[Pseudoangiomatous stromal hyperplasia: magnetic resonance findings in two cases]. / Hiperplasia pseudoangiomatosa estromal: hallazgos en resonancia magnética de dos casos.

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast tumor of uncertain etiology, although marked hormonal influence clearly plays a role in this disease. The differential diagnosis is important because this is an uncommon lesion that can simulate malignant lesions both at clinical and radiological examination, and even the histological results can be confusing. Little has been published regarding the MRI findings of PASH. The aim of this report is to describe the most remarkable findings observed at MRI in two patients with PASH.

Breast and pectoralis muscle hypoplasia. A mild degree of Poland's syndrome.

PURPOSE: Poland's syndrome is a congenital and unilateral aplasia of the pectoralis major muscle (PMM), with other anomalies of the ipsilateral upper extremity. We present 6 cases in which the only clinical expression was asymmetry of the breasts associated with partial absence of the PMM. MATERIAL AND METHODS: We reviewed 95000 mammograms (obtained 1985-1995) to find patients with asymmetrical breast size. Where the asymmetry could not be ascribed to any other cause, the patients were recalled for an examination of the PMM which was conducted at rest and with active contraction of the muscle. RESULTS: Unilateral volume reduction of the PMM was found in 5 women of whom 2 were studied with MR. A 6th case was a fortuitous finding in a male patient. CONCLUSION: Mild forms of Poland's syndrome are more frequent than severe forms, and may go undiagnosed. Hypoplasia of one breast or a horizontal anterior axillary fold may be the sole clinical manifestation of this syndrome.

Adverse reaction of acetaminophen as an alternative analgesic in A.A.S. Triad.

The syndrome of A.A.S. Triad consisting of an intolerance to analgesics such as aspirin, bronchial asthma and nasal polyps, is every day more frequent. During the last years, the use of acetaminophen as an analgesic-antipyretic alternative in patients with A.A.S. Triad has been imperative. However, there are already publications that show reversible bronchial obstruction symptoms similar to the ones produced by A.A.S., though of less intensity. A study was performed in 32 patients diagnosed of A.A.S. Triad by our allergy specialized office with a challenge test of acetaminophen and placebo. Basal spiromentry, physical examination and control of medication before the test, were noted. Of the 32 patients studied, six of them showed a positive provocation test. We maintain the need to perform a provocation test with acetaminophen at the hospital under medical observation before the medication is used by the patient. In terms of practical medicine, this study with acetaminophen as medications of common use in A.A.S. Triad underlies the importance of more caution in prescribing analgesic drugs to patients sensitive to aspirin and A.I.N.E.