[Benign breast diseases: clinical, radiological and pathological correlation]. / Patología mamaria benigna: correlación clínica, radiológica y patológica.

INTRODUCTION: Benign lesions of the breast are common; however, benign pathological states have always been neglected in comparison to cancer even though they account for as much as 90 percent of the clinical presentations related to breast. A useful classification system for benign breast disease has been described by Love and colleagues and is based on symptoms and physical findings, six general categories have been identified, which include physiological swelling and tenderness, nodularity, mastalgia, dominant lumps, nipple discharge, and inflammation. Another classification system developed by Page and coworkers separates the various types of benign breast lesions into three clinically relevant groups: non-proliferative lesions, proliferative lesions without atypia, and proliferative the histopathological evaluation of the biopsy specimen in order to determine the subsequent risk of developing carcinoma if the lesions represents atypia of lobules or ductal epithelium. OBJECTIVE: The study was made to evaluate the clinical, radiological and pathological correlation of the benign breast lesions. METHODS: We studied women aged 40 years or less that went to the Foundation Rodolfo Padilla Padilla by mastalgia or the presence of a mass. We determined the Kappa coefficient in order to identify the agreement between the three observers according to different pathologies: fibroadenoma, abscess, cyst, mastitis, fibrosis, and cancer. RESULTS: We made 698 breast Ultrasounds in women younger 40 years, we found 52% ultrasound normal and 48% were reported with benign breast pathology: fibroadenomas 38%, cyst 27%, dilated ducts 24%, benign nodule 4%, mastitis 3%, ectasia 2%, and abscess 2%. The correlation was made to 58 patients, finding the following coefficients kappa. Fibroadenoma: when evaluating the clinical examination versus ultrasound: K = 50%. Cysts: when evaluating clinical examination versus ultrasound: K = 17%, when evaluating ultrasound versus pathology: K = 3%. Fibrosis: when evaluating clinical examination versus ultrasound: K = 56%, when evaluating ultrasound versus pathology: K = 50%, when evaluating ultrasound versus pathology: K = 50%. CONCLUSION: The benign breast pathology must be studied carefully because the clinical and ultrasonic evaluation is not conclusive, and the histopathological evaluation of the biopsy specimens sometimes is necessary to discard malignancy.

Sangrado intestinal de 21 años en un caso de síndrome de nevo azul / Intestinal bledding for 21 years in a case of blue nevus Syndrome

Objetivo. Presentar un caso de sangrado intestinal por un síndrome de nevo azul en burbuja de goma(NABG). Caso: Mujer de 28 años que desde los siete años de edad padeció sangrado intestinal crónico. Recibió múltiples tratamiento con hierro oral y parental y cuatro transfusiones a lo largo de 21 años de evolución. Se presentó con anemia microcítica (HB = hemoglobina de 7.8 g/dL) con deficiencia de hierro y tumoraciones cutáneas en lengua, mano derecha y pies. Una biopsia cutánea mostró un hemangioma cavenoso. La presencia de múltiples tumoraciones intestinales por serie gastroduodenal, endoscopía y colonoscopía, permitieron el diagnóstico. El tratamiento con hierro oral aumentó los niveles de HB. Conclusión. Lo raro del síndrome y hasta donde sabemos el que no se haya informado previamente en México, probablemente llevaron a que la paciente estuviera 21 años sin diagnosticar y sometida a terapias peligrosas, pese a que el diagnóstico no era difícil