Mastopatia linfocítica simulando neoplasia de mama: relato de caso / Lymphocytic mastopathy mimicking breast malignancy: a case report

A mastopatia linfocítica acomete mulheres jovens e de meia idade e está frequentemente associada a doenças autoimunes. Seu diagnóstico é feito associando achados clínicos (espessamento ou nódulo mamário endurecido), radiológicos (aumento da densidade mamária, nódulo e calcificações), ultrassonográficos (nódulo com sombra acústica posterior), histopatológicos (fibrose e infiltrado linfocítico) e imuno-histoquímicos. É uma entidade benigna que pode simular carcinoma. Neste artigo, relata-se um caso de paciente com mastopatia linfocítica.

Lymphocytic mastopathy affects both young and middle-aged women and is frequently associated with autoimmune diseases. Diagnosis is done by associating clinical (breast tissue thickening or hardened breast lump), radiological (increased breast density, presence of mass and calcifications), sonographic (nodule with posterior acoustic shadowing), histopathological (fibrosis and lymphocytic infiltrate) and immunohistochemical findings. Lymphocytic mastopathy is a benign entity that may mimic carcinoma. The authors report the case of a patient with lymphocytic mastopathy.

Qualidade da interpretação do diagnóstico mamográfico / Quality of the interpretation of diagnostic mammographic images

OBJETIVO: Demonstrar o conhecimento mamográfico dos médicos interpretadores que trabalham na rede de saúde pública do Estado do Rio de Janeiro e avaliar o conhecimento adquirido após um curso elaborado com o objetivo de capacitar profissionais médicos no diagnóstico precoce do câncer de mama. MATERIAIS E MÉTODOS: Foram convidados 53 médicos que laudam exames mamográficos para o treinamento. Esses médicos eram submetidos a um pré-teste, no qual se avaliava o grau de conhecimento inicial. Depois, foram lecionadas aulas previamente elaboradas por mamografistas experientes, e para conclusão do curso esses médicos eram submetidos a um pós-teste para avaliação do conhecimento adquirido. RESULTADOS: O curso de capacitação de profissionais médicos, com ênfase em aulas teóricas, não mostrou aumento significativo na qualidade da interpretação mamográfica, destacando-se a persistência do erro na descrição morfológica das lesões fundamentais da mama, erro da classificação pelo sistema de padronização das lesões mamárias (BI-RADS®), falta de coerência entre a classificação BI-RADS adotada e a recomendação de conduta, tanto no pré-teste como no pós-teste. CONCLUSÃO: Concluiu-se que os médicos interpretadores mostram conhecimento insuficiente em relação ao diagnóstico precoce por imagem do câncer de mama e que o curso teórico não mostrou aumento significativo na qualidade da interpretação mamográfica.

OBJECTIVE: To demonstrate the knowledge of mammogram readers working in the public healthcare system in the State of Rio de Janeiro, RJ, Brazil, and to evaluate their progress in the early diagnosis of breast cancer after a training course specifically developed for medical professionals . MATERIALS AND METHODS: A group of 53 physicians with experience in mammography reports were invited. A pre-test was given to assess their initial knowledge level. Afterwards, they were trained by experts mammographers, and for final conclusion, requested to take a post-test for comparison and evaluation of gained knowledge. RESULTS: The course, with emphasis on theoretical classes, has not resulted in a significant improvement on the quality of mammogram reading, highlighting the persistence of errors in morphological description of fundamental lesions of the breast, in the classification of such lesions according to the BI-RADS®, besides the lack of coherence between the BI-RADS classification and follow-up recommendation as observed in both the pre- and post-test. CONCLUSION: The authors conclude that the mammogram readers have demonstrated insufficient knowledge in relation to early imaging diagnosis of breast cancer, and that the theoretical training has not resulted in a significant improvement on the quality of mammogram reading.

Development beyond the gastrula stage and digestive organogenesis in the apple-snail Pomacea canaliculata (Architaenioglossa, Ampullariidae)

Development of Pomacea canaliculata from the gastrula stage until the first day after hatching is described. Trochophore embryos are developed after gastrulation, showing the prototroch as a crown of ciliated orange-brownish cells. However, no true veliger embryos are formed, since the prototroch does not fully develop into a velum. Afterward, the connection between the fore- and midgut is permeated and the midgut becomes full of the pink-reddish albumen, which is stored into a central archenteron's lake, from where it is accumulated into the large cells forming the midgut wall ("giant cells"). Electron microscopy of giant cells in late embryos showed that albumen is engulfed by large endocytic vesicles formed between the irregular microvilli at the top of these cells. By the end of intracapsular development, giant cells become gradually replaced by two new epithelial cell types which are similar to those found in the adult midgut gland: the pre-columnar and the pre-pyramidal cells. Pre-columnar cells have inconspicuous basal nuclei and are crowned by stereocilia, between which small endocytic vesicles are formed. Pre-pyramidal cells have large nuclei with 2-3 nucleoli and show a striking development of the rough endoplasmic reticulum. The genesis of the three cell lineages (giant, pre-columnar and pre-pyramidal cells) is hypothetically attributed to epithelial streaks that occur at both sides of the midgut since early stages of development.

Intrahost distribution and trasmission of a new species of cyclopoid copepod endosymbiotic to a freshwater snail, Pomacea canaliculata (Caenogastropoda, Ampullariidae), from Argentina

A new species of cyclopoid copepod, Ozmana huarpium, is described as a symbiont to Pomacea canaliculata (Lamarck 1822) (Caenogastropoda, Ampullariidae). Rather large numbers (about one hundred copepods per snail)were found, althought there was no evidence of harm to the host. To our knowledge, O. haemophila (symbiont to P. maculata), and the currently described species, O. huarpium, are the only copepod species ever recorded as endosymbionts to freshwater invertebrates. While O. haemophila is restricted to the haemocoel of its host, O. harpium predominate in the penis sheath, the ctenidium and the mantle cavity, figuring in these pallial organs 63-65 por ciento of total mature forms. The sex ratio of the symbiont is skewed to the female side in these organs, specially in male hosts. The hypothesis that a special female tropism for the male host´s pallial organs might ensure interindividual transmission of the symbiont was tested, with indications that the symbiont is mainly transmitted during copulation.