Background: Fibrocystic disease of the breast in one of the commonest diseases in women above 30 years of age. The assumption of it being innocuous and benign is questionable with increased incidence of malignancies d...Background: Fibrocystic disease of the breast in one of the commonest diseases in women above 30 years of age. The assumption of it being innocuous and benign is questionable with increased incidence of malignancies developing in these women. Introduction: Understanding the pathophysiology of fibrocystic disease is essential for identifying determinants of malignant change. Case Report: A case of carcinoma of breast developing in a longstanding and recurrent fibrocystic disease is reported. Discussion: The pathological changes including the influence of hormones on the natural history of the disease arediscussed to identify the determinants of malignant transformation. Conclusion: Breast cyst fluid, patterns of cellular lining of the cysts, multiplicity, recurrence and patterns of cellular morphology are important determinants of malignant change.展开更多
The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Informat...The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.展开更多
In present clinical practice, point Tianzong (SI 11) is often used to treat pain and numbness in the scapular region and the upper limbs. The authors have tried various needling manipulations at this point and obt... In present clinical practice, point Tianzong (SI 11) is often used to treat pain and numbness in the scapular region and the upper limbs. The authors have tried various needling manipulations at this point and obtained extraordinarily good therapeutic result, as is reported in the following. ……展开更多
AIM To develop a MRI-based method for accurate determination of liver volume(LV) and to explore the effect of long-term everolimus(EVR) treatment on LV in PCK rats with hepatomegaly. METHODS Thirty-one female PCK rats...AIM To develop a MRI-based method for accurate determination of liver volume(LV) and to explore the effect of long-term everolimus(EVR) treatment on LV in PCK rats with hepatomegaly. METHODS Thirty-one female PCK rats(model for polycystic-liverdisease: PCLD) were randomized into 3 groups and treatment was started at 16 wk, at the moment of extensive hepatomegaly(comparable to what is done in the human disease). Animals received: controls(n = 14), lanreotide(LAN: 3 mg/kg per 2 wk)(n = 10) or everolimus(EVR: 1 mg/kg per day)(n = 7). LV was measured at week 16, 24, 28. At week 28, all rats were sacrificed and liver tissue was harvested. Fibrosis was evaluated using quantitative image analysis. In addition, gene(quantitative RT-PCR) and protein expression(by Western blot) of the PI3K/Ak T/m TOR signaling pathway was investigated. RESULTS LV determination by MRI correlated excellent with the ex vivo measurements(r = 0.99, P < 0.001). The relative changes in LV at the end of treatment were:(controls) +31.8%;(LAN) +5.1% and(EVR) +8.8%, indicating a significantly halt of LV progression compared with controls(respectively, P = 0.01 and P = 0.04). Furthermore, EVR significantly reduced the amount of liver fibrosis(P = 0.004) thus might also prevent the development of portal hypertension. There was no difference in phosphorylation of Akt(Threonine 308) between LAN-treated PCK rats control PCK rats, whereas S6 was significantly more phosphorylated in the LAN group. Phosphorylation of Akt was not different between controls and EVR treated rats, however, for S6 there was significantly less phosphorylation in the EVR treated rats. Thus, both drugs interact with the PI3K/Ak T/m TOR signaling cascade but acting at different molecular levels.CONCLUSION Everolimus halts cyst growth comparable to lanreotide and reduces the development of fibrosis. m TORinhibition should be further explored in PCLD patients especially those that need immunosuppression.展开更多
BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform...BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform,and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer.MGA may progress to atypical MGA and carcinoma arising in MGA.Among various invasive carcinomas from MGA,AdCC has been rarely reported.Here,we report a case of AdCC arising in MGA.CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram.The density was similar to or slightly lower than that of the breast parenchyma.Sonography showed an irregular mass with a slightly higher echo than that of fat.Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma.The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern.Microscopically,the tumor was composed of invasive AdCC,in situ AdCC,and MGA.AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets,or haphazardly scattered small cribriform or tubular glands.MGA showed small glands with a single epithelial lining and retained lumen.S-100 staining was strongly positive in MGA area.The patient underwent breast-conserving surgery with sentinel lymph node biopsy.CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.展开更多
Objective A typical brown tumor caused by hyperparathyroidism(HPT) is rare. In this report, we describe our pathological findings along with a review of the literature to enhance understanding of the disease and preve...Objective A typical brown tumor caused by hyperparathyroidism(HPT) is rare. In this report, we describe our pathological findings along with a review of the literature to enhance understanding of the disease and prevent misdiagnosis, as well as to provide evidence for treatment and prognosis.Methods We present a case of brown tumor of the left proximal femur and pelvis in a 57-year-old woman who was admitted to our hospital(Dalian Municipal Central Hospital, Dalian, China). Pelvic computed tomography(CT) showed cystic expansile lesions in the left proximal femur and pelvis. Lung and abdominal CT also revealed multiple lytic lesions in the ribs and lumbar spine. X-ray of the left ulna and radius showed that the middle of the left ulna had a fracture caused by a brown tumor. A bone biopsy from the left proximal femur showed focal distribution of giant cells, with hemorrhage and fibrin hyperplasia. Results The patient underwent internal fixation of the left intertrochanteric fracture, and postoperative bone biopsy showed focal distribution of giant cells with hemorrhage and fibrin hyperplasia. The patient had a parathyroidectomy 5 months after discharge. Two weeks later, the patient developed a fracture in the right femoral neck and pain in the left forearm. X-ray of the left ulna and radius showed that the middle of the left ulna was affected by a pathological fracture caused by a brown tumor. The patient was debilitated and declined surgical treatment. The patient and her family chose discharge.Conclusion Brown tumor of bone, also called osteitis fibrosa cystica, is a rare non-neoplastic lesion that reflects abnormal bone metabolism in patients with HPT. However, with fine needle aspiration cytology in combination with biochemical tests, a correct diagnosis can be reached. The increase in osteoclast activity leads to decalcification and dissolution of bone, and formation of a cystic bone defect with hyperplastic fibrous tissue. This eventually becomes a brown tumor, with deformed and bleeding fibrous tissue. The patient had a typical brown tumor, as well as osteoporosis, anemia, and pathological fractures.展开更多
Epidermal inclusion cyst in the breast is an uncommon condition. It may be congenital, originating from hair follicles or occurring after trauma (breast reduction or breast cytology puncture) or consists of squamous m...Epidermal inclusion cyst in the breast is an uncommon condition. It may be congenital, originating from hair follicles or occurring after trauma (breast reduction or breast cytology puncture) or consists of squamous metaplasia of the regular columnar epithelium within an ectatic ductus galactophorus. We report the case of a 22-year-old woman, with two pregnancies and with no particular pathological history, who presented with a 3 cm nodule of the right breast at the union of the upper quadrants, firm, mobile and painless. The skin, areola and nipple were unaffected. The axillary areas and the contralateral breast were unremarkable. The breast ultrasound showed a heterogeneous and well circumscribed hypoechoic mass classified as ACR3. Macroscopic examination revealed a unilocular cyst with a discretely thickened wall, abundant yellowish contents and measuring 2 cm on a long axis. Histologically, it was a cystic cavity whose wall was lined with a pseudo stratified keratinized squamous epithelium with a granular layer and whose lumen contained keratin lamellae. This cyst is surrounded by a more or less fibrous pallial tissue containing regular, sometimes dilated or even cystic milk ducts. The diagnosis of epidermal inclusion cyst of the breast on a background of fibrocystic mastopathy was thus concluded. The importance of this benign lesion lies in the differentiation between other non-neoplastic and neoplastic breast lesions.展开更多
Objective: To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods: One hundred patients with breast hyperplasia who met the inclusion criteria were randomly di...Objective: To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods: One hundred patients with breast hyperplasia who met the inclusion criteria were randomly divided into an acupuncture combined with traditional Chinese medicine(A&TCM) group and a traditional Chinese medicine(TCM) group, 50 cases in each group. The A&TCM group received acupuncture combined with oral TCM; the TCM group only received oral TCM. After two courses of treatment, the efficacy was observed. Results: During the two treatment courses, the recovery rates had been increasing in both groups. The recovery rate of the A&TCM group was 40.0% and the total effective rate was 98.0%. While the recovery rate of the TCM group was 18.0% and the total effective rate was 80.0%. According to statistical analysis, the differences of recovery rate and total effective rate between the two groups were statistically significant(P<0.01). Conclusion: Combination of acupuncture and TCM is more effective than simple oral TCM.展开更多
文摘Background: Fibrocystic disease of the breast in one of the commonest diseases in women above 30 years of age. The assumption of it being innocuous and benign is questionable with increased incidence of malignancies developing in these women. Introduction: Understanding the pathophysiology of fibrocystic disease is essential for identifying determinants of malignant change. Case Report: A case of carcinoma of breast developing in a longstanding and recurrent fibrocystic disease is reported. Discussion: The pathological changes including the influence of hormones on the natural history of the disease arediscussed to identify the determinants of malignant transformation. Conclusion: Breast cyst fluid, patterns of cellular lining of the cysts, multiplicity, recurrence and patterns of cellular morphology are important determinants of malignant change.
文摘The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.
文摘 In present clinical practice, point Tianzong (SI 11) is often used to treat pain and numbness in the scapular region and the upper limbs. The authors have tried various needling manipulations at this point and obtained extraordinarily good therapeutic result, as is reported in the following. ……
文摘AIM To develop a MRI-based method for accurate determination of liver volume(LV) and to explore the effect of long-term everolimus(EVR) treatment on LV in PCK rats with hepatomegaly. METHODS Thirty-one female PCK rats(model for polycystic-liverdisease: PCLD) were randomized into 3 groups and treatment was started at 16 wk, at the moment of extensive hepatomegaly(comparable to what is done in the human disease). Animals received: controls(n = 14), lanreotide(LAN: 3 mg/kg per 2 wk)(n = 10) or everolimus(EVR: 1 mg/kg per day)(n = 7). LV was measured at week 16, 24, 28. At week 28, all rats were sacrificed and liver tissue was harvested. Fibrosis was evaluated using quantitative image analysis. In addition, gene(quantitative RT-PCR) and protein expression(by Western blot) of the PI3K/Ak T/m TOR signaling pathway was investigated. RESULTS LV determination by MRI correlated excellent with the ex vivo measurements(r = 0.99, P < 0.001). The relative changes in LV at the end of treatment were:(controls) +31.8%;(LAN) +5.1% and(EVR) +8.8%, indicating a significantly halt of LV progression compared with controls(respectively, P = 0.01 and P = 0.04). Furthermore, EVR significantly reduced the amount of liver fibrosis(P = 0.004) thus might also prevent the development of portal hypertension. There was no difference in phosphorylation of Akt(Threonine 308) between LAN-treated PCK rats control PCK rats, whereas S6 was significantly more phosphorylated in the LAN group. Phosphorylation of Akt was not different between controls and EVR treated rats, however, for S6 there was significantly less phosphorylation in the EVR treated rats. Thus, both drugs interact with the PI3K/Ak T/m TOR signaling cascade but acting at different molecular levels.CONCLUSION Everolimus halts cyst growth comparable to lanreotide and reduces the development of fibrosis. m TORinhibition should be further explored in PCLD patients especially those that need immunosuppression.
文摘BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform,and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer.MGA may progress to atypical MGA and carcinoma arising in MGA.Among various invasive carcinomas from MGA,AdCC has been rarely reported.Here,we report a case of AdCC arising in MGA.CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram.The density was similar to or slightly lower than that of the breast parenchyma.Sonography showed an irregular mass with a slightly higher echo than that of fat.Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma.The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern.Microscopically,the tumor was composed of invasive AdCC,in situ AdCC,and MGA.AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets,or haphazardly scattered small cribriform or tubular glands.MGA showed small glands with a single epithelial lining and retained lumen.S-100 staining was strongly positive in MGA area.The patient underwent breast-conserving surgery with sentinel lymph node biopsy.CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.
文摘Objective A typical brown tumor caused by hyperparathyroidism(HPT) is rare. In this report, we describe our pathological findings along with a review of the literature to enhance understanding of the disease and prevent misdiagnosis, as well as to provide evidence for treatment and prognosis.Methods We present a case of brown tumor of the left proximal femur and pelvis in a 57-year-old woman who was admitted to our hospital(Dalian Municipal Central Hospital, Dalian, China). Pelvic computed tomography(CT) showed cystic expansile lesions in the left proximal femur and pelvis. Lung and abdominal CT also revealed multiple lytic lesions in the ribs and lumbar spine. X-ray of the left ulna and radius showed that the middle of the left ulna had a fracture caused by a brown tumor. A bone biopsy from the left proximal femur showed focal distribution of giant cells, with hemorrhage and fibrin hyperplasia. Results The patient underwent internal fixation of the left intertrochanteric fracture, and postoperative bone biopsy showed focal distribution of giant cells with hemorrhage and fibrin hyperplasia. The patient had a parathyroidectomy 5 months after discharge. Two weeks later, the patient developed a fracture in the right femoral neck and pain in the left forearm. X-ray of the left ulna and radius showed that the middle of the left ulna was affected by a pathological fracture caused by a brown tumor. The patient was debilitated and declined surgical treatment. The patient and her family chose discharge.Conclusion Brown tumor of bone, also called osteitis fibrosa cystica, is a rare non-neoplastic lesion that reflects abnormal bone metabolism in patients with HPT. However, with fine needle aspiration cytology in combination with biochemical tests, a correct diagnosis can be reached. The increase in osteoclast activity leads to decalcification and dissolution of bone, and formation of a cystic bone defect with hyperplastic fibrous tissue. This eventually becomes a brown tumor, with deformed and bleeding fibrous tissue. The patient had a typical brown tumor, as well as osteoporosis, anemia, and pathological fractures.
文摘Epidermal inclusion cyst in the breast is an uncommon condition. It may be congenital, originating from hair follicles or occurring after trauma (breast reduction or breast cytology puncture) or consists of squamous metaplasia of the regular columnar epithelium within an ectatic ductus galactophorus. We report the case of a 22-year-old woman, with two pregnancies and with no particular pathological history, who presented with a 3 cm nodule of the right breast at the union of the upper quadrants, firm, mobile and painless. The skin, areola and nipple were unaffected. The axillary areas and the contralateral breast were unremarkable. The breast ultrasound showed a heterogeneous and well circumscribed hypoechoic mass classified as ACR3. Macroscopic examination revealed a unilocular cyst with a discretely thickened wall, abundant yellowish contents and measuring 2 cm on a long axis. Histologically, it was a cystic cavity whose wall was lined with a pseudo stratified keratinized squamous epithelium with a granular layer and whose lumen contained keratin lamellae. This cyst is surrounded by a more or less fibrous pallial tissue containing regular, sometimes dilated or even cystic milk ducts. The diagnosis of epidermal inclusion cyst of the breast on a background of fibrocystic mastopathy was thus concluded. The importance of this benign lesion lies in the differentiation between other non-neoplastic and neoplastic breast lesions.
基金supported by Chenzhou Hospital of Traditional Chinese Medicine
文摘Objective: To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods: One hundred patients with breast hyperplasia who met the inclusion criteria were randomly divided into an acupuncture combined with traditional Chinese medicine(A&TCM) group and a traditional Chinese medicine(TCM) group, 50 cases in each group. The A&TCM group received acupuncture combined with oral TCM; the TCM group only received oral TCM. After two courses of treatment, the efficacy was observed. Results: During the two treatment courses, the recovery rates had been increasing in both groups. The recovery rate of the A&TCM group was 40.0% and the total effective rate was 98.0%. While the recovery rate of the TCM group was 18.0% and the total effective rate was 80.0%. According to statistical analysis, the differences of recovery rate and total effective rate between the two groups were statistically significant(P<0.01). Conclusion: Combination of acupuncture and TCM is more effective than simple oral TCM.
