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Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Duct ectasia, more common in women in their fifties, is caused by dilatation of the ducts behind the nipple and periductal inflammation causing areolar pain and erythema. Nipple discharge is thick and cream/green in colour. There may be an areolar mass and the nipple may retract after healing with fibrosis. Mammogram is essential. Treatment involves antibiotics if infected, incision and drainage if there is an abscess, or mammodochectomy.
Breast Abscess
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Jennifer Tomlins, Simon Tiberi
A breast abscess is a walled-off collection of inflammatory exudate (pus). It most commonly occurs as a complication of mastitis but may also be a primary presentation of breast infection. It is seen frequently in women aged 15–45 years and may be secondary to lactational mastitis or non-lactational causes such as duct ectasia (Table 4.8.1). Other causes including neonatal mastitis and systemic infection such as tuberculosis are rare. Mastitis during breastfeeding is common, with recent estimated prevalence reaching as high as 33%, and may lead to abscess in 3%–11% of these women. Duct ectasia occurs in older women, is associated with squamous metaplasia resulting in duct obstruction and has a prevalence of 5%–9%.
The breasts
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Duct ectasia is often symptomless but may present with nipple discharge. It affects one or more segments of the breast and very rarely is palpable, allegedly similar to a ‘bag of worms’. Uncommonly, associated periductal fibrosis may cause retraction of the nipple and raise the suspicion of underlying carcinoma. Occasionally leakage of lipid duct contents or rupture of a duct promotes an adjacent inflammatory reaction and fibrosis and histologically may resemble traumatic fat necrosis and may even be palpable as a tender, firm lump, again mimicking cancer clinically.
The correlation of immunologic derangement and juvenile recurrent parotitis: an investigation of the laboratory immunological observation
Published in Acta Oto-Laryngologica, 2018
Shufeng Wu, Huan Shi, Ningning Cao, Lei Ye, Chuangqi Yu, Lingyan Zheng
JRP is characterized by a periductal and intralobular cell infiltration of different intensity, duct ectasia. The cell infiltrates consist mainly of lymphocytes and plasma cells, with some histiocytes and single leukocytes. Imaging or histological examination reveals dilation of the distal ducts of the parotid gland, usually without obstruction, leading to chronic inflammation of the glandular parenchyma. Gumberz and Seifert [11] studied the immunoglobulin-containing plasma cell in the chronic recurrence parotitis revealing that in the immunohistological examinations of the area of inflammation, the plasma cell infiltrations with IgA content were more pronounced in the periductal zones than in the remaining interstitial intralobular tissue, the same applying to the plasma cell accumulations with IgG content. Study about the immune function associated with JRP was less and the aim of this study tries to confer both humoral immune function and cellular immune function during the process of JRP.
Breast Cancer Association with Cytomegalo Virus—A Tertiary Center Case-Control Study
Published in Journal of Investigative Surgery, 2019
Anilkumar Surendran, Meer M. Chisthi
Of the 44 patients initially included as controls, 2 women were removed from analysis as their histopathology revealed malignancy. From the 132 study subjects, when the study period ended, we had 130 patients to analyze. There were 88 cases of malignancies while 42 were benign conditions. The mean age among cases was 53.26 ± 10.80 years and that among controls was 34.33 ± 10.60 years. Of the benign conditions, 1 was duct ectasia, 2 were gynaecomastias, 1 was phylloides tumor, 17 were fibroadenomas, and 21 were fibrocystic diseases (Figure 1).
Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease
Published in Expert Review of Cardiovascular Therapy, 2019
Yskert von Kodolitsch, Anthony Demolder, Evaldas Girdauskas, Harald Kaemmerer, Katharina Kornhuber, Laura Muino Mosquera, Shaine Morris, Enid Neptune, Reed Pyeritz, Svend Rand-Hendriksen, Alexander Rahman, Nina Riise, Leema Robert, Ingmar Staufenbiel, Katalin Szöcs, Thy Thy Vanem, Stephan J. Linke, Marina Vogler, Anji Yetman, Julie De Backer
Cholelithiasis may be more common in Marfan syndrome (in the only study of unselected, asymptomatic patients, 18% vs. 2% of controls) [216]. Biliary duct ectasia, likely contributing to bile stasis has been reported [217].