ABSTRACT
Resumen OBJETIVO: Describir las características clínicas de la mastitis granulomatosa idiopática y exponer los esquemas de tratamiento indicados a una serie de pacientes. MATERIAL Y MÉTODOS: Estudio retrospectivo y transversal efectuado en una serie de casos de pacientes con mastitis granulomatosa idiopática atendidas entre mayo de 2012 y julio 2013 por el Grupo de Alta Especialidad Ginecológica y Mamaria de la Ciudad de México. A todas las pacientes se les tomó una biopsia escisional, justificada y guiada por un estudio radiológico previo. RESULTADOS: Se incluyeron 21 pacientes de edad promedio de 42 años (DE ± 12.5 años) 7 de 21 estaban en la menopausia, 3 de 21 habían permanecido asintomáticas, 2 de 21 con telorragia, 14 de 21 con tumoración mamaria y 2 de 21 con mastalgia. El reporte radiológico de BIRADS fue: 3 = III, 8 = IVa, 8 = IVb y 2 = IVc. La resección quirúrgica se practicó a 19 de 21 pacientes y a 14 de 19 se les administró, antes de la operación, prednisona. CONCLUSIONES: La combinación del tratamiento médico y quirúrgico mejora el pronóstico funcional y cosmético de las pacientes con mastitis granulomatosa y disminuye el riesgo de coincidencia inadvertida de carcinoma de mama.
Abstract OBJECTIVE: To describe the clinical characteristics of the patients studied with Mastitis idiopathic granulomatous (MGI), also to provide therapeutic tools for these kind of patients. MATERIAL AND METHODS: Retrospective cross-sectional study of 21 patients with MGI who underwent excision, justified and guided by a previous radiological study, with a complete file and a histopathology report that confirmed the pathological entity. Results: We included 21 patients with an average age of 42 years (SD +/- 12.5 years) 7/21 were in the menopause stage. The clinical presentation was: 3 asymptomatic, 2 with sporulation, 14 with mammary tumor and 2 with mastalgia. The radiological report of BIRADS was: 3 = III, 8 = IVa, 8 = IVb and 2 = IVc. Surgical resection was performed at 19/21 and at 14/19, prednisone was administered preoperatively. CONCLUSIONS: The combined use of medical and surgical treatment improves the functional and cosmetic prognosis in the patient, as well as decreases the risk of inadvertent coincidence of a breast carcinoma.
ABSTRACT
La enfermedad de Rosai-Dorfman es una entidad rara que afecta al tejido linfático. Hasta un 43% de los casos pueden tener afección extranodal. La etiología se desconoce; se ha propuesto que es una disfunción inmune. Se caracteriza por la dilatación de los sinusoides linfáticos, ocasionada por un aumento en el número de histiocitos, que van acompañados por múltiples células plasmáticas. En el citoplasma de los histiocitos se encuentran células inflamatorias: fenómeno conocido como «emperipolesis». Se presenta el caso de un paciente varón, quien acude por tumoración en mama derecha. Los estudios confirmaron la enfermedad de Rosai-Dorfman. Se realizó el diagnóstico por biopsia y estudio de anatomía patológica. Se concluyó que esta afección puede confundirse con cáncer de mama. El interés que tiene la presentación de este caso es debido a la escasa frecuencia de esta enfermedad en tejido mamario de pacientes masculinos
Rosai-Dorfman disease is a rare entity that affects the lymphatic tissue; up to 43% of cases may have extranodal involvement. The aetiology is unknown but immune dysfunction has been suggested. This disease is characterised by dilation of the lymphatic sinusoids, caused by an increase in the number of histiocytes, which are accompanied by multiple plasma cells. Inflammatory cells are found in the cytoplasm of the histiocytes, a phenomenon known as «emperipolesis». We present the case of a male patient who presented with a tumour in the right breast. Studies confirmed Rosai-Dorfman disease. The diagnosis was made by biopsy and pathological analysis. This condition may be confused with breast cancer. The interest of this case lies in the low frequency of this entity in the breast tissue of male patients
Subject(s)
Humans , Male , Middle Aged , Histiocytosis, Sinus/diagnosis , Emperipolesis/physiology , Breast Neoplasms, Male/diagnosis , Diagnosis, Differential , Lymphadenopathy/diagnosis , Neck Pain/etiology , MammographyABSTRACT
BACKGROUND: Inherited thrombophilia is a genetic tendency to suffer thrombotic events clinically evident at an early age, with frequent re- currences without apparent cause. In recent years thrombophilia has earned a place as a primary risk factor for abnormal pregnancy. OBJECTIVE: To determine the incidence of hereditary thrombophilia in patients with recurrent pregnancy loss. MATERIAL AND METHOD: A retrospective, linear and descriptive study was conducted at Clinic of Reproduction IMMUNOREP with patients treated from January 2007 to December 2012. The study included patients with a diagnosis of recurrent pregnancy loss and inherited thrombophilia with laboratory studies of thrombophilia including different genes: G1619A (factor V Leiden), R2 H1299R (factor V polymorphism), C677T (methylenetetrahydrofolate reductase enzyme polymorphism), A1298C (methylenetetrahydrofolate reductase enzyme mutation), G20210A (mutation of the prothrombin gene), V34L (factor XIII polymorphism), 455G > A (fibrinogen gene mutation), 4G/5G (plasminogen activator inhibitor) and a/b L33P (ribosomal polymorphism of methylenetetrahydrofolate reductase enzyme). RESULTS: 211 files were reviewed and only 10.4% of patients were negative for hereditary thrombophilia, a percentage that is consistent with the results of different series of studies in patients with unexplained recurrent pregnancy loss. The most prevalent genetic condition was 4G/5G (plasminogen activator inhibitor, 85.5%) in homozygous and heterozygous with 63.4% (120) and 22.4% (42), respectively. CONCLUSIONS: It was demonstrated the direct relationship between thrombophilia and recurrent pregnancy loss depending on whether the patient is heterozygous or homozygous for the disease.
