Cytological diagnostic clues in fine needle aspiration of breast myofibroblastoma: a case report.

Myofibroblastoma of the breast is a rare, benign mesenchymal tumor derived from the stroma and tends to occur mainly in middle-aged to elderly men. There are a few cases reported in the literature describing its cytological features. We report the cytological and histological findings of a breast myofibroblastoma in a 68-year-old man. He presented with a palpable nodule of 2-months duration in his left breast. The cytological smears obtained by fine needle aspiration showed less cohesive cellularity in a fascicular arrangement consisting of spindle cells with elongated cytoplasm, occasional nuclear grooves, and intranuclear cytoplasmic inclusions associated to fragments of stromal collagen. The cytological diagnosis was a mesenchymal proliferation suggesting the possibility of myofibroblastoma which was confirmed on histopathological examination. The breast myofibroblastoma has distinctive cytological features that in conjunction with the clinical and radiological data allow a specific diagnosis.

Treatment of the open abdomen with topical negative pressure therapy: a retrospective study of 46 cases.

The open abdomen is an ongoing challenge for professionals engaged in its treatment. The change in the integrity of the abdominal wall, the loss of fluids, heat and proteins and contamination of the wound are the main problems. The objective of this article is to describe our experience using the abdominal dressing vacuum-assisted closure therapy in treatment of the open abdomen. Since December 2006, all patients requiring treatment with the open abdomen technique have been treated with the abdominal dressing system and vacuum-assisted closure therapy (VAC(®) KCI, San Antonio, USA). The results obtained with this technique in non traumatic patients are analysed herein. The abdominal dressing system was used on 46 patients in the period between January 2006 and December 2009, with a mean 63 years old (29-80), with a gender distribution of 33 men (72%) and 13 women (28%). Closure of the abdominal wall was possible in 24 patients, 5 of which were primary in the recent postoperative phase, 5 had primary suture of the fascia and application of the supra-aponeurotic prosthesis and 14 had closure of the abdominal wall with a composite polytetrafluoroethylene (PTFE) and polypropylene mesh. Second intention closure took place in the remaining 22 patients (48%), as their conditions did not allow primary closure. The mean treatment time with abdominal dressing was 26 days (6-92) with an average of eight changes per patient. The abdominal dressing topical negative pressure system is a useful option for consideration in the event of needing to leaves the abdomen open. It stabilises the abdominal wall and quantifies and collects exudate from the wound, protects the intra-abdominal viscera and keeps the fascia intact and the cutaneous plane for subsequent closure of the wall.