Lokuhetty M D S, Saparamadu P A M, Al-Sajee D M A, Al-Ajmi R
Department of Pathology, Sultan Qaboos University Hospital, Al Khoud, Muscat, Oman.
Diagn Cytopathol. 2011 Feb;39(2):141-3. doi: 10.1002/dc.21393.
Giagantomastia is a rare disorder known to occur in pregnancy, causing enlargement of the breasts greater than that of gravid enlargement. The histological features of gigantomastia are glandular hyperplasia and an increase of stromal tissue. Illustrated by one documented case, cytomorphology of gigantomastia was misdiagnosed as a phyllodes tumor. We document the cytomorphology of an axillary mass in a gravid woman of 24 years with gigantomastia. She presented in her first trimester with bilateral mastalgia and swelling, nonresponsive to antibiotics. Imaging excluded mass breast lesions and a pituitary prolactinoma. The breasts progressively enlarged, became warm, tender, and developed skin ulcerations and a peau d'orange appearance. Subsequently she developed a mass in her left axilla. On aspiration of the mass, some of the cytomorphological features were suspicious for a metastasis, which correlated well with her clinical features. Careful evaluation suggested cytomorphology to be compatible with benign accessory breast tissue with possible hormone related changes of pregnancy. Histology of the excised axillary mass confirmed this diagnosis. Thus, awareness of this rare condition and careful evaluation is mandatory to avoid misdiagnosis in a similar clinical context.
巨乳症是一种已知在孕期发生的罕见病症，会导致乳房增大超过孕期正常的增大程度。巨乳症的组织学特征为腺体增生和间质组织增多。有一个记录在案的病例显示，巨乳症的细胞形态学被误诊为叶状肿瘤。我们记录了一名24岁患有巨乳症的孕妇腋窝肿块的细胞形态学情况。她在孕早期出现双侧乳房疼痛和肿胀，对抗生素无反应。影像学检查排除了乳腺肿块病变和垂体泌乳素瘤。乳房逐渐增大，变得温热、触痛，并出现皮肤溃疡和橘皮样外观。随后她左侧腋窝出现一个肿块。对该肿块进行抽吸时，一些细胞形态学特征怀疑为转移，这与她的临床特征高度相关。仔细评估表明细胞形态学与良性副乳腺组织相符，可能伴有与妊娠相关的激素变化。切除的腋窝肿块组织学检查证实了这一诊断。因此，了解这种罕见病症并进行仔细评估对于避免在类似临床情况下的误诊是必不可少的。
