By Dr. med Marton Lanyi (auth.)
Very thorough wisdom of breast pathology is a sine qua non for interpretation of breast motion pictures ... growth in X-ray analysis might simply be made via cautious comparability of the movie with the particular specimen. H.INGLEBY Multiplication of an analogous e"oneous prognosis doesn't make that analysis co"ect. J.G.AzZOPARDI ironically sufficient, our area of expertise considers the radiologist who mis takes a epidermis fibroma or the calcifications in a sponge kidney for a child ney stone to lack easy wisdom, whereas the radiologist who imme diately demands the health care provider as a result of a number of white spots on a mammogram is believed to be performing in accordance with the principles of clinical perform. Misunderstandings and confusion with reference to breast pathology in addition to the comfy philosophy that superfluous biopsies are the cost we need to pay for the early detection of carcinomas have in lots of areas resulted in a lack of self belief in mammography. but this can be a meth od with which carcinomas should be detected prior to with the other imaging technique.
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Extra info for Diagnosis and Differential Diagnosis of Breast Calcifications
29a-c. In an experiment, an air balloon was filled with barium sulfate and with calcium tablets. Lateral radiographs were taken without compression (a) and with compression (b) and a craniocaudad film (c) was taken. While the calcium tablets exhibit the teacup sign without compression (a), the "bottom sediment" becomes heaped up when compression is applied (b) psammoma bodies in the cyst lumen (Figs. 38 c). Sometimes milk of calcium cysts present a fusiform shape on lateral mammograms. This is most likely caused by the compression of the breast, which heaps the loose sediment into a pile (Fig.
The proliferative changes include not only the proliferation of glandular epithelium, ranging from simple epitheliosis and hyperplasia to papillomatosis, but also a dilatation and proliferation of ductal elements throughout the ductolobular system. When these proliferative changes occur in the lobular region, adenosis is said to be present. Various histologic fonns are recognized according to the extent of the proliferative process: Simple Lobular Hypertrophy. The number of acini are increased up to fourfold, but their lumina and epithelial lining are nonnal (Fig.
37). The explanation for this phenomenon is simple: on the mediolateral projection in the standing patient, the calcific psammomatous granules, with their higher specific gravity, settle out of the lighter components of the secretion (protein and fat) and form a visible sediment on the bottom of the cyst. This stratification is not apparent in the craniocaudal projection. ) Similarly, fluid levels are sometimes seen in cysts visualized by galactography when the cyst fluid does not mix well with the water-soluble contrast medium (Figs.