Apocrine metaplasia Symptoms, Causes, Ultrasound, Cytology, Treatment


Apocrine metaplasia is the condition in which reversible changes in cells occur due to involvement in any disorder related to cyst. It is seen in the breast cells. It is a benign condition of breast cells which do not lead to malignancy i.e. breast cancer. It is present on the top layer that is epithelium lining of breast having cysts and can also present in papillomas and adenomas. It is a fibrocystic change. Most commonly occurs in adult females normally above 50 years of age. It occurs when patient feel itching on breast and rubbing will lead to the formation of cysts on surface.

Apocrine metaplasia Symptoms

       

  • Patient feel itching on breast surface.
  • Soreness occurs and the breast gets red due to rubbing and scratching on surface.
  • Fibrocystic cells are formed on the surface of breast which closely resembles lumps or bulges.
  • Sometimes an unusual discharge occurs from breast which is the main indication of apocrine metaplasia. 
  • Patient feel irritation on breast which is main symptom associated with apocrine metaplasia. 
  • If all the above mentioned symptoms appear in women above 50 years of age or in women with menopause, then it is obvious that apocrine metaplasia do exist.

Apocrine metaplasia Symptoms, Causes, Ultrasound, Cytology, Treatment


Apocrine metaplasia Causes

   
Causes behind apocrine metaplasia are not known. But it is reported that this may arise secondary to a malignant breast carcinoma disease. Presence of fibrocystic lesion may lead to irritation on breast cells and this irritation will lead to rubbing and then the small cells formed on surface. It may also occur as a result of unusual secretions of hormones related to gonads. The hormonal imbalance of estrogen and progesterone and oxytocin related to lactation may lead to apocrine metaplasia. These are the some causes reported regarding the occurrence of apocrine metaplasia in breast cells.

Apocrine metaplasia Ultrasound

       
Apocrine metaplasia is diagnosed with three main techniques named mammography, ultrasound and biopsy. After mammography, the ultrasound is considered 2nd best technique to diagnose apocrine metaplasia. In ultrasound, small anechoic foci of size 2 to 5 mm are seen in cluster form along with intervening septae. It is seen in 77 % of cases of apocrine metaplasia. In 23 % of patient a hypo echoic component was seen which was solid in form. And an enhancement of posterior acoustic was seen in 85 % of cases. All these appearance are seen in ultrasound report.


Apocrine metaplasia Cytology

       
Cells of apocrine metaplasia are removed via fine needle aspirates in lesion of breast. The feature of signet ring also appear in the apocrine metaplasia and these rings are responsible for creating difference between benign and malignant apocrine metaplasia. Papillary cohesive clusters of duct cells are also seen. Any false or negative diagnosis will lead to false diagnosis of cancer. Benign lesions are easy to diagnose via fine needle aspiration technology (FNAC). The signet ring cells identified (from the sclerosing papilloma) in fine needle aspiration technology mostly resembles with mucinous carcinoma cells. Loss of heterozygosity is seen in 53% of reported cases.

Apocrine metaplasia Treatment

Treatment of apocrine metaplasia mainly depends upon size of metaplasia and symptoms associated with it. If patient feels intense pain due to abnormal proliferation of cells and size is large then your health care provider may perform a surgical procedure to removal it. Early detection is the key to spread it further.

Apocrine metaplasia Symptoms, Causes, Ultrasound, Cytology, Treatment Apocrine metaplasia Symptoms, Causes, Ultrasound, Cytology, Treatment Reviewed by Simon Albert on May 02, 2017 Rating: 5
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