Infiltrating duct cell carcinoma in lactating adenoma: A rare case in pair.

Lactating adenomas, though considered being benign, sometimes turn out to be malignant. We are hereby presenting two cases of lactating adenomas which turned out to be harboring infiltrating duct cell carcinoma (DCC). Two lactating women with mass in the breast were referred from surgery for fine-needle aspiration cytology and biopsy. On histopathology, it was found that both had infiltrating DCC (either as collision tumor or as a malignant transformation of lactating adenoma). These cases point toward some association between lactating adenoma and DCC, however, small it may be. Therefore, any mass lesion in the breast should be followed up under strict vigilance for an early diagnosis and management of this deadly disease. A large sample size and elaborate study are required to frame its prognostic relevance. Like estrogen receptor and progesterone receptor, prolactin and prolactin receptor expression can be exploited for developing newer receptor-targeted therapy.

Removal of comfort pads underneath babies: a method of reducing radiation exposure to neonates.

RATIONALE AND OBJECTIVES: The recent increasing utilization of imaging has increased the population exposure to ionizing radiation. With increasing knowledge of the potential harm of radiation exposure, efforts should be made to minimize patient radiation whenever possible, especially in young children. The purpose of this study was to use the exposure index (EI) standard to assess the potential for reducing radiation dose to babies by removing a soft comfort pad, often placed underneath the baby. The pad is located between the baby and the image detector plate. As such it absorbs x-rays that have already passed through the baby but have not yet reached the imaging detector plate. MATERIALS AND METHODS: Using a thoracic infant phantom and fixed exposure factors, we measured the percentage of the radiation exiting a neonatal chest phantom that was absorbed/attenuated by the comfort pad, before it hit the detector to create the image. We studied comfort pads of 4 different thicknesses, ranging from 0.5″ to 8″. RESULTS: Radiation beam attenuation, ranging from 12% to 72.1%, was found with all comfort pads, with increased x-ray beam attenuation occurring with increasing pad thickness. CONCLUSIONS: The study shows that comfort pads cause a high attenuation of the radiation beam, after it exits the chest phantom. As such, removal of the pads prior to radiographic exposure of babies is a method of potentially reducing patient radiation exposure in the newborn nursery.

Pectus excavatum imaging: enough but not too much.

BACKGROUND: Pectus excavatum (pectus) is a common congenital deformity of the chest wall resulting in a diminished anterior-posterior dimension. Chest CT has become a common study for preoperative assessment. CT evaluation was initially described using a single CT image; it is now common to perform a CT of the entire chest to evaluate pectus. OBJECTIVE: To evaluate the efficacy of chest radiographs compared to chest CT in identifying additional clinically significant abnormalities in the preoperative evaluation of children with pectus. MATERIALS AND METHODS: We reviewed the chest CT scans of 209 children and young adults who had been evaluated for possible surgical repair of pectus. Additional abnormalities were categorized as (1) incidental, (2) potentially significant, and (3) findings that affected the decision to perform surgery. Chest radiographs were reviewed for category 3 findings. RESULTS: Seventy-six scans showed additional abnormalities, five in group 2 and two in group 3. Both group 3 findings, a vascular ring and an acute pneumonia, were identified on chest radiographs. CONCLUSION: Conventional radiographs identified clinically important findings in children and young adults evaluated for pectus surgery. Radiation risks and medical costs might be substantially decreased by obtaining a chest radiograph and using a limited CT technique when a CT scan is ordered for the purpose of obtaining a Haller index.