Article

Breast inflammatory gigantomastia in a context of immune-mediated diseases

Department of Endocrinology and Reproductive Medicine, Hôpital Necker, 149, rue de Sèvres, 75743 Paris Cedex 15, France.
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.31). 10/2005; 90(9):5287-94. DOI: 10.1210/jc.2005-0642
Source: PubMed

ABSTRACT Localized breast lesions have been described in lupic or diabetic patients. However, the description of breast gigantomastia in women presenting with autoimmune diseases has not been reported.
The study took place within the Department of Endocrinology and Reproductive Medicine, Necker Hospital, Paris, France.
We describe eight patients with inflammatory gigantomastia, occurring in a context of immune-mediated diseases: myasthenia, chronic arthritis, or thyroiditis.
Together with hormonal, immunological, and breast magnetic resonance imaging (MRI) evaluation, breast histology enabled us to perform immunocytochemical and indirect immunofluorescence studies. Control sera were obtained from patients with (n = 10) and without (n = 7) antinuclear antibodies.
Six of the eight patients developed gigantomastia either at puberty or during pregnancy. Neither a hormonal oversecretion nor a specific immunological pattern was observed. All patients except one presented antinuclear antibodies. Histological study revealed a diffuse, stromal hyperplasia and a severe atrophy of the lobules. A rarefaction of adipocytes was also noted, as previously suggested on MRI. There was a perilobular lymphocytic infiltrate made of CD3+ lymphocytes. Study of sera from five of six cases of gigantomastia showed a nuclear immunofluorescence pattern in normal mammary ductal and lobular glandular epithelium, as well as in kidney and intestine epithelial cells. In control sera, a nuclear signal was observed only when antinuclear antibodies were present.
We suggest that breast tissue may be a target tissue in autoimmune diseases, this process being favored by the hormonal milieu. However, the precise mechanism of such association is not individualized. The fact that stromal hyperplasia is the main histological feature justifies the search for the involvement of growth factors in such a process.

0 Followers
 · 
137 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Gigantomastia is a breast disorder that is associated with an exaggerated, rapid growth of the breasts, generally bilaterally. Since the pathology is rare and has seldom been described, its etiology has yet to be fully established, although there are speculations that a hormonal component may play an important role. Treatment is aimed at improving the clinical and psychological symptoms; however, the best therapeutic option varies from case to case. The present report describes a case of gestational gigantomastia seen at the Department of Obstetrics and Gynecology of the Hospital da Santa Casa de Misericórdia, Vitória, Espírito Santo, Brazil, in a primigravida in the second trimester of pregnancy. The report follows this patient from her diagnosis until the completion of treatment with a third and final surgical procedure.
    08/2014; 2014:610363. DOI:10.1155/2014/610363
  • Source
    Revista colombiana de obstetricia y ginecología 09/2007; 58(3):249-253.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: True macromastia is a rare but disabling condition characterized by massive breast growth. The aetiology and pathogenic mechanisms for this disorder remain largely unexplored because of the lack of in vivo or in vitro models. Previous studies suggested that regulation of epithelial cell growth and development by oestrogen was dependent on paracrine growth factors from the stroma. In this study, a co-culture model containing epithelial and stromal cells was used to investigate the interactions of these cells in macromastia. Epithelial cell proliferation and branching morphogenesis were measured to assess the effect of macromastic stromal cells on epithelial cells. We analysed the cytokines secreted by stromal cells and identified molecules that were critical for effects on epithelial cells. Our results indicated a significant increase in cell proliferation and branching morphogenesis of macromastic and non-macromastic epithelial cells when co-cultured with macromastic stromal cells or in conditioned medium from macromastic stromal cells. Hepatocyte growth factor (HGF) is a key factor in epithelial–stromal interactions of macromastia-derived cell cultures. Blockade of HGF with neutralizing antibodies dramatically attenuated epithelial cell proliferation in conditioned medium from macromastic stromal cells. The epithelial–stromal cell co-culture model demonstrated reliability for studying interactions of mammary stromal and epithelial cells in macromastia. In this model, HGF secreted by macromastic stromal cells was found to play an important role in modifying the behaviour of co-cultured epithelial cells. This model allows further studies to investigate basic cellular and molecular mechanisms in tissue from patients with true breast hypertrophy.
    Journal of Cellular and Molecular Medicine 04/2014; DOI:10.1111/jcmm.12275 · 3.70 Impact Factor

Preview

Download
17 Downloads