the spectrum of benign fibrocystic changes and that it usually occurs in young patients.
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keywords = hyperplasia
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8/29. Pseudoangiomatous stromal hyperplasia: presentation as a mass in the female nipple.

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign, localized fibroblastic and myofibroblastic overgrowth that occurs almost exclusively in premenopausal women as a painless, palpable intramammary mass. The lesion has a pale, fibrous, and homogeneous cut surface, is typically well circumscribed, and may have a diameter of 2.0-15 cm. Its ramifying slits lined by flattened myofibroblastic cells are apt to be mistaken for vascular spaces, leading to an erroneous diagnosis of angiosarcoma. The etiology of the condition is unknown, but a relationship to myofibroblastoma has been postulated. Hormonal factors, too, are thought to play a developmental role. The potential for PASH to create a palpable breast mass has been only quite recently advanced in the medical literature, and it has evidently not been reported in the nipple.
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keywords = hyperplasia
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9/29. tamoxifen in the management of pseudoangiomatous stromal hyperplasia.

    Pseudoangiomatous stromal hyperplasia (PASH) is a relatively uncommon histologic finding in breast specimens. The clinicopathologic spectrum of this disease entity can range from a focal nonsignificant microscopic finding to a dominant palpable breast mass. To confirm the diagnosis, a biopsy is required primarily to distinguish PASH from a low-grade angiosarcoma. The mammographic description of PASH is a round or ovoid, circumscribed or partially circumscribed mass. The sonographic feature is a hypoechoic mass. PASH is similar to a fibroadenoma in clinical and imaging features. Progressive breast enlargement associated with engorgement, cyclical breast pain, and burning sensation is of significant concern for some women. The management of the palpable mass and associated symptoms has included excisional biopsy, often leading to recurrent excisions and even mastectomy. This report documents an impressive response to tamoxifen in a patient with PASH presenting with breast enlargement, pain, and breast masses. To our knowledge, there are no reports on the use of tamoxifen or other selective estrogen receptor modulators in the management of this benign breast condition.
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ranking = 5
keywords = hyperplasia
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10/29. pathology of the breast associated with hiv/AIDS.

    Breast pathology that is characteristic of patients infected with human immunodeficiency virus (hiv) has not been addressed in the literature. hiv may directly and indirectly affect the glandular, mesenchymal, and intramammary lymphoid tissue in seropositive patients. Likely infections in this setting include tuberculous mastitis and pyogenic abscesses that may lead to fatal septicemia. Benign stromal changes include gynecomastia, adipose tissue deposition as part of the fat maldistribution syndrome, and pseudoangiomatous stromal hyperplasia. Breast carcinoma in hiv-infected patients occurs at a relatively early age, with increased bilateral disease, unusual histology, and early metastatic spread with a poor outcome. However, the link between breast cancer and hiv remains controversial. Kaposi's sarcoma and non-Hodgkin's lymphoma may also be localized to the breast in patients with acquired immunodeficiency syndrome (AIDS). This article reviews benign and malignant breast diseases that are likely to be encountered in patients with hiv/AIDS.
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keywords = hyperplasia
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