Background : Papillary carcinoma of breast is rare and account for approximately 1-2% of newly diagnosed cases of breast cancers. The common age group of presentation is 6-7th decade. These tumours usually present with a painless retroareolar swelling associated with bloody nipple discharge in 50% cases. Case 1) 57 year old most Cases : menopausal woman presented with huge ulcerative lump in right breast over a period of 1 year. After confirming diagnosis with incisional biopsy, patient was proceeded with Neoadjuvant Chemotherapy (NACT) followed by Right MRM with SSG. Case 2) 66 year old male patient came with complaints of bloody discharge from nipple for past 1 year. A small subcentimetric lump present in retroareolar region on left breast was present, on which USG guided CNB revealed Invasive Ductal Carcinoma. Patient was proceeded with Left MRM. Case 3) 65 year old male patient presented with painless lump in left breast for 3 months. Clinical examination revealed a 1*2 cm lump in left breast with a single mobile ipsilateral axillary node. Image guided CNB revealed Invasive Papillary carcinoma. Patient was taken up for upfront Left MRM. All 3 patients are on regular follow-up for more than a year, and no recurrence is noted on followup
Background: Systemic sclerosis (SSc) is a complex immune-mediated condition. Systemic sclerosis related cardiac pathologies can be detected in an early stage using various imaging techniques. Aim was to study cardiac involvement in patients with systemic sclerosis.
Methods: The present study was carried out as a descriptive hospital-based study of 31 patients with systemic sclerosis above 13 years of age, of either sex or who fulfilled American Rheumatism Association (ARA) diagnostic criteria. A detailed profile of lab investigations and imaging including inflammatory markers, immunological parameters, ECG and ECHO were done. Data analysis was done using SPSS (statistical package for social sciences) version 21.0. A p value <0.05 was considered statistically significant.
Results: Median age of the study patients was 36 years and 90% females. Nearly 19% of the patients were classified as limited, 39% as early diffuse and 42% as late diffuse systemic sclerosis. Rheumatoid factor was positive in 19% of the patients, while antinuclear antibodies (ANA) was positive in all the patients. Pulmonary arterial hypertension (PAH) was noted in 61%. Right ventricular systolic pressure (RVSP) was relatively higher in limited SSc patients. Patients with late diffuse SSc had higher RVSP than early diffuse SSc. RV systolic function assessed by tricuspid annular plane systolic excursion (TAPSE) showed abnormally low value (<18) in five patients.
Conclusions: Considerable proportion of patients with systemic sclerosis present with cardiac involvement. Tissue Doppler imaging can help in diagnosing subclinical RV dysfunction by measuring TEI index of right ventricle, which can predict PAH.
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