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Question: My son is 15 years old (in January 16) .When undergoing ultrasound of the thyroid gland, the following results: the right lobe 47x17x15 is not homogeneous, the node is 9 mm and liquid inclusions (multiple) up to 3 mm, the right jar vein 2mm, isthmus 4mm, left jar vein 17 mm, left lobe 28x10x8. Not homogeneous. Susp. Anomaly in the structure of the vascular bundles of the neck.
In parallel, it is aimed at REG. Conclusion: Decreased blood filling function of the cerebral vessels, most pronounced in the basin of the vertebral arteries. Severe hypovolemia with OMd> OMs asymmetry. How are these conclusions interrelated?
He goes in for sports (swimming) quite actively. What is the possible diagnosis and are intensive sports loads?
Doctor's answer: Hello. The presence of thyroid nodules and a decrease in blood supply in the basin of the vertebral arteries are two independent diseases. Most likely, there is no direct connection between them. Unfortunately, without examination, it is impossible to establish a diagnosis, prescribe treatment and give recommendations on physical activity... It is important to take into account all the features of the clinical picture of the disease. You should consult with an endocrinologist, neuropathologist.
Medical services in Moscow:
Question: Hello. I have had a temperature of 37.2-37.4 for 3 months. went through a bunch of examinations and found nothing. and yesterday I did an ultrasound of the thyroid gland.
here's what they wrote:
right lobe 1.7 * 1.8 * 4.5 cm
isthmus 0.6 cm
left lobe 1.8 * 1.9 * 4.5cm
echogenicity - significantly increased. structure diff. heterogeneous. throughout - pl. anechoic inclusions, maximum diameter - 0.5 cm3.
in the left d. (on the border of the isthmus) a node of a heterogeneous echo structure with cystic cavities and partitions - 1.0 * 0.9 cm - a reduced echo structure.
conclusion: Diffuse nodular goiter.
Tell me: can such a temperature be kept from this?
Can this disease be treated and is it generally very dangerous? if I am pregnant during this period - will there be a threat to the fetus?
Doctor's answer: Hello. It is necessary to continue the examination. Get your thyroid hormone tested. Hyperthyroidism (high levels of thyroid hormones) can lead to an increase in body temperature. Other reasons are also possible. Unfortunately, without examination, it is impossible to establish a diagnosis and recommend treatment. You should consult an endocrinologist.
Question: Hello. The fact is that my mother (she is 42 years old) was found on an ultrasound scan with some kind of seal in thyroid gland... Before that, she took hormones (since her thyroid gland does not produce enough hormone) for 10 years, then her endocrinologist canceled her hormone, and she did not drink it for two months, during which time her health deteriorated very sharply. It has been undergoing treatment for two years already (since almost all systems in the body have been disturbed: autonomic, nervous, cardiovascular). What is a lump in the thyroid gland, how dangerous is it, which doctor should she go to to treat, what medications to use, maybe there is some proven folk remedy? ?? Thanks in advance.
Doctor's answer: Hello. A thyroid nodule requires serious consideration. An examination is necessary to establish an accurate diagnosis. In addition to ultrasound, a scan of the thyroid gland can be performed. It is imperative to determine the level of blood hormones. In some cases, a histological examination is shown - a puncture of the thyroid nodule. Unfortunately, without examination, it is impossible to establish a diagnosis and recommend treatment. You should consult an endocrinologist.
Question: Hello.
My daughter is 1 year old. At 6 months, her breasts enlarged. At a consultation with a doctor, they said that it was mastitis, and should have passed by a year. Recently I discovered an inflamed lymph node under the arm of a child. We went to an endocrinologist. They wrote out something for the intestinal flora (befidobactarine, if I am not mistaken), advised to smear nipples with brilliant green, took a smear on the fungus. A day after the consultation, the next morning changing the diaper were in shock, All the diaper was in the blood (discharge as during menstruation). They immediately called the ambulance and advised me to consult a gynecologist. The hospitalization was refused. By the time of opening, I went to the polyclinic to see a generalist who had previously taken a smear. I didn't hear anything intelligible, so we went together to the endocrinologist. They consulted and sent us to the Institute of Endocrinology. The endocrinologist said that nothing threatens the child's life. They wrote another prescription for nestatin. They said something about powders that would have to be penetrated up to 8 years. Immediately I went to the institute, it was 08/06/04. We made an appointment on Wednesday 11.08.04. Allocations are still going on, though less. The wife is in shock, crying all day. Tell me how serious it is. What to do, where to go.
Breast puncture
Asks: Daria
Female gender
Age: 25
Chronic diseases: not specified
Help decipher the results of a cytological study. I underwent a breast puncture under ultrasound control. "In n-those drops of fat, oxyphilic substance, single accumulations of glandular epithelium with signs of slight hyperplasia." Thank you in advance!
530 replies
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Hello! You have a completely ordinary cytological analysis, if the word hyperplasia scares you, it means that you have single complexes of the glandular epithelium with an increased number of cells, this is not scary, it happens. The glandular epithelium is what the entire mammary gland consists of.
Hope 2017-10-26 14:45
Hello, Alexey Alexandrovich! Tell me what my diagnosis means: they took a biopsy with an ultrasound scan and found atypical cells on one side 10x5 mm. I went to the oncology there on the glass, they checked it again and already diagnosed it, I will write how I read it, maybe it is not correct Cr mam olix T1N1M0. Is it really cancer already? Sincerely.
Hello!
Is it really cancer already?- you suspect breast cancer, without metastases. But the problem is that the doctor cannot give you such a final dianosis, since the final diagnosis is established on the basis of a histological examination. You will have to undergo a sectoral resection of the tumor and direct an express histology during the operation. If confirmed, then the mammary gland will be removed completely. You can also ask the attending physician to conduct a biopsy for you before the operation and conduct a histology already on it, followed by an immunohistochemical analysis (IHC).
Yuliya 2014-06-17 15:02
Hello. I am 29 years old. At 22 I had my breast fibroadenoma removed. Now she underwent an ultrasound scan, in the area of the postoperative scar, focal hyperplasia was determined, which cannot be detected by palpation. The mammologist recommended taking a puncture under ultrasound control. The result of cytological examination: interstitial substance, "naked" cell nuclei, single groups of cells of the cubic epithelium with signs of hyperplasia. Please tell me what this means and what to do about it. P. S. There was one pregnancy, one childbirth at 24 years old. Thanks.
Hello! At the moment, there is no reason for concern, you have ordinary cells that have not yet fully recovered for some reason and they have no nuclei, so they look like "naked". Hyperplasia means there are a lot of them. You don't have to do anything about it. Observation only.
Irina 2014-08-07 12:15
Good afternoon, I was 62 years old had a breast puncture for the formation of some substance, with suspicion of fibroma, the result: a positive small number of nano-nuclear elements, the presence of erythrocytes of a structureless substance. What does it mean? Thank you in advance.
Hello! It is a little unclear what does positive mean? Holonuclear elements with erythrocytes means that your cells do not have nuclei inside and blood elements are present. Either the puncture was performed a little incorrectly, or they did not get into the formation itself, but poked it next to it or right through it.
Darya 2014-09-09 11:58
Help me decipher they did a breast puncture under ultrasound control, as a result, moderate proliferation of cubic epithelium and meager oxyphilic in
Hello! I apologize for such a long answer. This cytology suggests that you have moderate cell growth, it seems that they got into a benign neoplasm (fibroadenoma, cyst), or age-related changes. I would recommend that if you have a benign neoplasm, follow-up for 3 months, then repeated ultrasound and puncture.
Natalia 2014-11-18 11:34
Good day! Help decipher the puncture result: punctate contains cystic-hemorrhagic fluid, hemosiderophages, neutrophils, "naked" nuclei, rare layers of flattened and proliferating epithelium with dystrophic changes. thanks
Hello! This cytology suggests that you got directly into a breast cyst and evacuated its contents. The content, as a rule, is different, but you should not be confused by the names of the cells, since they are already, basically, all dead, the only key phrase here is cystic-hemorrhagic fluid, apparently a drop of blood got into the contents of the cyst.
Irina 2014-12-07 07:14
Good day! Help decipher the puncture results: Unstructured masses, fat, groups, clusters of proliferating ductal epithelium cells, flattened in places, naked nuclei. Thank you in advance.
Hello Irina! The picture is more reminiscent of mastopathy (benign disease), which is well treated with medication ("Mastodinon", "Progestogel"). To do this, you need to consult with a mammologist or surgeon so that you can be prescribed treatment.
Irina 2014-12-16 06:27
@ Lee Alexey Alexandrovich, Thank you very much, operation is not required?
Irina, no surgery is required. Be healthy!
Jkmuf 2014-12-12 12:21
Hello, dear Alexey Alexandrovich!
My mother is 83 years old, but she is vigorous, active despite the diabetes of the 2nd degree. And in order not to sit at home, she goes to the doctors.
Well, she got to the point that she was diagnosed with "" breast cancer.
She was sent to the distant lands in Istra, to hospital No. 62. But getting there from Moscow for a person of this age is simply unthinkable!
In this regard, I have two questions:
1. How terrible is the diagnosis?
2. And if it is so necessary to continue the treatment, can it not be carried out in Moscow, within the Moscow Ring Road?
Best regards, Olga.
Hello Olga! " single holonuclear elements, fat droplets and erythrocytes"The mammary gland is not a diagnosis, but the result of a breast puncture. The diagnosis, to be honest, should sound like fibrous cystic mastopathy(benign neoplasm), if, of course, this is a complete result of cytology. This diagnosis can be treated by an ordinary mammologist or surgeon at the place of residence.
Olga 2014-12-14 14:17
@ Lee Alexey Alexandrovich,
Dear Doctor! Thank you very much!
Please, Olga! Be healthy!
Catherine 2015-01-07 11:16
Hello! After several fibroadenomas were seen on the ultrasound, the puncture was made the largest.
Here is the result "In the presented preparations there are erythrocytes, single cells of the cubic epithelium with degenerative changes."
What does it mean?
Hello Ekaterina! These are fibroadenoma cells with blood drops that have gotten during the puncture.
Zoya 2015-01-30 15:49
Good day! As a result of the study of secretions from the nipple of the mammary gland, it is written: in finished preparations against the background of a basophilically colored protein secretion, dilapidated erythrocytes, hemosiderophages. The epithelium of the mammary gland was not found. Please help me to decipher. Thank you in advance!
Hello Zoya! According to the description, it is very similar to colostrum with a lubricating secret, which is necessary to protect the nipple. In any case, it would not hurt to get tested for the hormone prolactin.
Ira 2015-02-05 13:14
Good day! Please decipher the study of the mammary gland. Discovered blood cells, non-nuclear scales, single cells of the ductal epithelium with pronounced degenerative changes, elements of adipose tissue.
thank you in advance
Hello Irina! It looks like the contents of a breast cyst or fibroadenoma. In any case, it would not hurt to undergo an ultrasound of the mammary glands.
thanks a lot
Olya 2015-02-18 14:28
Hello! Please help me to decipher the results of a puncture biopsy of the breast. I am 24 years old, 19 weeks pregnant. A year and a half ago, I was diagnosed with fibroadenomas of both mammary glands. Now, against the background of pregnancy, she was sent for a second examination. We took 4 samples: the first two from a large formation, 3 and 4 from the other two. The results are as follows:
1 - blood elements, single groups, clusters of cells of moderately proliferating cubic epithelium.
2 - structureless masses, an abundance of macrophage elements.
3 - structureless masses, fat, groups, clusters of proliferating cubic epithelium cells, flattened in places, an abundance of naked nuclei.
4 - structureless masses, fat, groups, clusters of cells of proliferating cubic epithelium, sometimes flattened, naked nuclei.
Thanks in advance for your reply!
Hello Olga! Each of the 4 samples contains elements of fibroadenoma. If you underwent an ultrasound of the mammary glands, then you should know the size of the formations. If this is in reality fibroadenomas (on ultrasound without a capsule), then there will be only one treatment - surgery. But do not be very scared, you can do it at any time convenient for you, even after feeding the baby.
Anna 2015-02-19 16:01
The result of a puncture of the mammary gland is single complexes of cells of the cubic epithelium in a state of severe dysplasia what does this mean
Hello Anna! This means that you have fibroadenoma (benign neoplasm) with elements of mastopathy in your mammary gland.
Olga 2015-03-01 13:58
Doctor, which means the result of a cytological examination of secretions from the breast: "In the material obtained, a structureless substance was found, cells of the macrophage type, scales" /. I am 34 years old, two children (5 and 3 years old), I finished feeding my youngest less than 2 years ago.
It means that you have signs of mastopathy (benign disease). You need to consult a mammologist or gynecologist again so that you can be prescribed treatment
Svetlana 2015-04-12 19:56
Hello, Doctor. Please tell me what the results of a cytological examination of a cyst mean (presumably): fat masses, a little blood. As far as I understand, they did not get into the cyst (it is less than 1 cm)
Hello Svetlana! You are absolutely right, you did not get into the cyst, and, accordingly, the results of cytology are not informative. You can repeat the puncture, but under ultrasound control.
Helena 2015-05-06 15:09
Good day! Received the result of a puncture of the mf. There are still two weeks before the doctor's appointment. Please help me to decipher the result: there is blood, lymphoid cells, hemosiderophages, stromal elements, groups of fat cells in the punctate. thanks
Hello! Based on the test results, it looks more like fibroadenoma cells (benign tumor) than cyst cells.
K. N. 2015-05-20 20:30
Hello! Can you please tell me, a year ago they did a puncture, the composition: structureless masses, small fragments of adipose tissue, single cells such as colostrum bodies. Ultrasound size does not change year 30/10/20 mm with uneven contours. What does this mean? What is necessary? thanks
Hello! I dare to suggest that 1 year ago you were breastfeeding your baby and you had a lump, you went for an ultrasound of the mammary glands. The presence of cells by the type of colostrum bodies indicates that you have formed a seal (lactostasis), burnt milk, but I could be wrong. In any case, you need to repeat the ultrasound of the mammary glands, as well as for the mammologist to prescribe treatment for you.
Natalia 2015-05-21 17:21
Good day! Please help to decipher the results of cytological examination of breast punctate. The attending physician is on vacation.
In the material obtained, against the background of detritus, a small number of degeneratively changed cells of the cubic epithelium were found. Bare kernels.
What does it mean? Thank you in advance!
Hello, Natalia! The results of this cytology may indicate the presence of a benign disease (fibrocystic mastopathy) of the mammary glands. You need to consult with a mammologist about the appointment of your treatment.
Good afternoon, Alexey Alexandrovich!
Thanks for the answer.
Can you tell me what bare kernels mean?
Ultrasound revealed fibroadenomas.
Hello, Natalia! Please! This means that their nuclei, located in cells, are without membranes.
Thanks!
Can you explain what this shows?
I just don't understand what that means. And on the Internet, I did not find normal information.
Please! This indicates that in the structure of your mammary glands there are small deviations with the differentiation of glandular tissue, hence the appearance of benign tumors (cyst or fibroadenoma).
Hello! They took a puncture from me, the result of a cytological study: There are drops of fat on the glass, in a stained preparation there are few erythrocytes, single accumulations of adipose tissue cells, cells of the flattened epithelium of the cyst lining with dystrophic changes.
Hello Diana! You have a breast cyst and the preparation contains the contents of the cyst. You need to consult a mammologist to prescribe treatment for you.
Good afternoon. Help decipher the cytological examination of the contents of the cyst
structureless substance, erythrocytes, a large number of macrophage-type cells, areas
oxyphilic mucus
Hello Tatiana! The usual cellular content of the cyst. There is nothing special about him and not any useful information for you does not bear. You need to consult a mammologist regarding treatment.
Ludmila 2015-05-22 09:23
Good afternoon. The diagnosis is nodular mastopathy, they took a puncture the answer: In a transparent firm. , elements of the stroma, I write verbatim from the analysis. What does this mean and is the operation necessary? Thank you!
Hello Lyudmila! The results of cytology are not very informative. If you have been diagnosed with an ultrasound scan, you do not need any surgery. Talk to your mammologist for treatment.
Tatiana 2015-06-17 08:28
Hello! Today I received the results of a mammary gland puncture: in the preparations of asfones of structureless masses, the components of the flattened cells of the cyst lining. What does it mean?
Hello Tatiana! This means that cyst cells (benign tumor) were found in your punctate. To find out how it treats, you need to consult with a mammologist or gynecologist.
galina 2015-06-22 08:35
Hello! Please help me to decipher the results of breast puncture. Cells of ducts and acini: a scattered arrangement of a small number of cells with atypia, a loose, disordered arrangement of cells in the structure. Cytogram background: drops of fat, abundant structureless substance erythrocytes.
Hello! According to the results of cytology, tumor cells were found in you - it may turn out to be like a benign tumor, but "a small number of cells with atypia" is a little alarming. Nothing special was found in the cytogram. What do you get for an ultrasound of the mammary glands?
Hello, Alexey Alexandrovich! On ultrasound, they write me signs of a heterogeneous palpable formation 16.7 * 17.7. Thanks!
Hello! Indeed, some kind of ambiguous conclusion. Try to undergo an ultrasound of the mammary glands again, but only with another specialist, that is, you can change the clinic or hospital. You can also try to contact an independent laboratory to have the puncture of the formation repeated.
Helena 2015-06-26 16:01
Hello! Please help me to decipher the results of puncture of nodular mastopathy (Bi-rads 3).
The preparation contains blood, fat, secretion of cells of cubic epithelium with moderate proliferation.
What does it mean?
Hello! According to the results of puncture, you have found blood cells, fat cells and cells of the contents of the breast cyst with a tendency to accelerated division. Nothing wrong with that. Consult a mammologist to prescribe treatment for fibrocystic breast disease.
Yuliya 2015-06-26 19:39
Hello! A puncture of the mammary gland was done. Result: very scarce cellular material against the background of detritus, destroyed cellular elements, erythrocytes and fat droplets, single cellular elements were found with signs of hyperplasia, and with atypia of a part of the cells by the type of dysplasia. Ultrasound showed a heterogeneous hypoechoic formation measuring 1.6 * 0.8 cm in the upper-outer square, near the armpit, uneven contours, slight vascularization on the left mammary gland.
Hello! According to the results of cytology, you have fibroadenoma cells, but with atypia (cells with a tendency to malignancy). In order to find out more precisely about this atypia, you need to consult with a mammologist to prescribe a treatment, or rather, the removal of this formation. After removal, the doctor must send the formation to histology, so that everything is checked again there.
Irina 2015-07-06 10:54
Good day! Please help to decipher the result of mom's puncture.
Description of the cytogram: in smears, complexes and structures of epithelial cells with small homogeneous nuclei, naked nuclei.
punctate is obtained from fibroadenomatosis of the left breast.
I would also like to note that before that, my mother had already taken a puncture twice in one day, a week before the puncture, the results of which I have already described above. Thank you in advance for your response!
Hello! Judging by the data obtained, the result corresponds to the content of fibroadenoma cells, and since there are no atypical cells in the analysis, correspondingly fibroadenoma cells without atypia. You need to consult with a mammologist or oncologist about the appointment of treatment (surgery) for your mother.
Irina 2015-07-06 22:54
Great to you thanks for a detailed answer!
Olga 2015-07-10 10:20
Good afternoon, Please help to decipher the result of breast puncture: The material is small-celled and is represented by blood elements, an insignificant amount of elements of inflammation, a fragment of the stroma, single scattered cells of the duct epithelium.
Hello! According to the results of the ultrasound, it looks like you got into the duct of the mammary gland and could have captured elements of the inflamed mammary gland, or rather mastopathy (benign tumor). Nothing terrible was found, atypical cells are absent. Talk to your mammologist or oncologist about your prescription for treatment.
Helena 2015-07-28 10:19
Hello!
Help me deal with the result of histology.
I am 33 years old, gave birth 10.5 months ago, breastfed for up to 4 months. Recently I noticed that a drop of blood is released from the right breast when pressing on the nipple (the day before, the child very strongly grabbed the breast). She donated blood for tumor markers, the result is 4.944. and smear analysis for abnormal cells. Result: Against the background of homogeneous masses and fat cells, single scale cells and cells of the colostrum type. What does it mean?
Thank you in advance for your response!
Hello, Elena! Blood from the nipple can go if your baby hit you hard or grabbed you by the chest, there is nothing wrong with that. You did everything right and insured yourself by passing a smear for cytology. As a result, nothing was found in you, except for blood cells, fat, cells of the excretory ducts of the mammary gland and milk. Be healthy!
Olga 2015-08-01 18:38
Hello, help, please, decipher the analyzes of the puncture mol. Glands. In the first: blood, drops of fat, some naked cells. In the second: erythrocytes, single drops of fat. The puncture was taken under ultrasound control. Many thanks.
Hello Olga! In the first analysis, we see holonuclear cells, which may be the contents of a cyst or fibroadenoma cells (benign tumors). The second analysis is not very informative, since nothing was found except for blood cells and fat. For treatment, you need to consult a mammologist or gynecologist.
Natalia 2015-08-03 14:36
Good afternoon, please help me to decipher the analysis result. Cytological examination: erythrocytes, drops of fat were found in the obtained material! The conclusion of the mammologist before the analysis: diffuse fibrocystic mastopathy, fibroadenoma of the m / f, cysts of both mammary glands! Thank you in advance!
Hello, Natalia! Your analysis is not very informative and, apparently, was not done quite correctly, the doctor, most likely, did not get into the tumor, since only blood and fat cells were found. You can repeat the puncture under ultrasound guidance or start treatment for cysts and fibroadenomas with your doctor.
Mayan 2015-08-05 22:03
Good afternoon. Help to understand the result of a puncture under the control of ultrasound. Three samples:
1.plot of cystic mastopathy with apocrinization of erythelium.
2. acidic cavity against the background of hyperplasia of apocrine erythelium, a significant number of neutrophils.
3. blood elements and macrophages.
Thank you very much in advance.
Hello Maya! 1 - Contents of the breast cyst (benign tumor). 2 - The wall of the breast cyst with its contents. 3 - Blood elements and cells that are responsible for the immune response in your body (macrophages). Talk to your mammologist for treatment.
Thanks for the quick response. I went to the doctor. Prescribed Indinol forto 200 ml. A month later, again to him and if the cyst fills up again, he wants to make a resection and prescribe a course of antibiotics (says inflammation in the chest). I really don't want to cut and hope for the best. May God grant you health.
Hello Maya! The doctor should have prescribed you the standard treatment for mastopathy. "Mastodinon" or "Mamoklam" + "Progestogel" + vitamin therapy.
Alina 2015-08-26 14:43
Good day! Please help to decipher the results of a cytological study. The result is colostrum cells in large numbers and small cellular debris. In the mammary gland where colostrum bodies were found, fibroadenoma was removed 5 years ago. Age 26 years old, did not give birth. Thank you in advance!
Hello Alina! Cytology is not very informative, since typical cells of the mammary glands are found. You need to undergo an ultrasound of the mammary glands.
Nastya 2015-08-27 11:05
Good afternoon.
I am 30 years old, did not give birth. I have been seen by a mammologist since 2004. Sectoral resection was performed to remove fibroadenomas in 2004, 2006, 2008, 2009, 2013. At the moment, according to the ultrasound results, a puncture of two formations was made, the result: 1. among the fat unit, partially destroyed cells of the cubic epithelium; 2. The element of blood and fat.
What does this mean and how to cure FCM, I am already desperate, doctors do not prescribe treatment, only Indinol is prescribed, I think I need more serious treatment.
Thank you in advance for your response.
Hello Anastasia! 1 - Cells of a benign tumor (probably fibroadenoma). 2 - not very informative. The main cause of FCM is hormonal imbalance. Check your hormone levels with your gynecologist or endocrinologist (T3, T4, TSH, TPO antibodies, estradiol, progesterone, testosterone, prolactin, FSH, LH, progesterone). It also makes sense to undergo an ultrasound of the pelvic organs (polycystic ovaries, benign tumors of the adrenal glands and ovaries).
Irina 2015-08-28 12:18
Hello. Please help me decipher the result of a cytological study: in the punctate of the mammary gland there are significant areas of hyperplasia of the ductal epithelium, with areas of secreting apocrine epithelium. Signs of breast fibroadenoma (I wrote it all right). Before that, I did an ultrasound scan: anechoic, avascular formations are located, with smooth and clear contours, with a diameter of 5mm to 20mm, including in the outer quadrant an inhomogeneous structure is determined, measuring 12 * 5 * 11mm, in the CDC mode, blood flow is determined both by the periphery and in the central areas. Thank you in advance.
Hello Irina! You have fibro-xytosis (benign disease) that causes fibroadenoma (benign tumor) to form. Treatment - only surgery + a course of vitamin therapy + a course of hormone therapy, if there are hormonal disorders. In order to find out, check the level of your hormones with a gynecologist, since it is hormonal imbalance that is the main cause of this disease.
Marina 2015-09-05 11:09
Good afternoon, dear doctor! Help pzhl figure it out.
I am 52 g. I have been seen by an oncologist-mammologist for several years. FKB diagnosis. Ultrasound protocol (dated 07.2015) Structure - fatty transformation, fibrosis of the stroma. Hyperplasia of glandular lobules. Cyst 24 mm. X10 mm. Puncture: Flaky amorphous masses, apocrine epithelium. Conclusion: cytogram of apocrine cyst, pier. Glands.
Before that, there were also punctures (in different years) and they showed something different:
In ave. Breasts, in the preparation amorphous protein masses, fat, elements of flattened epithelium and epithelial lining of the cyst m.
NS. gr. In smears, amorphous oxyphilic masses, erythrocytes. No cellular elements were found in the mammary gland.
NS. gr. In smears, amorphous and fatty masses. No cellular elements of the cyst lining were found.
NS. breast. Against the background of amorphous and fatty masses, a single accumulation of epithelial cells was found. Cyst lining m.
What does apocrine cyst mean? Worsening? Compared to the previous. Research? What is the threat and what to do? The doctor does not explain, says to be observed and continue to drink Mastodinon, herbs according to the scheme and vitamins.
Hello Marina! Apocrine cyst is a type of benign tumors that must be removed, since it will no longer respond to conservative treatment. It is an apocrine cyst that can degenerate into a malignant tumor, therefore, the sooner you remove it, the better.
Anna 2015-09-08 18:04
Hello dear doctor. Please help me figure out I passed a puncture under an ultrasound scan, the result is fat masses and rare macrophages, what is it, please help. Thank you very much and God bless you and all the best.
Hello Anna! Macrophages are special cells and are considered the most important protectors. Cells capture and digest bacteria, dead cells and other foreign or toxic to the body. This can be observed with inflammation of the mammary gland, such as mastopathy. What are your ultrasound results?
Yuliya 2015-09-09 18:14
Good afternoon, dear doctor!
Help me understand what the diagnosis is. Cytogram of glandular s-g. Atepic complexes of cells with degenerative changes.
That's all! Why do doctors speak in riddles to instill panic?
Hello Julia! Glandular c-r - glandular breast cancer. This is what your doctors suggest. You need to donate blood for CA 15-3 (breast tumor marker), as well as undergo an ultrasound of the mammary glands or mammography (only after 45 years), perform a biopsy of the formation in the mammary gland or axillary lymph node and consult an oncologist.
Aleksey Aleksandrovich,
further examination can disprove the diagnosis? A year ago, ultrasound and mammography showed nothing.
Operation and chemistry - this can not be avoided?
There are many mistakes when making a diagnosis, so you need further examination, which in the future can refute or confirm this diagnosis. Chemistry or surgery, everything will depend on the stage and damage from the given diagnosis.
Victoria 2015-09-13 15:19
Hello dear doctor. Please help me understand the analyzes.
Ultrasound of the mammary glands revealed 2 formations:
1. oval hypoechoic formation 1.2 * 0.55 cm with a clear, even contour, homogeneous structure without acoustic effects. Cytology: on the fibrous cords of a group of cells of cubic epithelium with signs of moderate and severe dysplasia.
2. in the thickness of the layer of glandular tissue, an oval hypoechoic formation of 1.2 * 0.5 cm with a clear uneven contour with small-point hyperechoic inclusions. Cytology: single cells of the cubic epithelium against the background of erythrocytes and fatty inclusions.
Is the operation required?
Hello! According to the description of the ultrasound and cytological examination, it is very likely that you have 2 cysts (benign tumors) of the breast. One of them is already slowly calcifying. There is nothing wrong with that, and you need to consult with a mammologist so that he can prescribe treatment for you. The operation can be skipped as they are small in size.
Thank you very much for your reply! The fact is that I consulted with a mammologist-oncologist, who, according to these analyzes, diagnosed me with breast fibroadenomas in both cases and prescribed an operation, since I am planning a pregnancy. We also conducted a study for sex hormones (within normal limits), ultrasound of the pelvic organs (within normal limits). How can you determine more accurately that these are cysts or all the same fibroadenomas? Is it possible for their resorption after childbirth or, on the contrary, an increase?
Visually, by ultrasound, you can see if it is of an even size and there is a capsule with a cavity, then it is a cyst, if it is of the same size, but without a cavity, then a fibroadenoma. I wrote that this is a cyst, but I could be wrong and it may turn out to be fibroadenoma, since the description of ultrasound is scarce. But cytological cells (cubic) are characteristic of cysts, although in rare cases they can turn out to be fibroadenoma. Even if you do not remove the tumor now, you can easily do it after childbirth and breastfeeding, Nothing wrong with that. It may increase slightly after childbirth or even decrease under the influence of the pregnancy hormone (progesterone), if it is fibroadenoma. If it disappears completely, then it was a cyst. There is no urgency in the operation. Considering the size of the tumor, conservative treatment can be tried.
Olga Mikhailovna 2015-09-30 12:30
Hello, dear Alexey Alexandrovich! Please help me understand my situation. I am 57 years old and have a long-standing diagnosis of fibroadenomomatosis. In 1980, fibroadenoma of the right breast was removed sectorally. In 2003 and 2005, cysts were removed in both glands. In 2009, due to a large neoplasm on the ovary, the uterus and ovaries were amputated. Histology showed that the lesion was 100% benign. She regularly visited a mammologist. Ultrasound in November 2014 showed nothing but multiple small cysts. Mammography and ultrasound in August 2015 showed "in the right mammary gland in the upper-inner quadrant, closer to the areola, a hypoechoic formation measuring 15x11x14 mm with a fuzzy, uneven contour, heterogeneous echo structure due to calcifications is determined." They did a biopsy. Its description: the preparations contain abundant structureless masses, cords and accumulations of proliferating cubic epithelium cells with monomorphic nuclei and dystrophic changes; layers of fat cells, macrophages, erythrocytes. "The mammologist whom I am seeing said that it was fibroadenoma and sent it for further treatment (removal) to the oncological dispensary. surgical department Oncologic dispensary looked ONLY pictures. I simply did not look at the ultrasound and the results of the biopsy and made the diagnosis - malignant neoplasm I p. Is there a chance that this is still fibroadenoma? And if it turns out that this is still a fibroadenoma, wouldn't it be safer to remove the entire mammary gland, and not just the neoplasm?
Hello! In cytology, there are cubic epithelial cells - cells that are characteristic only of benign tumors (cyst or fibroadenoma). I think that the doctor wrote the ZNO as a preliminary diagnosis. After removal, in any case, your tumor will be sent for repeated histological examination, everything will become clear there. Do not worry about this, if you have fibroadenoma, then it will.
Natalia 2015-10-09 20:40
good evening, Aleksey Aleksandrovich! Please help to decipher the result of the cytological study: "The sent material contains an abundant granular component, detritus, erythrocytes, a large number of neutrophilic granulocytes in the lysis stage, there are macrophages and histiocytes, single cells and small groups of cells of reactive epithelium of the mammary gland." Thanks!
Hello! Judging by the description, you have fibrous mastopathy (benign disease). to receive treatment, you need to consult a mammologist or gynecologist.
Olga 2015-10-14 20:47
Good evening to you! I ask for help in decoding. Ultrasound revealed a hypoechoic formation with an even, clear outline of the layered structure, giving a slight increase behind the formation and weak lateral shadows 10.4x5.2x9.3 avascular. An ultrasound is shown in two weeks. I made a repeat, in another medical institution - echo signs of the presence of a volumetric formation 9.7x5.6 hypoechoic homogeneous structure, avascular, with lateral distal amplification of the echo signal. I made a puncture, the answer came - In the material received (1st), elements of peripheral blood, a structureless substance, drops of fat, single naked nuclei of destroyed cells were found. They sent me for an operation. They said to have a mammogram. The doctor said that she did not see anything in the picture, wrote that against the background of the diffusions of the fcm on the right, there was a fuzzy rounded shadow (shown by ultrasound). She said that I would take glasses and look for a competent cytologist. I have eco on my nose. The mammologist does not give permission, due to the protocol (hormones) and the possible growth of ibroadenoma. It is not clear from the puncture - is it a fibroadenoma? Mammograph - I'm not sure at all about the presence of fa. Help me to understand. There is a greenish discharge, the chest hurts - on certain days of the cycle. Doctors say that this is just mastopathy and no treatment is prescribed (thank you in advance
Hello Olga! Judging by the first description of ultrasound, it looks more like a calcified "old" cyst with large calcification, which gives an acoustic shadow (overlay), such cysts only need to be operated on. According to the second description, one can already judge about fibroadenoma. Both the cyst and fibroadenoma, which are also operated on, are benign tumors and are the result of mastopathy (benign disease), which in turn appears due to hormonal disruption. Sizes, if they are indicated in millimeters, are insignificant and are not a contraindication to IVF, but! You must understand that you will be prescribed hormone therapy and it may increase in size. In this case, after childbirth, during or after hepatitis B, you will have to remove it, having previously agreed with the doctor. Now you need to once again undergo an ultrasound of the mammary glands, on the 8-10th day from the beginning of menstruation, in order to once again confirm for yourself the picture of what is happening.
Thank you for your reply. Tomorrow I'm going to the rtm. Advise as one of the diagnostic methods dangerous conditions mf.
Evgeniy 2015-10-15 10:06
Good day! My mother is 52 years old, she was diagnosed (when referred for cytological examination) Fibroadenoma of the left breast. Cyst? Took a puncture of the tumor, the result showed: In the sediment-flattened epithelium with the formation of atypical papillary structures. What does it mean? Appointment to the oncologist only on 10/20/2015.
Hello Eugene! Judging by the description of cytology, your mother has fibrocystic mastopathy, namely a breast cyst (benign tumor), unless, of course, the cytologist has confused anything with the description, otherwise there may be fibroadenoma. You need to clarify the size of this formation and if it is not large in size, then a mammologist or gynecologist will prescribe treatment for you after consultation.
I.P. Shabalova, T.V. Dzhangirova, N.N. Volchenko, K.K. Pugachev
Russian Medical Academy of Postgraduate Education
Inflammatory lesions
Inflammatory lesions of the mammary gland are rarely the object of cytological examination, only small part of them has an infectious etiology.
- Acute mastitis and abscess [show]
Acute mastitis is almost always a complication associated with lactation and breastfeeding. The etiological agent of mastitis is usually staphylococcus or streptococcus, which enters the mammary gland through cracks in the nipple, a factor contributing to the development of the disease, is milk stagnation. The clinical picture is characterized by redness, induration, soreness of the gland area. Diffuse, predominantly neutrophilic, infiltration of the mammary gland, sometimes with destruction of the structures of the duct, lobule and surrounding stroma, is noted histologically.
Usually, the diagnosis is made clinically and treatment is carried out without cytological examination. Sometimes the abscess is opened to allow drainage of the cavity.
In some cases, it is necessary to carry out differential diagnosis with an inflammatory form of cancer, in this case a puncture is necessary. In punctate, neutrophilic granulocytes, macrophages, an abundant necrotic background, and sometimes reactive cells of the duct epithelium are found.
[show]
- Breast tuberculosis [show]
Mycobacterium tuberculosis can penetrate into the gland through the lactiferous ducts, as well as through the lymphatic pathways (from the lymph nodes of the root of the lung, mediastinum, axillary lymph nodes), hematogenously (in acute miliary tuberculosis). Usually there is a nodular, fistulous or ulcerative form of tuberculosis.
Cytological signs:
- Epithelioid cells (Fig. 12):
- elongated and polygonal shapes;
- the cytoplasm is light;
- the kernels are delicate, oval in shape, the boundaries are clear;
- looped chromatin, evenly distributed
- Giant multinucleated cells of the Pirogov-Langhansa type:
- nuclei are rod-shaped, chaotically located, chromatin looped, spongy, small nucleoli
- Epithelioid cells (Fig. 12):
- Duct ectasia [show]
Duct ectasia usually occurs in postmenopausal women. The clinical picture can simulate cancer. Histologically, the lesion is manifested by the expansion of the large ducts in the subareolar region. Periductal fibrosis and infiltration of the affected area with elements of chronic inflammation are noted. There are amorphous masses in the lumen of the ducts.
In cytological preparations obtained by puncture, a structureless substance, drops of fat, macrophages are found, neutrophilic granulocytes, fibroblasts can be found.
- Lipogranuloma (fatty necrosis) [show]
The occurrence of lipogranuloma may be associated with rupture of the duct with ectasia of the duct or cysts with fibrocystic disease. In this case, the lesion can be located in the deep parts of the mammary gland.
The cause of the development of lipogranuloma can also be trauma, household or as a result of surgery; in the latter case, lipogranuloma is often located superficially. Clinically, lipogranuloma usually appears as a dense mass in the mammary gland, sometimes mimicking cancer.
The histological picture is characterized by foci of fatty necrosis with the formation of granulomas from giant multinucleated histiocytes, macrophages filled with drops of fat (lipophages, the outdated term is xanthoma cells), and lymphoid elements. Aspirate is usually abundant, crumbly, and contains a lot of fat.
Cytological picture (Fig. 13, a-f):
- Foamy macrophages (xanthoma cells): the cells are large, the nucleus is small, round, hyperchromic, the cytoplasm is abundant, fine-celled (contains small drops of fat).
- Giant multinucleated cells that are a characteristic feature of lipogranuloma. The nuclei are hyperchromic, sometimes enlarged, small-celled cytoplasm.
- Unstructured granular masses, drops of fat, tissue scraps of adipose tissue that make up the background of the preparation.
- Sometimes other elements of inflammation are found, usually in small numbers.
- Epithelial cells may be present, but they are usually few.
The differential diagnosis is with tuberculous mastitis. Giant xanthoma cells may resemble cancer cells. In this case, a close examination of cells at high magnification helps correct differential diagnosis: for mononuclear and multinucleated xanthoma cells, rounded-oval nuclei of the same size, a fine-mesh structure of the cytoplasm are characteristic.
Chronic mastitis is more often a secondary granulomatous lesion associated with a systemic disease, such as tuberculosis or sarcoidosis, and may result from a breast abscess (Fig. 11).
Proliferative lesions
Fibrocystic disease (FCD)
FKB - "background" processes with varying degrees of risk - a combined group, including hyperplastic and / or atrophic processes of the parenchyma and stroma or one of these elements. The severity of hyperplasia and / or atrophy is different, and therefore the morphological manifestations of the disease can be very diverse. As a rule, changes from the parenchyma and stroma are combined with the formation of small or large cystic cavities. The defeat is usually associated with dyshormonal processes (see "Mastopathy in women of fertile age", the symptoms of the disease (local or diffuse soreness, engorgement of the mammary gland or its parts) often intensify before menstruation. In postmenopausal women, regression of the lesion is often noted.
The collective concept of fibrocystic disease (FCB) (mastopathy) includes up to 30 different names for this disease: benign dysplasia, dyshormonal hyperplasia, dyshormonal dysplasia, cystic mastopathy, cystic disease, cystic fibroadenomatosis, chronic cystic mastitis, cystymmelus disease, Schmidt's disease etc.
According to the 1995 International Statistical Classification of Diseases, the group of "benign dysplasias" of the mammary gland includes: cyst, diffuse cystic mastopathy, fibroadenosis, fibrosclerosis, duct ectasia and unspecified benign dysplasias. More appropriate to describe this group of lesions is the term PCB, which is most often used in the literature due to the fact that the term dysplasia is currently usually denoted intraepithelial neoplasia (precancerous processes). The term PCB (mastopathy) sometimes also combines such, in fact, very different pathological conditions, such as adenosis, adenomatosis, intracanalicular papilloma, atypical hyperplasia and other variants of nodular hyperplasia.
Fibrocystic disease is a widespread disease, however, in the latest histological classification of breast tumors (WHO, 2003), it is not separated into a separate heading. This is due to the fact that, as already noted, fibrocystic disease is a collective concept that has a wide diagnostic framework that does not reflect the malignant potential of this process.
Histological features: microscopic changes in fibrocystic disease include cystic dilatation of the ducts, apocrine metaplasia of the ductal epithelium, intralobular and intralobular fibrosis, adenosis (enlargement of acinar structures with proliferation of the end sections of the glands) and intraductal proliferation of the epithelium 14 of varying severity, 15 ...
In cytological preparations from the mammary gland, we do not see a clear morphological structure of the lesion, therefore, it is not possible for a cytologist to judge the form of PCB in most observations. One of the forms of FCB, in which a diagnosis can be made cytologically, is a cyst, cystic mastopathy [show]
Cyst
Depending on the mechanism of formation, cysts can be different, including:
- containing milk (galactocele);
- resulting from traumatic fat necrosis;
- with the formation of intraductal papilloma
Breast cysts can be single and multiple, single and multi-chambered. Cysts are lined with flattened or cubic and cylindrical epithelium, often with apocrine metaplasia, sometimes with small papillary growths. Cysts are usually well-defined rounded formations, but they are not always clearly distinguished from other conditions: fibromas, lipomas, papillomas, hemangiomas, adenomas, abscesses, metastases, and sometimes from a primary malignant tumor of the breast. Thus, aspiration puncture of clearly delineated nodes is a necessary procedure.
Histological features: Large cysts are usually lined with a monolayer, flattened epithelium, but sometimes the epithelial lining is absent. In these cases, the walls of the cyst are represented by connective tissue.
Due to the fact that they try to avoid surgical intervention as much as possible, in the clinical picture of a cyst, puncture is the method of choice, which in case of large cysts is not only diagnostic, but in most cases it is also a therapeutic procedure. Recurrence of cysts after a properly performed puncture is rare. Cancer in a cyst is also rare (0.05-0.5% of observations), however, due to the fact that such a possibility exists, a cytological examination of the contents of the cyst should be performed without fail.
The liquid is usually clear, straw-yellow in color; in this case, cytological examination, as a rule, only confirms the benign nature of the cyst. Concerns about its benign nature can be in the presence of a cloudy, bloody or brown fluid, and it is necessary to especially carefully study the cellular composition of the drugs.
Cytological picture
As a rule, the cellular composition of smears from cyst material is scarce: single "foam cells" and not big number elements of the cyst lining. These are either flattened or apocrine cells. The elements of the cyst lining are usually arranged in layers, and the cells are of different sizes.
- Flattened cells large, polygonal, with abundant cytoplasm of blue or gray-blue color, often with many processes. The nuclei are medium in size, the chromatin is "sparse", the nucleolus is often visible (Fig. 16). Often there are multinucleated flattened cells, the nuclei may differ slightly in size, which, in combination with enlarged nucleoli and coarse chromatin, can cause difficulties in cytological diagnostics. The benign nature of the lesion is evidenced by the abundant cytoplasm, the absence of cellular and nuclear polymorphism.
- small and medium-sized are located in groups. Small cells have a basophilic cytoplasm, a small, centrally located nucleus. Due to the pronounced basophilia of the cytoplasm, the structure of the nucleus is hardly visible. In medium-sized cells, the nuclei are larger, often located eccentrically, have a rounded shape, chromatin is somewhat sparse, evenly distributed. The cytoplasm is abundant, unevenly colored, usually along the periphery in the form of a more intensely colored "cap", often with basophilic or oxyphilic granules (Fig. 17-23; Pappenheim staining).
Excisional cyst biopsy is indicated in the following cases:
- Detection pathological changes with pneumocystography (compaction or unevenness of the cyst wall, papillary structures in the lumen, multi-chamber cysts).
- Hemorrhagic fluid, even in the absence of data for a malignant process in cytological examination.
- Residual masses after fluid aspiration.
- Threefold relapse of fluid accumulation.
Other variants of FKB are characterized by the following features (Fig. 24, 25):
- poor cellular composition;
- small clusters of cells of indefinite shape or in the form of honeycomb-like structures;
- apocrine cells, single or in groups; there can be many of them with severe apocrine metaplasia;
- single myoepithelial cells;
- there may be foam cells;
- single "naked" nuclei of destroyed cells, round or oval in shape.
In fibrocystic disease, there may be changes that are difficult for differential diagnosis with fibroadenoma, structures with finger-like outgrowths, "windows" and others (see also below "Fibroadenoma of the mammary gland). Therefore, the conclusion about fibrocystic disease usually given in a presumptive form ("Hyperplasia of the epithelium of the mammary gland, possibly PCB").
Also, in fibrocystic disease, cell atypia can be noted, which casts doubt on the benign nature of the lesion (Fig. 27; Pappenheim staining).
Hypertrophy of the mammary gland in men (Fig. 28). Ductal and periductal hyperplasia with stromal proliferation is usually present. One-sided lesion is more often noted. The reason may be hormonal imbalance, sometimes - the use of anabolic steroids. It is more common during puberty and in old age, as well as in men with cirrhosis of the liver and testicular tumors.
Discharge from the nipple with FCB
They meet quite often. May be colorless, but usually have a whitish, yellowish or greenish tint. In cytological smears, squamous epithelium scales, homogeneous or structureless masses are found, fat drops, leukocytes, cells such as colostrum cells, erythrocytes, and epithelium can be found. With galactorrhea, the cellular composition resembles the composition of colostrum or milk: against the background of a homogeneous structureless substance, there are abundant drops of fat, a different number of cells such as colostrum bodies and groups of duct epithelial cells, sometimes in the form of loose papillary structures (Fig. 29).
Benign breast tumors
- Fibroadenoma of the breast [show]
Fibroadenomas- a group of benign breast tumors with proliferation and a violation of the ratio of the epithelial and stromal components. These are the most common breast tumors in women. The occurrence of fibroadenoma is associated with the local sensitivity of breast tissue to the effects of estrogenic hormones; it occurs at any age after puberty, but more often develops in young women under 30 years of age. There can be both single and multiple lesions. On palpation, the tumor is easily mobile, the skin above it is not changed, the regional lymph nodes are not enlarged.
Distinguish between pericanalicular, intracanalicular and mixed fibroadenoma.
Histological features
Perianalicular fibroadenoma characterized by the proliferation of stromal cells around the ducts.
At intracanalicular fibroadenoma proliferating stromal cells compress the ducts to form slit-like structures. The stromal component is especially pronounced in tumors in young women and girls, often with significant proliferation of connective tissue cells in combination with myxomatosis (mucus), as well as hyalinosis and calcification. The epithelial component demonstrates a different degree of proliferation, foci of apocrine and squamous cell metaplasia are found, and a rather pronounced proliferation of myoepithelium is also noted.
Juvenile (giant) fibroadenoma characterized by pronounced, more often pericanalicular and sometimes peri-intracanalicular proliferation of stromal elements and epithelial hyperplasia.
Leaf-shaped tumors
Leaf-like tumors are a special group of tumors characterized by the proliferation of both the stromal and epithelial components with the formation of peculiar leaf-like structures. Distinguish between benign, malignant and borderline leaf-shaped tumor.
Benign foliar tumor - intracanalicular fibroadenoma with pronounced proliferation of fusiform stromal cells with monomorphic nuclei, with rare mitoses. Significant cellularity of the stroma is noted at the site of contact with the epithelial component. In the tumor, there can be foci of necrosis, as well as muscle, fatty, cartilaginous and bone metaplasia.
Malignant leaf-shaped tumor characterized by pronounced cellularity of the stromal component with the formation of beam structures, polymorphism and hyperchromia of cellular elements, foci of pronounced mitotic activity. As a rule, fibrosarcoma structures are formed, but there may be liposarcoma, osteochondrosarcoma and rhabdomyosarcoma.
Borderline foliate tumor is diagnosed with pronounced proliferation of the stromal component, but the absence of pronounced mitotic activity, polymorphism and nuclear hyperchromia does not allow interpreting the existing changes as sarcoma.
Cytological features
It is quite problematic to distinguish fibroadenoma from PCB cytologically, but some signs suggest the presence of this tumor. It is characterized by:
- extensive structures ("deer, elk antlers", globular structures);
- often in structures, cells are arranged in two or more layers;
- in multilayer structures there can be rounded areas of enlightenment ("windows"), consisting of one row of cells; an abundance of "naked" oval nuclei;
- a significant number of fibrocytes may be present;
- more often than with PCB, atypia of structures, cells and nuclei is noted (enlargement of size, congestion of cells and nuclei, coarse chromatin, nucleoli), but the cells are located approximately at the same distance from each other, oriented in one direction, the contours of the nuclei are even, chromatin is distributed evenly, nucleoli are small, of the same size (Fig. 30-34).
A homogeneous structureless substance of a bright crimson color with fibrocytes enclosed in it is a fairly clear criterion for fibroadenoma; especially often it is found in intracanalicular fibroadenoma and leaf-shaped tumors (Fig. 35), with pericanalicular fibroadenoma such a substance is rare (Fig. 36).
If there is cell atypia, then its presence should be noted.
[show]
- Abundant cellular composition.
- Large structures of epithelial cells (branching, in the form of antlers, elk, spherical, layers, etc.).
- Atypia in the epithelial component, expressed in varying degrees however, as a rule, the connections between epithelial cells are strong enough and the cells are located in clusters and structures.
- Abundance of stromal cells.
- Fragments of crimson stroma with fibrocytes enclosed in them, located in close connection with epithelial cells or separately from them.
- The background of the drug is often represented by a homogeneous or granular pinkish-crimson substance.
- "the found changes correspond (or" most correspond ") to fibroadenoma (possibly leaf-like)";
- "The changes found are most consistent with a benign leaf-shaped tumor."
Often during the initial visit to the doctor, a tumor of significant size (up to 100 mm or more) is found, however, if a tumor is detected in the early stages of its development, it may be small. On palpation, the tumor is usually less dense and less mobile than normal fibroadenoma. Differential diagnosis between a leaf-shaped tumor and a giant fibroadenoma can only be made with histological examination.
The following cytological signs suggest a leaf-shaped tumor (Fig. 37):
The conclusion about a leaf-shaped tumor is also given in a presumptive form:
If the stromal component is pronounced significantly and, in addition to crimson patches, there is a large number of scattered stromal cells (such as fibrocytes) without pronounced signs of atypia and we cannot exclude a borderline tumor, the conclusion should be drawn: tumors ".
If cellular and nuclear polymorphism is noted in the stromal component, the presence of a malignant leaf-shaped tumor can be assumed (see section: "Malignant leaf-shaped tumor").
However, sometimes a pinkish-crimson substance and enlightenment in the form of "windows" are found in both PCB and PCB combination with fibroadenoma (Fig. 38-40).
With fibroadenoma, atypia of epithelial cells is often noted (Fig. 41, 42).
Difficulties in the differential diagnosis of benign and malignant lesions can occur with a combination of PCB and fibroadenoma with sclerosing adenosis.
Loosely located stromal elements in fibroadenoma can also simulate cancer (Fig. 43).
[show]
It develops more often in premenopausal or menopausal women.
Clinical signs
Discharge from the nipple is more common in benign lesions than in cancer. Intraductal papilloma is the most common reason the appearance of nipple discharge, which is usually brown or bloody. Surgical treatment - sectoral resection.
Histological features
Intraductal papilloma is accompanied by the formation of papillary structures in the lumen of the duct, represented by epithelial and myoepithelial cells lining the fibrovascular "leg" (Fig. 44).
Intraductal papillomas are divided into central with lesions of large ducts and peripheral, arising in a duct-lobular unit, as a rule, multiple.
In the papilloma, there can be foci of inflammation, necrosis, apocrine, squamous, fatty, mucinous, bone and cartilaginous metaplasia. The degree of proliferation of the epithelial component is different, so it is sometimes difficult to differentiate between intraductal papilloma and intraductal papillary carcinoma. This helps the assessment of cytological signs of cellular anaplasia.
Cytological signs
- Epithelial cells in the form of papillary structures (the nuclei are located eccentrically, the cytoplasm is abundant).
- Red blood cells.
- Macrophages with hemosiderin.
In the presence of all three signs or the first two, it is customary to establish a confident cytological conclusion about intraductal papilloma (Fig. 45, 46). Usually it coincides with the histological diagnosis, however, in isolated observations during the histological examination of the resected area of the mammary gland, with a similar cytological picture, fibrocystic disease with papillary growths of the duct epithelium is found. The opposite situation is also possible, when only cells of the colostrum body type and a structureless substance are found in cytological preparations, and intraductal papilloma is histologically revealed.
Thus, both in the presence and in the absence of classical cytological criteria for intraductal papilloma, other research methods are needed to confirm the diagnosis, for example, ductography.
Papillary structures from epithelial cells can also be found in punctates from the mammary gland (Fig. 47).
Differential diagnostic criteria for benign breast lesions
Differential diagnosis of various benign lesions of the mammary gland presents certain difficulties, although on the basis of a number of signs, one or another pathological process can be assumed. To do this, you need to consider:
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A source: I.P. Shabalova, T.V. Dzhangirova, N.N. Volchenko, K.K. Pugachev. Cytological atlas: Diagnosis of breast diseases. - M.-Tver: Triada Publishing House, 2005 | ||||
Irina asks:
48 years old. Fibrocystic breast disease. Cytological examination6 in the preparations are abundant structureless lumpy masses, scales of the integumentary epithelium. Conclusion: morphological signs secerinating mammary gland. The manipulation was harsh and painful, although prior to the study there was no cause for concern. Subsequently, a long time nipple sensitivity. Ultrasound: the mammary glands are glandular and small. amount of adipose tissue. Connective tissue structures of increased echogenicity. The milky ducts are dilated on the right up to 4 mm, on the left up to 3 mm. Och.image not defined. Lymph nodes armpit. are not visible. (Ultrasound was performed 4 days before a month.). Passed examination: thyroid ultrasound - normal. Gynecology - uterine myoma (interstitial myomatous nodes D from 8 to 20 mm, avascular; VMK-Mirena). A blood test for hormones: androstenedione, TSH, FSH, estradiol, prolactin with macroprolactin is the norm. Doubts and discrepancies: on the 4th day of menstruation - progesterone ‹0.64 at a rate of 1.0-3.6, although I read in other sources before ovulation the rate of 0.32-2.23, which I get into; total testosterone ‹0.69 at a rate of 0.2-2.8, am I not within these limits, the doctor claims that it is low. Mammography - signs of FCM. The course of treatment: Aevit - 2 months, Estrovel - 3 months, Wobenzym - 1 month, Progestogel ointment - 3 months. Please answer the following questions: 1. My general condition in terms of indicators? ... 2.Comment all the same hormones for progesterone and testosterone. 3.Secerating mammary glands - regarding my description. What is it, there is no spontaneous discharge. 4. Do you agree with the prescribed treatment. Without begging the merits of the DC doctor due to the fact that much has not been explained and questions arise. Thanks.
1. Unfortunately, without a personal examination, it is impossible to assess the patient's condition, even with the results of the examination passed.
2. For the correct interpretation of the analyzes, in addition to laboratory standards, it is necessary to know the units of measurement in which the examinations were carried out. Different laboratories can determine the level of the same hormones in the blood using different diagnostic systems and using completely different units of measurement. That is why, in addition to the numbers showing the level of the hormone in the blood, it is necessary to indicate the units of measurement in which this level was determined, for example, g / l, μme / ml, and so on.
3. The diagnosis of "secerinated mammary glands" in this situation was made on the basis of a cytological examination. On early stages of this pathological condition, there is no discharge from the nipple, however, the secret can be found in the ducts of the breast lobules.
4. The prescribed treatment regimen is fully consistent with the diagnosis.
You can read more about mastopathy, the causes of its occurrence, methods of diagnosis and treatment of this disease in our thematic section with the same name: Mastopathy.
Irina comments:
Thanks for the answer. To clarify: in my case, the unit for measuring the level of the hormone in the blood is nmol / L. On the 4th day of menstruation - progesterone <0.64 at a rate of 1.0-3.6, and total testosterone <0.69 at a rate of 0.2-2.8. And they tell me that testosterone is too low. Unclear. thanks
In the results provided by you, the level of progesterone in the blood is normal, and the level of testosterone is slightly reduced (the norm for adult women is a testosterone level above 0.73 nmol / l).
Arina asks:
Hello. My husband and I are trying to get pregnant, but so far it has not worked. I donated blood for progesterone at 24 dc. less than 0.64. what does this mean? I am 24 years old. The analysis of sperm analysis from my husband is as follows: agglutination, testospermia, asthenospermia, oligospermia. how can the quality of sperm be improved. I am waiting for an answer. Thank you in advance.
Please specify the units of measurement in which the progesterone level in your blood was measured. Read more about the effect of progesterone on the menstrual cycle and about fluctuations in its level in the blood throughout menstrual cycle, You can read in our section of the same name: Progesterone. With this information, it will be possible to correctly interpret the survey results. For a correct assessment of the results of a spermogram, complete information about the composition of the sperm is necessary (not only a conclusion). You can read more about the interpretation of spermogram results in our thematic section with the same name: Spermogram. More about possible reasons the occurrence of infertility (both male and female), about diseases that are accompanied by problems with conception, their clinical manifestations, methods of diagnosis and treatment of these diseases, you can read in our thematic section with the same name: Infertility.
Marina asks:
At one time, I underwent 2 operations to remove the formed seals in the mammary glands. Now I am 52 years old. I passed the analysis "Breast biopsy, separating the nipple". The results are as follows:
MICROSCOPIC DESCRIPTION: Right mammary gland: the preparation contains abundant structureless lumpy masses, single cells such as colostrum corpuscles, single altered erythrocytes. Left mammary gland: the preparation contains abundant structureless lumpy masses, single cells such as colostrum bodies, scales of the integumentary epithelium.
CONCLUSION: Right mammary gland: Morphological signs of a secerinating mammary gland. Morphological signs of erythrocytes. Left mammary gland: Morphological signs of a secerinating mammary gland.
RECOMMENDATIONS: Dynamic control.
Please tell me how to understand these results? What do all these terms mean? The results of the analyzes were given verbatim in full. Thank you in advance!
The diagnosis of "secerinated mammary glands" in this situation was made on the basis of a cytological examination. In the early stages of this pathological condition, there is no discharge from the nipple, however, the secret can be found in the ducts of the breast lobules. V in this case, it is recommended to be registered with a mammologist and strictly follow all recommendations to prevent the development of breast cancer pathology. Read more about diseases of the mammary glands in the series of articles by clicking on the link:
The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question on the topic "nodular mastopathy of the mammary gland" and get a free online doctor's consultation.
Ask your questionQuestions and answers on: nodular breast disease
2015-12-05 16:50:29
Elena asks:
Good evening! In my right mammary gland in 2007, 2 fibroadenomas were first discovered, 1 - in the upper outer quadrant 11 * 6mm, 2 - on the border of the internal quadrant 10 * 6 mm. Repeatedly punctured: groups of cells of cubic epithelium, structureless substance, macrophages, erythrocytes. They did not take on the operation - the reason is too small and there is no negative dynamics. But in November of this year: ultrasound from the cancer center:
Right mammary gland:
- the upper outer quadrant - the formation of "No. 1" of reduced echogenicity, with a moderately uneven clear contour 11 * 6 mm and a complex of dilated ducts in the area of 10 * 5 mm,
- on the border of the inner quadrants multinodular formation No. 2, reduced echogenicity, 14 * 6 mm, with an uneven clear contour.
Left breast:
- the upper outer quadrant of education No. 3 of reduced echogenicity, with moderately uneven clear contours, 9 * 6 mm, with pinpoint inclusions and local expansion of the milky duct up to 3.7 mm over a stretch of 12 mm.
Diagnosis: nodular formations of the mammary glands. FKM.
Puncture from 04.12.15:
Formation No. 2 is a structureless substance, Formation No. 3 is a cytogram of fibroadenoma with pronounced proliferation of cube. Epithelium.
Formation No. 1 was not punctured.
The doctor at the moment said that she can only cut out a 14 * 6 mm formation, the rest are small, so observe.
I insist on the operation, but so far I have stopped at the fact that I am treating mastopathy: mastopol, progestin.
Then after 3 months. Uzi and decide what to do next.
Please help me with advice on what to do. It scares me that there is already fibrodenoma in the other breast. Before that I took Mastopol - it helped a little.
Answers:
Hello, Elena! The main reason for the development of fibroadenomas and fibrocystic mastopathy is hormonal imbalance. Judging by the fact that the treatment does not give a sufficient effect and the progression of breast disease is observed, the hormonal disorders present in your body have not been identified and eliminated. With this approach, recovery is not expected. Therefore, we strongly advise you to discuss with your mammologist a thorough examination of the hormonal status with an emphasis on the function of the ovaries and thyroid gland. If you do not find understanding from a mammologist, seek help from a competent endocrinologist or gynecologist-endocrinologist. Take care of your health!
2012-07-10 14:51:51
Lyudmila asks:
Hello. passed Mammography in the description it was stated the following: On mammograms on both sides in two projections, the skin and subcutaneous tissue are not changed, the nipples are symmetrical, without signs of retraction. The parenchyma is diffusely nonuniformly compacted due to large-loop deformation of the stroma and multiple focal-like shadows without clear contours. Nodal pathology against this background is not determined. R-SIGNS OF DIFFUSE FIBROCYSTIC MASTOPATHY OF THE BREAST. 0.6 mm.
2015-12-24 19:32:55
Marina asks:
Hello! I am 49 years old, in July, a sectoral resection of the right breast (right-sided nodular mastopathy) was performed. But I felt a lump in another place and it sometimes hurt. I was told that if this focus is found during the operation, it will be removed, but not found. Three months later, during the control examination, a dark spot was revealed. After a biopsy, the doctor did not explain anything and said that if I agree to a second operation, he will give a direction. This lump, which was in July hurts, sometimes pulls like an abscess and the pain radiates under hand. What should I do and is there any treatment after the operation? Thanks.
Answers Medical consultant of the portal "site":
Hello Marina! The only treatment for nodular mastopathy is surgery. However, you should only agree to the operation after the doctor explains to you in detail the results of the examination and, above all, of the biopsy. After the operation, it will be necessary to undergo an examination by an endocrinologist and a gynecologist in order to identify hormonal disorders, which usually underlie the development of mastopathy, and eliminate them. Take care of your health!
2015-06-24 12:19:31
Elena asks:
Hello. I am 35 years old. 10 years ago, on the basis of an examination by an oncologist, I was diagnosed with diffuse cystic mastopathy, and treatment was prescribed. In 2007 she gave birth to a little son. She was breastfeeding for a long time 2.5 g. I did not feel hardening. After a divorce from my husband (5 years ago), there is no sexual activity. Now there are hardness in the chest and aching pain at night sometimes. Conclusion of ultrasound of the mammary glands: uneven expansion of the milk ducts in both mammary glands against the background of diffuse changes in the structure of the mammary gland parenchyma of a fibrous nature. There are also problems in gynecology - small nodular fibroids + cervicitis. The thyroid gland is also not in order in 2013 - signs of DNZ 1 tbsp. Help me find out if there is a need for an additional examination of the mammary glands, what are the causes of this disease and what methods of treatment are.
Answers Medical consultant of the portal "site":
Hello, Elena! Most likely, the cause of mastopathy is a hormonal imbalance caused by problems with the thyroid gland and dysfunction of the reproductive system. In such a situation, the best help for a woman can be provided by treatment under the auspices of a gynecologist, endocrinologist and mammologist. Restoration of the normal balance of hormones is achieved by medication and in most cases eliminates disturbances in the breast tissue. Take care of your health!
2015-01-12 07:39:59
Daria asks:
Hello! I was diagnosed with nodular mastopathy (a small nodular formation in the lower part of the left breast, the middle between a cyst and lymph node size 2x4mm). The mammologist-oncologist said that it was possible to become pregnant, did not prescribe treatment, said only to be observed by the district gynecologist.
I am tormented by doubts whether it is possible for me to become pregnant now, there is no need for me to treat this formation?
2014-09-10 13:20:10
Alla asks:
Microscopic descriptions: cells of cubic epithelium, conclusion: morphological signs of hyperplasia of the mammary gland epithelium. What does this mean? doctors make different diagnoses, I don’t know who to listen to, they put fibrocystic mastopathy with a predominance of the cystic component, nodular form; place LVF fibroadenoma; place diffuse fibrocystic mastopathy, with a predominance of the fibrous component
Answers Demisheva Inna Vladimirovna:
2014-05-07 12:28:24
Igor asks:
She was sent for a consultation with an oncologist. She is in tears, she is afraid that cancer. I reassure her, saying that it is not yet clear what she has. While we are waiting for the call, I would like to know at least first what she has. Based on mammography results
Leather of normal thickness up to 2mm. subcutaneous fat layer without pathological formations, uniform. The nipples are symmetrical, without signs of deformation. The glandular tissue is pale, involuted with a pronounced spread of adipose tissue. The stroma is moderately fibrosed.
Against this background, osified cysts and locally dilated ducts are determined (more pronounced on the left). On the right, in the upper-outer square, a nodal medium-intensity formation of 9x12x15mm is determined. with the presence of calcifications.
Conclusion: Diffuse mastopathy with manifestations of fibrous-fatty involution of the mammary glands, plasmacytic mastitis. Nodular formation of the right breast (to differentiate fibroadenoma and lobular cancer.
Answers Filonenko Andrey Grigorievich:
Good afternoon, Igor. Your spouse has a mammogram that suspects a malignant tumor in the breast on the right. This suspicion needs to be refuted or confirmed. The most accurate method for this is to remove the formation and conduct a histological examination.
2014-04-05 14:53:51
Elena asks:
Hello! What to do, please, advise.
In 2011, there was an operation to remove the fibroadenoma.
Histological examination for 2011:
Three sections of fabric of gray-yellow color, densely elastic consistency, dimensions: 1.7 × 1.5 × 0.7 cm 2.0 × 1.3 × 0.7 cm 2.8 × 1.7 × 0.7 cm
Conclusion:
Fibrocystic breast disease, proliferative form.
Ductal and intraductal hyperplasia without atypia of the ductal epithelium. Per Americanalicular fabroadenoma of the mammary gland.
After the operation, not a single doctor told me that a diagnosis such as fibrocystic disease, of a proliferative form, needs to be treated. Only one doctor said that you need to apply a cabbage leaf.
I know that there are 3 degrees, judging by the histological examination, I have 2 degrees of FCM - a proliferative form. The diagnosis was made in 2011, and now it is already 2014 and all this has not been treated.
A) mastopathy without proliferation (I degree);
B) fibrocystic disease with epithelial proliferation (II degree);
C) mastopathy with atypical proliferation of the epithelium (III degree);
The last two forms are considered as obligate precancer.
Today I have a lot of nodular formations - cysts from 0.5 to 1.3 cm, painful, with clear contours, mobile, in both mammary glands and recurrence of fibroadenoma at the site of the previous operation.
Cytological examination of fibroadenoma for 2014:
The investigated material is represented by erythrocytes, structures of cells of hyperplastic cubic epithelium, fragments of the stroma.
Clinical diagnosis:
Fibroadenoma of the left breast. (Same size as previously deleted)
A new fibroadenoma is now forming in the right breast.
I went to the doctor, they said the fibroadenoma needs to be cut out with the surrounding tissues. I have a small breast volume of about 0.5, the doctor did not give guarantees that a relapse would not occur again or a new one would not appear elsewhere. I perfectly understand that after 2-3 such operations, what will remain of my breast.
1. Could you decipher the cytological study 2014?
2. Why didn't a single doctor say about the treatment?
3. What to do in such a situation.
4. Can you take extreme measures? What are the options? I don’t want to be under threat, anxiety, stress and endless treatments and surgeries all my life. I am extremely determined and well informed.
Thank you for your attention.
Answers Olga Bondaruk:
In principle, nowhere in the world is mastopathy treated, and even more so it does not operate, since the operation eliminates the consequence and does not affect the cause in any way. Find a good homeopath.
2013-02-15 18:52:25
Oksana asks:
Hello! I'm 32 years. 02/14/2013 visited the oncologist-mammologist. Diagnosis: Nodular mastopathy on the right, class group 1b. A puncture biopsy was prescribed. Its result: hyperplasia of the mammary gland epithelium with atypia of the D-III type. (fibroadenoma with suspected cancer, a large number of reactive cells). We made a trephine biopsy of the tumor of the right breast (there are no results yet, I'm waiting) and again looked at the glass again. Result: the background of the preparation is represented by a large amount of "vaseline-like" substance with a large number of "smeared" cellular elements, very single large light-nuclear cells with single nucleoli and small clusters of them. What are the predictions and odds in my case? Please provide detailed clarifications. Thank you in advance!!!
Answers Filonenko Andrey Grigorievich:
Good afternoon, Oksana. It is about differentiation between benign and malignant tumor processes. Since we are talking about this, then regardless of the result of the trephine biopsy, one should prepare for the operation. If we take the worst option (the malignant character is confirmed), then a breast resection will be performed (only a small part of the gland is removed) with axillary lymph nodes. There will be a scar on the skin of the gland with a transition to the armpit. Additional treatment may be needed depending on the results of the surgery. The prognosis for recovery and life is good. If we take the best option (the tumor will still be benign), then an operation will be performed to remove the formation (only the tumor itself is removed). There will be only a tiny scar on the skin of the gland.
