I must say that the "foam cells" had me stumped...That is a literal translation from the report
which is in Hebrew (Taay ketzef) I went to the only book I have at home with a more detailed
description of breast diseases. "Pathological Basis  of Disease" by Robbins, Cotran and
Kumar.Saunders, 1984. (I have no library time this week) On page 1168 under Mammary Duct Ectasia
(Plasma Cell Mastitis; Periductal Mastities) is written: "On histologic examination, the
characteristically dilated ducts are filled by granular,, necrotic, acidophilic debris
(secretion), which sometimes contains mixed white cells, principally lipid-laden mac
rophages . The lining epithelial cells of the ducts may persist in small foci, but for the most
part are necrotic and atrophic. The periductal and interductal inflammation in the full-blown
disease, caused by inflammatory erosion of the duct walls. is manifested bby heavy infiltrates
of inflammatory cells,i.e., neutrophils, lymphocytes, and histiocytes, with a striking
predominance of plasma cells. Occasionally, foci of inflammation about lipid debris create
small, granulomatous, inflammatory reactions, composed of central masses of FOAMY (emphasis
mine) macrophages and precipitated spicules
of cholesterol and fatty acids, surrounded by a fibroblastic proliferation and scattered foreign
body giant cells. The axillary lymph nodes that drain the focus may also be the site of chronic
lymphadenitis and secondary enlargement. The dilated ducts should not be confused with cysts of
fibrocysic disease. THe latter form in lobules, not ducts, and thus
have no elastic tissue in their walls as do the dilated ducts in plasma cell mastites."
    The mother has not called in yet!!!!
Name: Toby Gish R.N.LLLL.IBCLC
E-mail: Toby Gish <[log in to unmask]>
Date: 19/03/96
Time: 04:21:24 PM

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