Carcinoma in situ dentro de un fibroadenoma de mama: tres casos clínicos / Carcinoma within a fibroadenoma of the breast: report of three cases

El fibroadenoma (FA) es un tumor frecuente de la mama que se presenta usualmente en la segunda y tercera década de la vida. Los carcinomas de la mama raramente se desarrollan dentro de un FA, existiendo alrededor de 200 casos descritos en la literatura. Nosotros reportamos la presencia de carcinoma ductal in s/fu(CDIS) al interior de un FA en tres pacientes mujeres de 31, 45 y 47 años. La presencia de microcalcificaciones en dos pacientes y la sospecha de un papiloma intraductal en la tercera, determinaron la necesidad de mastectomía parcial y el consiguiente hallazgo de CDIS al interior de un FA. En dos casos hubo presencia de CDIS extenso en el parénquima mamario adyacente y fueron sometidas finalmente a una mastectomía total. Recomendamos un seguimiento estricto en mujeres con FA a partir de la cuarta década de la vida. En pacientes con lesiones mamarias pro I iterativas o con CDIS que presentan además un FA, se recomienda vigilancia del FA o resección de éste al momento de extirpar el CDIS.

The fibroadenoma (FA) is a common tumor of the breast that usually occurs in the second or third decade of Ufe. The carcinomas of the breast rarely arising within a FA, with around 200 cases reported in the literature. We report the presence of DCIS within a FA on three female patients of 31, 45 and 47 years old. Due to the presence of microcalcifications in two patients and the suspicion of an intraductal papilloma in the third, they underwent a partial mastectomy with the consequent finding of DCIS inside a FA. In two cases there were extensive DCIS in the adjacent breast parenchyma and finally they underwent a total mastectomy. We recommend a strict follow up in women with FA from the fourth decade of life. In patients with proliferatives breast lesions or DCIS that simultaneously presenting a FA, we recommend surveillance of FA or remove it at the same time of the resection of DCIS.

Stromal cellular response in breast tumours and allied lesions.

Histopathological study for stromal cellular response was made on 200 cases of benign and dysplastic lesions and malignancy of breast. Infiltrations with lymphocytes and plasma cells were observed in 64% cases of fibroadenoma, 66.6% cases of giant fibroadenoma, 61% cases of mammary dysplasia and 33.3% cases of gynaecomastia. While mast cell infiltration was not observed in giant fibroadenoma, its presence was observed in 92% cases of fibroadenoma, 77.8% cases of mammary dysplasia and 33.3% cases of gynaecomastia. Lymphocytes and plasma cells infiltrations were observed in 100% of cases of invasive duct carcinoma, medullary carcinoma and fibrosarcoma. Comedocarcinoma showed infiltration with these cells in 75% of cases while that for colloid carcinoma and Paget's disease of breast were observed in 50% of cases of each. Infiltrations with mast cells were observed in 92.3% cases of invasive duct carcinoma, 75% cases of comedocarcinoma and 25% cases of medullary carcinoma. Other malignant conditions of breast did not show mast cell infiltration. Degree of infiltration with lymphocytes and plasma cells was mainly of low grade in benign and dysplastic lesions compared to high degree of infiltration in malignancy. Mast cell infiltration was of low degree in both the types of lesions.

Quantitative analysis of nuclear area variation in benign and malignant breast fine needle aspirates.

The measurement of nuclear area was carried out in 30 benign and 32 malignant breast lumps using Omnicon Alpha 500 Image Analyzer. The mean nuclear area of duct cells in malignant group was greater (157.6 +/- 58.64 sq.microns with a peak around 140 sq.microns) and more heterogenous within and amongst cases than observed in duct cells from most of the cases of fibroadenoma (85.05 ae 14.2 sq.microns with a peak around 80 sq.microns). Taking into consideration 110 sq.microns as a differentiating limit, a significant difference was observed between benign and malignant conditions (p). Similarly taking 118 sq.microns as differentiating limit duct cell carcinomas could be divided into two groups i.e. 9(28.1%) cases of small nuclear type with a range of 80-118 sq.microns and 23(71.9%) cases of large nuclear type with a range of 118-320 sq microns .6(18.8%) cases with small nuclei had an overlap with fibroadenoma. Although 13(72.2%) cases of large nuclear type carcinomas had lymph node metastasis as against 4(44.4%) in small nuclear group, the difference was not statistically significant.

Fibroadenomas cardiacos en la infancia. Informe de un caso y revisión de la literatura / Cardiac fibroadenomas in childhood: Case report and review of literature

Se presenta un caso de fibroma cardíaco en una niña de cuatro meses con cuadro clínico final de choque cardiogénico. El diagnóstico se estableció en el estudio de autopsia. El tumor midió 4 X 6 cm. y se localizó en el septum interventricular con extensión amplia a ambos ventrículos, reduciendo la cavidad cardíaca en un 30% aproximadamente. Se analizan las características epidemiológicas, clínicas e histopatológicas de esta entidad

Serum leucine aminopeptidase estimation: a sensitive prognostic indicator of invasiveness in breast carcinoma.

Serum Leucine Aminopeptidase (LAP) was studied in 25 patients of breast tumors, and compared with 50 age matched controls. Clinical staging was done in 13 cases of breast carcinoma. Serum LAP was increased but not significantly in stage I (P less than 0.1), while in stage II & III, significant increase was observed (P less than 0.05), but a sharp peak was noted in stage IV with metastasis in liver (P less than 0.001). Serum LAP values were correlated with histological sub-types of breast carcinoma. Highest serum LAP values were observed in filtrating duct carcinoma with productive fibrosis (P less than 0.01), followed by medullary carcinoma and the enzyme values were slightly decreased in intraductal carcinomas.

Carcinoma y fibroadenoma de mama / Carcinoma and fibroadenoma of the breast

Se revisaron 8 casos de carcinoma de mama en coexistencia con fibroadenoma del archivo de la División Patología del Hospital de Clínicas, comprendidos entre los años 1957 y 1987. En 3 de los pacientes el carcinoma se originó en el fibroadenoma (grupo I), en los 5 restantes en el tejido mamario adyacente (grupo II: carcinomas sincrónicos). Todos los pacientes eran mujeres. Durante el peródo 1957-1987 se estudiaron 987 fibroadenomas y 2004 carcinomas. De acuerdo a estas cifras el 0,30% de los fibroadenomas desarrolló un carcinoma en el componente epitelial, y el 0,15% de los carcinomas se originó a partir del epitelio de un fibroadenoma. La edad promedio general fue 43,3 años. En los carcinomas in situ el promedio descendió a 39 años y en los infiltrantes alcanzó los 45,5 años. La edad promedio fue 20 aös mayor que la edad pico de aparición de los fibroadenomas. En el grupo I, se encontró un carcinoma lobulillar y dos carcinomas ductales, todos ellos in situ. Dos de los 3 pacientes mostraron la coexistencia de otra neoplasia ginecológica. En el grupo II, se observó un carcinoma lobulillar, tres ductales y uno lobulillar y ductal. Todos ellos fueron infiltrantes. El tejido mamario adyacente mostró en todos los casos patologia significativa consistente en: múltiples fibroadenomas, enfermedad fibroquística, adenosis esclerosante, carcinoma que tratan de explicar la asociación entre carcinoma y fibroadenoma mamarios. La baja probabilidad que tiene un fibroadenoma de dessarrollar un...

Ultraestrutura de los fibroblastos en el fibroadenoma de la mama / Ultrastructure of fibroblasts in fibroadenoma of the breast

Se estudian seis casos de fibroadenoma de la mama desde el punto de vista ultraestructural, con especial referencia a los fibroblastos acompaña de un estudio comparativo ultraestructural de los fibroblastos de la mama normal. También los hallazgos ultraestructurales se comparan con los fibroblastos del cistosarcoma phyllodes benigno y del cistosarcoma phyllodes maligno. Se complementa el estudio con microscopia óptica. Se llega a conclusiones, y se hacen algunos aportes de la ultraestructura de los fibroblastos, no señalados en la literatura