RESUMEN
Intracystic papillary carcinoma (IPC), a breast tumor mainly occuring in the elderly, has long been considered as a variant of ductal carcinoma in situ (DCIS). This is now debated since metastatic cases have been reported. In this study, surgical pieces of 20 IPCs were reassessed, and markers of myopepithelial layer (p63, CD10 and Smooth Muscle Actin) as well as estrogen receptors (ER) and progesterone receptors (PgR) and C-erb-B2 oncoprotein expression were systematically performed and quantified. In 10 cases, an associated unequivocal invasive component was found. In all 20 cases, no myoepithelial layer was found. Eighteen tumors were ER positive, 14 were PgR positive. Moreover, none of the tumors over-expressed C-erb-B2 oncoprotein. Therefore this study showed that in all cases of IPC there were microscopic features of invasive carcinoma despite good clinical prognostic indicators, and that precise characterization of tumors requires extensive paraffin embedding of surgical pieces.
Asunto(s)
Neoplasias de la Mama/patología , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Papilar/patología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/química , Carcinoma Intraductal no Infiltrante/química , Carcinoma Papilar/química , Femenino , Humanos , Inmunohistoquímica , Mamografía , Proteínas de la Membrana/análisis , Persona de Mediana Edad , Receptor ErbB-2/análisisRESUMEN
This study was designed to determine visible and measurable morphological parameters in normal swallowing using dynamic MRI with single-shot fast spin echo (SSFSE), as a preliminary study in view of noninvasive MRI swallowing evaluation in patients with dysphagia. Seven healthy volunteers aged 24-40 underwent dynamic MRI with SSFSE, with a 1.5-T unit, using a head and neck antenna. Patients repeated dry swallow, water swallow, marshmallow swallow, cake swallow, and cookie chewing for a total of five series, with 15 acquisitions per series at a rate of 700 ms per acquisition. A checklist of swallowing events and anatomic landmarks was used to determine which anatomic landmarks are always visible, which phases or swallowing movements are always visible, and which landmarks can be used to measure oral and pharyngeal motion in swallowing. The oral preparatory, oral, and oropharyngeal phases of deglutition were visible in all cases. No aspiration, reflux, or abnormal residue was observed. Spatial resolution allowed for anatomical measurements of laryngeal elevation, oropharyngeal diameter, and tongue base and velum displacement in all cases. SSFSE dynamic MRI is pertinent for evaluation of the anatomical and physiological characteristics of swallow. The temporal parameters, however, cannot be studied using this technique. Motion artifacts preclude its use in the study of mastication. It remains complementary to videofluoroscopy and other techniques in swallow evaluation.