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Pathological Panorama of Lactating Adenoma

Year 2014, Volume: 39 Issue: 3, 464 - 469, 22.07.2014
https://doi.org/10.17826/cutf.32916

Abstract

Purpose:Lactating adenoma is the most common lesion found in a pregnant or a puerperal lady. Apart from its occurrence in normally located breasts, it has also been reported in ectopic breast that may be located anywhere along the milk line. Often it presents as a firm and palpable mass. Prompt diagnosis is possible with help of Fine needle aspiration cytology (FNAC). This study was carried out with the aim of studying the panorama of various such breast lesions on FNAC in our setup. Correlation with sonomammography was also performed. Materials and Methods: This was a four year prospective study carried out from May 2010 to February 2014. Palpable breast mass in any lactating lady was first evaluated by sonomammography. FNAC was then performed and the smears were stained with MGG and Papanicolaou stain. Results:Out of the 14 palpable breast masses in lactating women that were diagnosed as lactating adenoma on sonomammography, 05 were found to be tense galactoceles and 09 were found to be lactational adenomas. Panorama of lactational adenomas showed 4 distinct patterns. Pattern A( 04 cases): low columnar epithelium, No necrotic areas or cytoplasmic vacuoles.Pattern B (03 cases): high columnar epithelium with cytoplasmic vacuoles. No necrotic areas. Pattern C (1 case): prominent lactiferous ductules with areas of necrosis and infarct. Pattern D (1 case): cytoplasmic vacuoles, and islands of ductal cells in a background of prominent foamy material. This internal nature of lesions on FNAC was not identifiable by clinical palpation alone. None of the lesions labelled as lactating adenomas on sonomammography showed any signs of malignancy on FNAC. Conclusions:FNAC is a useful method for confirming that a palpable breast lump in a lactating lady is lactating adenoma indeed. Four different patterns of microscopic appearances of lactational adenoma were noted in this study.

References

  • Grenko RT, Lee KP, Lee KR. Fine needle aspiration cytology of lactatingadenoma of the breast. A comparative light microscopic and morphometric study. Acta Cytol. 1990;34:21-6.
  • O'Hara M F, Page D L. Adenomas of the breast and ectopic breast under lactational influences. Hum Pathol. 1985;16:707-12.
  • Manipadam MT, Jacob A, Rajnikanth J. Giant lactating adenoma of the breast.Journal of Surgical Case Reports. 2010;9:8.
  • James K, Bridger J, Anthony PP. Breast tumour of pregnancy ('Lactating adenoma'). Journal of Pathol. 1988;156:37-44
  • Slavin JL Billson V R, Ostor AG. Nodular breast lesions during pregnancy and lactation. Histopathology.1993;22:481-5.
  • Hertel BF, Zaloudek C, Kempson RL. Breast adenomas. Cancer. 1976;37:2891-905.
  • Rosen PP and Oberman HA. Benign Epithelial lesions. Chapter in tumors of themammary gland. Atlas of Tumor Pathology. Rosai J and Sobin LH eds. Washington D.C: ARP press AFIP; 1992;67-96.
  • Reeves ME, Tabuenca A. Lactating adenoma presenting as a giant breast mass. Surgery. 2000;127:586-8.
  • Allyson N. Parnes, Ali Akalin, Robert M. Quinlan, Gopal R. Vijayaraghavan. AIRP Best Cases in Radiologic-Pathologic Correlation: Lactating Adenoma. RadioGraphics. 2013;33:455-9.
  • Sumkin FH, Perrone AM, Harris KM, Nath ME, Amortegui AJ, Weinstein BJ. Lactating adenoma: US features and literature review. Radiology. 1998;206:271-4
  • Choudhury M, Singal MK. Lactating adenoma-cytomorphologic study with review of literature. Indian J Pathol Microbiol. 2001;44:445-8.
  • Behrndt VS, Barbakoff D, Askin FB, Brem RF. Infarcted lactating adenoma presenting as rapidly enlarging breast mass. Am J Roentgenol. 1999;173:933-5
  • Yu JH, Kim MJ, Cho H, Hyun Liu J, Han S, Ahn T. Breast diseases during pregnancy and lactation The Obstet Gynecol Sci. 2013;56:143-59.
  • Kumar Y, Chahal A, Garg M, Bhatia A, Mahajan NC, Ganju A. Delayed involution of lactation presenting as a non-resolving breast mass: a case report. J Med Case Rep. 2008;2:327.
  • Yazışma Adresi / Address for Correspondence: Dr.Smita Sankaye Rural Medical College, PIMS(DU), Loni, Ta-Rahata, Ahmednagar Maharashtra, INDIA Email: smitasankaye@gmail.com G eliş tarihi/Received on: 12.02.2014
  • Kabul tarihi/Accepted on:14.03.2014

Laktasyonel Adenomun Patolojik Panoraması

Year 2014, Volume: 39 Issue: 3, 464 - 469, 22.07.2014
https://doi.org/10.17826/cutf.32916

Abstract

Amaç: Laktasyonel adenom hamile ve doğum yapmış bayanlarda en yaygın görünen lezyondur. Memede normal olarak bulunduğu bölge dışında süt hattı boyunca herhangi bir yerde de ektopik olarak da bulunabilir. Sıklıkla sert ve hissedilir bir kitle olarak kendisini gösterir. Hızlı tanısı İnce İğne Aspirasyon Sitolojisi (İİAS) (FNAC) yardımıyla mümkündür. Bu çalışma kurumuzuzda çeşitli meme lezyonlarının panaromasının belirlenmesi amacıyla İİAS yöntemi ile çalışılmış hastalarda yürütülmüştür. Aynı zamanda sonomamografi ile kolerasyonda çalışmamızda uygulandı. Materyal ve Metot: Bu çalışma 2010 Mayıs'tan 2014 Şubat'a kadar yürütülmüş 4 yıllık prospektif bir çalışmadır. Göğüsünde hissedilir kitle olan emziren bayanlar önce sonomamografi ile değerlendirildikten sonra İİAS ile alınan doku MGG ve Papanicolaou boyası ile boyandı. Bulgular: Hissedilir meme kitlesi olan emziren bayanların 14'üne sonomamografi ile laktasyonel adenom tanısı konmuştur. Bunlardan 5'inin yoğunlaşmış galaktosel, 9'unun ise laktasyonel adenom olduğu bulundu. Laktasyonel adenomlar 4 farklı patern göstermektedir. Patern A (4 vaka): düşük kolumnar epitel, nekrotik bölge veya sitoplazmik vakuol yok. Patern B (3 vaka): sitoplazmik vakuollü yüksek kolumnar epitel, nekrotik bölge yok. Patern C (1 vaka) nekroz ve enfarktüs bölgeleri olan prominent süt kanalları Patern D (1 vaka): sitoplazmik vakuol, prominentköpüksü materyalin gerisinde duktal hücre adaları vardır. İİAS yöntemi ile bulunan, lezyonların bu içsel doğasını sadece klinik palpasyon ile tespit etmek mümkün değildir. Sonomamografi ile laktasyonel adenom olarak belirlenmiş lezyonladan hiçbiri İİAS' de malinsel bir bulgu göstermemiştir. Sonuçlar: İİAS yöntemi emziren bayanlarda ki hissedilir meme yumrularının gerçekte laktasyonel adenom olup olmadığını doğrulamada faydalı bir yöntemdir. Bu çalışma laktasyonel adenomlara ait 4 farklı mikroskopik görüntü olduğunu belirlemiştir.

References

  • Grenko RT, Lee KP, Lee KR. Fine needle aspiration cytology of lactatingadenoma of the breast. A comparative light microscopic and morphometric study. Acta Cytol. 1990;34:21-6.
  • O'Hara M F, Page D L. Adenomas of the breast and ectopic breast under lactational influences. Hum Pathol. 1985;16:707-12.
  • Manipadam MT, Jacob A, Rajnikanth J. Giant lactating adenoma of the breast.Journal of Surgical Case Reports. 2010;9:8.
  • James K, Bridger J, Anthony PP. Breast tumour of pregnancy ('Lactating adenoma'). Journal of Pathol. 1988;156:37-44
  • Slavin JL Billson V R, Ostor AG. Nodular breast lesions during pregnancy and lactation. Histopathology.1993;22:481-5.
  • Hertel BF, Zaloudek C, Kempson RL. Breast adenomas. Cancer. 1976;37:2891-905.
  • Rosen PP and Oberman HA. Benign Epithelial lesions. Chapter in tumors of themammary gland. Atlas of Tumor Pathology. Rosai J and Sobin LH eds. Washington D.C: ARP press AFIP; 1992;67-96.
  • Reeves ME, Tabuenca A. Lactating adenoma presenting as a giant breast mass. Surgery. 2000;127:586-8.
  • Allyson N. Parnes, Ali Akalin, Robert M. Quinlan, Gopal R. Vijayaraghavan. AIRP Best Cases in Radiologic-Pathologic Correlation: Lactating Adenoma. RadioGraphics. 2013;33:455-9.
  • Sumkin FH, Perrone AM, Harris KM, Nath ME, Amortegui AJ, Weinstein BJ. Lactating adenoma: US features and literature review. Radiology. 1998;206:271-4
  • Choudhury M, Singal MK. Lactating adenoma-cytomorphologic study with review of literature. Indian J Pathol Microbiol. 2001;44:445-8.
  • Behrndt VS, Barbakoff D, Askin FB, Brem RF. Infarcted lactating adenoma presenting as rapidly enlarging breast mass. Am J Roentgenol. 1999;173:933-5
  • Yu JH, Kim MJ, Cho H, Hyun Liu J, Han S, Ahn T. Breast diseases during pregnancy and lactation The Obstet Gynecol Sci. 2013;56:143-59.
  • Kumar Y, Chahal A, Garg M, Bhatia A, Mahajan NC, Ganju A. Delayed involution of lactation presenting as a non-resolving breast mass: a case report. J Med Case Rep. 2008;2:327.
  • Yazışma Adresi / Address for Correspondence: Dr.Smita Sankaye Rural Medical College, PIMS(DU), Loni, Ta-Rahata, Ahmednagar Maharashtra, INDIA Email: smitasankaye@gmail.com G eliş tarihi/Received on: 12.02.2014
  • Kabul tarihi/Accepted on:14.03.2014
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Smita Sankaye This is me

Sushil Kachewar This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 3

Cite

MLA Sankaye, Smita and Sushil Kachewar. “Laktasyonel Adenomun Patolojik Panoraması”. Cukurova Medical Journal, vol. 39, no. 3, 2014, pp. 464-9, doi:10.17826/cutf.32916.