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Relato de Caso
Stewart-Treves syndrome: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):211-214
09-08-2003
Summary
Relato de CasoStewart-Treves syndrome: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):211-214
09-08-2003DOI 10.1590/S0100-72032003000300011
Views106See moreThe authors present a case of lymphangiosarcoma in the upper left limb of a 52-year-old patient previously submitted to a left-sided modified radical mastectomy followed by radiotherapy due to breast cancer six years earlier. This rare syndrome is associated with chronic lymphedema as a consequence of radical mastectomy followed by radiotherapy. Approximately 400 cases have been reported in the literature. The infrequent occurrence of this disease and the rather innocuous appearance of the tumor often lead to late diagnosis and treatment. In the present case, the diagnosis was based on an incision biopsy of the lesion and confirmed immunohistochemically using endothelial markers, antibodies (anti-CD31), vimentin and muscle actin. The patient's limb was amputated and no local or distant recurrence has so far been observed during 18 months of follow-up.
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Relato de Caso
Mastitis due to Paracoccidioidomycosis: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(9):593-596
07-10-2000
Summary
Relato de CasoMastitis due to Paracoccidioidomycosis: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(9):593-596
07-10-2000DOI 10.1590/S0100-72032000000900009
Views49See moreParacoccidioidomycosis is an important systemic endemic mycosis in Latin America. This infection is usually acquired via inhalation of mycelial particles. Most infected subjects develop an asymptomatic infection, which is associated with various host-related factors such as sex, age, genetic, as well as characteristics of the infecting agent, mainly its virulence. It is a systemic pathology. A case of mastitis due to paracoccidioidomycosis is presented with the objective to demonstrate that elderly patients with a breast abscess should be submitted to biopsy.
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Trabalhos Originais
Factors Related to Insufficient Material in Fine Needle Aspiration Cytology of Solid Breast Tumors
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):635-639
07-01-2001
Summary
Trabalhos OriginaisFactors Related to Insufficient Material in Fine Needle Aspiration Cytology of Solid Breast Tumors
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):635-639
07-01-2001DOI 10.1590/S0100-72032001001000004
Views63See morePurpose: to analyze the factors that may be related to insufficient material in fine needle aspiration cytology (FNAC). Patients and Methods: a total of 351 FNAC of patients with solid breast tumors were studied in a random way: 180 (51%) by Cameco's pistol holder and 171 (49%) by the auto-vacuum device. All smears were analyzed by only one cytopathologist, and they were described as malignant, suspicious, benign or insufficient for diagnosis. The significance of each variable was tested by the c² test. Results: among the 351 cases analyzed, we found 67 (19%) of insufficient material. The device used (pistol or auto-vacuum), the size of the tumor and the clinical stage of the lesions were not related to the frequency of sufficient and insufficient material. The age of the patient and the histological type of the tumor were related to the rate of insufficient material. Patients younger than 50 had a 12% rate of insufficient material, compared to 30 above 50 (p<0.03). The patients with fibroadenosis had a rate of 30%, those with ductal carcinoma, 20%, and those with fibroadenoma 12% (p<0.02). Conclusion: the present study showed a relatively high rate of insufficient material (19%), which was influenced by the age of the patient and the histological type of the biopsied breast lesion.
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Trabalhos Originais
Morphological and Morphometrical Study of Permanent Estrus Rat Mammary Gland Treated with Danazol
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):41-45
06-27-2001
Summary
Trabalhos OriginaisMorphological and Morphometrical Study of Permanent Estrus Rat Mammary Gland Treated with Danazol
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):41-45
06-27-2001DOI 10.1590/S0100-72032001000100006
Views46See morePurpose: the morphologic and morphometric aspects of the breasts of rats in permanent estrus submitted to danazol were studied. Methods: the animals were divided into three groups: group A (n = 12) received water and was used as control, group B (n = 13) was exposed to 20 mg danazol kg-1 day-1, and group C (n = 10) was exposed to 80 mg danazole kg-1 day-1 for 35 consecutive days. The microscopic study evaluated the ductal and acinar distribution. Histometry of the relationship duct/stroma was based on the principles of stereology with a Zeiss k-10X ocular, with Integrationsplatte I reticulum of Weibel of 25 hits, with 100X magnification. For each studied section, 10 aleatoric fields were counted, with a total of 250 points. The variance analysis test (Kruskal-Wallis) was applied to compare the three groups in relation to the mean number of alveoli and ducts (alpha = 0.05). Results: when submitted to morphological study, all groups presented lobules with alveoli lined with cubic cells with nuclei in their central or basal portion. Small amounts of eosinophilic material were observed in some cases in the lumen, with no differences between the groups. At morphometry, with a magnification of 100X, a mean number of 28.6 ducts/10 fields was found in group A, 28.4 in group B and 29.2 in group C (Kruskal-Wallis test: Hcrit = 0.1). The mean number of alveoli in 10 fields was 5.9, 9.3 and 6.5 in groups A, B and C, respectively (Kruskal-Wallis test: Hcrit = 2.9), with no significant differences between the groups. Conclusion: danazol did not cause any changes in the morphology and morphometry of the permanent estrus mammary epithelium.
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Trabalhos Originais
Fine Needle Aspiration Cytology Guided by Ultrasound in Nonpalpable Lesions
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):321-327
06-26-2001
Summary
Trabalhos OriginaisFine Needle Aspiration Cytology Guided by Ultrasound in Nonpalpable Lesions
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):321-327
06-26-2001DOI 10.1590/S0100-72032001000500008
Views44See morePurpose: to determine the relationship between fine needle aspiration cytology guided by ultrasound of nonpalpable breast lesions (cystic or solid masses) with the ultrasound and histopathological features of the biopsy lesions. Methods: a total of 617 nonpalpable lesions were analyzed by ultrasound. Fine needle aspiration cytology was guided by ultrasonography and the cysts were distinguished from the solid masses by comparing the biopsies. The cytologic results were compared with the histological results in the case surgical biopsy was carried out. Results: of the 617 nonpalpable lesions 471 were cysts (451 simple cysts with 100% negative cytology and 20 cases were considered complex cysts; 3 (15%) of these had a positive or suspected cytology and in 2 cases malignancy was confirmed. There were 105 solid masses, 63 of them with negative cytology. Fifty-nine cases had a negative biopsy, and 4 cases (0.3%) were false-negative but all of them presented disagreement between the cytological and image features; in 14 cases (13%) there was a suspected cytology and in 5 of them carcinoma was confirmed; in 14 cases (13%), the samples were insufficient, 1 case was carcinoma and in 51 cases, a triple diagnosis was concordant and the lesions were followed-up. Conclusion: cytological analysis of simple cysts is not required, but when they are complex, cytological analysis is mandatery. In the case of nonpalpable solid masses, cytology must be correlated with ultrasound and mammography features. If the results are discordant, the lesion should be followed-up.
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Relato de Caso
Actinomycosis of the Breast in Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):605-607
06-25-2001
Summary
Relato de CasoActinomycosis of the Breast in Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):605-607
06-25-2001DOI 10.1590/S0100-72032001000900009
Views71See moreActinomycosis of the breast is a rare inflammatory disease that has been infrequently reported. It can be primary actinomycosis of the breast, when caused by lesions of the mammary skin and secondary, when there is thoracic or pleural infection; it has extremely variable clinical presentations and may simulate mastitis and malignancies such as inflammatory carcinoma. The diagnosis is confirmed by culture and by finding typical actinomycotic colonies. The usual treatment is surgical drainage and intravenous and oral long-term administration of antibiotics. The authors present a case of actinomycosis of the breast in a 12-week pregnant woman who presented a tumor in the left breast.
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Trabalhos Originais
Cyclical mastalgias: a nonpharmacological treatment (reassurance)
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):77-82
06-25-2001
Summary
Trabalhos OriginaisCyclical mastalgias: a nonpharmacological treatment (reassurance)
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):77-82
06-25-2001DOI 10.1590/S0100-72032001000200003
Views47Purpose: to evaluate the nonpharmacologic treatment (reassurance) as a first line therapy for women with cyclical mastalgia, and to observe if a prolonged course of pain alters the outcome. Methods: we conducted a noncontrolled experimental study with a sample of 128 eligible women with a clear history of cyclical mastalgia treated with reassurance. A visual linear analogical scale of the pain was used before and after treatment in order to assess its severity and the mastalgias were classified into degrees I (mild), II (moderate) and III (severe) according to the intensity of pain. We also used a modified Cardiff Breast Score (CBS) to assess the clinical response. The data analysis was performed using the chi² test (Epi-Info 6.04 software). Results: we verified a success rate of 59.4% with reassurance, but there was no significant statistical difference between the groups (p = 0.16) with different degrees of mastalgia. The less satisfactory response to the nonpharmacologic treatment in those pacients with a prolonged course of pain was only apparent, since there was no significant statistical difference (p = 0.14). Conclusion: reassurance should be always tried as the first choice treatment for women with cyclical mastalgia, independently of pain intensity. Prolonged course of pain did not alter the outcome.
Key-words BreastMastalgia, reassuranceSee more -
Trabalhos Originais
Effect of Conjugated Estrogens and of Medroxyprogesterone on Breast Tissue: an Experimental Study
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(8):507-513
06-24-2001
Summary
Trabalhos OriginaisEffect of Conjugated Estrogens and of Medroxyprogesterone on Breast Tissue: an Experimental Study
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(8):507-513
06-24-2001DOI 10.1590/S0100-72032001000800005
Views65See morePurpose: to evaluate the effect of hormone replacement therapy on breast cell proliferation and on collagen and elastic fiber formation and to analyze the changes occurring in the breast parenchyma as a whole. Method: a total of 61 adult Wistar rats were divided into 5 groups. The standard group (12 rats) represented the normal hormonal ovarian status. The remaining 49 rats were oophorectomized and, starting on the 96th P.O. day, received the specific drug for 30 days. The CEE group received 50 mg/day conjugated equine estrogens (13 rats); the MPA group, 2.0 mg/day medroxyprogesterone acetate (12 rats); the CEE + MPA group, both drugs (12 rats), and the DW group, distilled water (12 rats). On the 31st day of medication, the animals were sacrificed and the inguinal mammary glands were removed for histological analysis. Cell proliferation was assessed at the ductal and acinar levels using anti-PCNA antibody. Mature collagen (type I) and immature collagen (type III) were quantified by Sirius-Red staining, and elastic fiber formation was quantified by Weigert staining. Anatomopathological analysis was performed by hematoxylin-eosin staining, with the determination of number of acini per terminal duct, number of ducts per field, presence of intraductal secretion, and intensity of intracytoplasmic vacuolization. Results: the CEE + MPA group presented a smaller percentage of proliferating ductal cells (46.1%) (p<0.0001) and a greater proliferation of acinar cells (66.3%), similar to those detected in the MPA group (p=0.075) but differing from those detected in the remaining groups (p<0.004). The CEE group showed the largest amount of immature collagen (33.6%) (p<0.01) and the MPA group showed the highest concentration of elastic fibers (11.7%) (p<0.0001). The CEE + MPA and MPA groups showed secretory acinar hyperplasia that was intense (91.7%) in the CEE + MPA group and mild (41.7%) or moderate (58.3%) in the MPA group, but differering in both cases from the remaining groups (p<0,097). Conclusions: conjugated equine estrogens in combination with medroxyprogesterone inhibit ductal cell proliferation and stimulate acinar cell proliferation causing secretory acinar hyperplasia; conjugated horse estrogens intensify the formation of immature (type III) collagen, and medroxyprogesterone acetate increases the formation of elastic fibers.