Sonographic focally thick duct of breast found in screening, why is it concerning? A report of three cases.

We report three cases of focally thickened ductal lesions found on screening ultrasonography with fine needle aspiration (FNA)-proven benign cytology in order to demonstrate the different fates of this radiographic finding. All three patients, aged 74, 69 and 68 years old, had their first time mammography and concurrent ultrasonography. Their mammograms did not show abnormalities except a focal asymmetry in one case. The sonographic focally thick ducts were the lesions of concern and all the patients had long-term follow-up.One patient had a slightly decreased lesion size on follow-up, likely to be a non-proliferative alteration of the breast. One patient's FNA revealed a benign papillary lesion whose ductal diameter slightly increased in size with internal echo after two years with repeat FNA demonstrating epithelial papillae consistent with intraductal papilloma. The final patient had an alteration of the imaged ductal lesion in the third year of follow-up and the final specimen after surgical wide excision that was done in the fourth year confirmed cancer. We emphasize the importance of focally thickened ductal lesions found on screening sonography and underscore their need for scrutinized characterization and long term follow-up.

Paediatric oral pathology in Thailand: a 15-year retrospective review from a medical teaching hospital.

OBJECTIVES: To determine whether the spectrum of oral pathology in children seen at a medical institution differs from studies derived from dental facilities. METHODS: Oral biopsy records from paediatric patients (<16 years of age) were retrieved from the pathology archives at Chulalongkorn University Hospital over a period of 15 years. Lesions were categorised as inflammatory/reactive, tumour/tumour-like or cystic. RESULTS: Two-hundred and thirty biopsies were identified. Most lesions were inflammatory/reactive (62%), followed by tumour/tumour-like (35%) and cystic (3%). The largest proportion of lesions was found in the 12-16 years' age group. Mucocele was the most common lesion (38%), followed by hemangioma (8.3%), irritation fibroma (6%) and nevus (6%). The predominance of mucocele is similar to that in reports from other countries. The proportion of malignant tumours (5%) was higher than in other studies (<1-2%). In contrast, odontogenic cysts and odontogenic tumours were rare (3% and <1%, respectively), compared with published studies (7-35% and 2-21%, respectively). CONCLUSIONS: This study from a medical institution shows a somewhat different spectrum of paediatric oral pathology compared with that reported from dental institutions. While some of the lesions may not be treated by dentists, they still need to be aware of these lesions because affected patients can still present initially to a dentist.