Changes in total choline concentration in the breast of healthy fertile young women in relation to menstrual cycle or use of oral contraceptives: a 3-T 1H-MRS study

BACKGROUND: To evaluate changes in total choline (tCho) absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC). METHODS: After institutional review board approval, we prospectively evaluated 40 healthy fertile volunteers: 20 with physiological MC, aged 28 ± 3 years (mean ± standard deviation; nOC group); 20 using OC, aged 26 ± 3 years (OC group). Hormonal assays and water-suppressed single-voxel 3-T proton magnetic resonance spectroscopy (1H-MRS) were performed on MC days 7, 14, and 21 in the nOC group and only on MC day 14 in the OC group. [tCho] was measured versus an external phantom. Mann-Whitney U test and Spearman coefficient were used; data are given as median and interquartile interval. RESULTS: All spectra had good quality. In the nOC group, [tCho] (mM) did not change significantly during MC: 0.8 (0.3-2.4) on day 7, 0.9 (0.4-1.2) on day 14, and 0.4 (0.2-0.8) on day 21 (p = 0.963). In the OC group, [tCho] was 0.7 (0.2-1.7) mM. The between-groups difference was not significant on all days (p ≥ 0.411). All hormones except prolactin changed during MC (p ≤ 0.024). In the OC group, [tCho] showed a borderline correlation with estradiol (r = 0.458, p = 0.056), but no correlation with other hormones (p ≥ 0.128). In the nOC group, [tCho] negatively correlated with prolactin (r = -0.587, p = 0.006) on day 7; positive correlation was found with estradiol on day 14 (r = 0.679, p = 0.001). CONCLUSIONS: A tCho peak can be detected in the normal mammary gland using 3-T 1H-MRS. The [tCho] in healthy volunteers was 0.4-0.9 mM, constant over the MC and independent of OC use

Imaging diagnosis of pneumonia in children

Editorial on importance of ultrasound in the diagnosis of paediatric pneumoni

The value of fine needle aspiration cytology in the diagnosis of breast proliferative lesions.

In order to further characterize fine needle aspiration cytology of breast proliferative lesions, we analyzed 723 FNA of patients with palpable breast abnormalities who underwent physical, mammographic and/or echographic examination. In 28 biopsies (3.9%), the final cytologic diagnosis was a proliferative lesion, a group of uncommon breast proliferative diseases not yet explored, in which cytology is sufficiently cellular with plenty of atypical elements but not suspicious of carcinoma. Histologic material was available in 22 cases and represented the basis of this retrospective evaluation. Among the positive proliferative lesions (PPL), 10 cases were infiltrating ductal carcinomas and 1 was a microinvasive carcinoma; whereas for the negative proliferative lesions (NPL), in 8 cases the histologic findings demonstrated fibrocystic changes, in 1 a fibroadenoma and in 1 a cystosarcoma phyllodes. The cytologic criteria utilized to define breast proliferative lesions were the following: increased cellularity, occasional single atypical cells, decreased cellular cohesion, crowded, enlarged and overlapping nuclei with three dimensional groupings with prominent nucleoli and chromatic changes. The cytologic characteristics examined demonstrated that the PPL are characterized by single atypical cells with nuclear alterations such as coarsely granular chromatin with a thick nuclear membrane and numerous prominent nucleoli. These features are common to many malignancies, therefore surgical biopsy confirmation is suggested

Incidental detection of an in situ lobular carcinoma during the study of an intramammary lymph node: Utility of FNA cytology. A case report

Anticancer Res. 1998 Jul-Aug;18(4B):2875-6. Incidental detection of an in situ lobular carcinoma during the study of an intramammary lymph node: utility of FNA cytology. A case report. De Iorio P, Cenci M, Midulla C, Amanti C, Vecchione A. Source Dipartimento di Medicina Sperimentale e Patologia, Università La Sapienza Rome, Italy. Abstract Intramammary lymph nodes appear in routine mammograms and are present in about 5% of patients undergoing mammography. Normal lymph nodes appear with ultrasonography, as well defined echo-poor masses with echogenic centers. This case report is an example of ultrasonography guided with FNA cytology in the diagnostic procedure of non-palpable breast lesions on an outpatient basis and choice of adequate therapy. PMID: 9713478 [PubMed - indexed for MEDLINE

Role of HE4, CA72.4, and CA125 in monitoring ovarian cancer

The aim of this study was to investigate the role of biomarkers CA125, HE4, and CA72.4 at diagnosis and throughout the follow-up in patients with epithelial ovarian cancer (EOC). Thirty-nine patients with EOC were deemed eligible, and 20 were followed up. CA125, HE4, and CA72.4 serum levels were determined for all patients at initial diagnosis of EOC. Among these patients, the number of cases with an elevated level of each individual marker was CA125 77 %, HE4 85 %, and CA72.4 72 %. A statistically significant difference was observed between the level of HE4 when compared to CA72.4 (p < 0.02). In the follow-up phase, we observed tumor marker levels fluctuating according to response to chemotherapy. When combining two out of the three biomarkers together, we observed increased values of CA125 and CA72.4 in 55 % of the patients, increased values of CA125 and HE4 in 65 % of the patients, and finally increased HE4 and CA72.4 in 75 % of the patients. A statistically significant difference was observed when combining HE4 and CA72.4, but not CA125 and CA 72.4 (p < 0.002). In conclusion, our study demonstrates that the association of three biomarkers CA125, HE4, and CA72.4 provides a valuable contribution in the follow-up of EOC patients

Unusual breast tumors: primary lymphoma. A case report.

An 82-year-old woman presented with a right breast lump with erythematous reaction of the overlying skin and corresponding lymph nodes. Cytological examination of the breast lesion and lymph nodes suggested a lymphoid proliferation. Frozen section revealed carcinoma with lymphoid stroma. Simple mastectomy was performed because of the extent of the lesion. Histological diagnosis was non-Hodgkin type B large-cell lymphoma. Primary breast lymphomas behave similarly to lymphomas of similar histologic types occurring in other sites. The authors illustrate the diagnostic difficulties and the usefulness of complementary techniques in the diagnosis of an unusual breast mass