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Inflammatory and necrotic diseases

Acute mastitis and abscess. In the first weeks of feeding a baby, cracks often occur in the breast nipple, which become the entrance gate for infections ascending along the ducts and affecting the mammary glands. In addition, eczema or some other dermatological disease (see chapter 25) that affects the skin of the chest can serve as the entry gate for infection. The most common microbial agents that cause mastitis are Staphylococcus aureus and streptococci. The disease usually develops in one of the mammary glands. From the inflamed duct, the process often spreads and leads to the development of several purulent foci. If treatment is not completed on time, then abscess formation occurs, requiring surgical dissection and drainage of abscesses. Complications: fistula formation, cicatricial deformation of breast tissue (sometimes with cicatricial retraction of the nipple).

Ectasia (expansion) of the milk ducts. This is a progressive expansion of the large and middle ducts around which chronic inflammation occurs. One, sometimes several segments are involved in the process. In the latter case, the affected ducts can be palpated as a “ball of worms”. Such highly dilated ducts contain a thick and lipid-rich material in which macrophages with lipid inclusions are detected. The duct wall is thickened and lined with partially necrotic and sometimes atrophied epithelium, under which it is densely infiltrated by plasma cells, lymphocytes, macrophages and neutrophils. In some patients, plasma cells predominate in the infiltrate.
In the mammary sinuses, squamous metaplasia of the epithelium is detected. Outside the ducts, granulomatous inflammation sometimes develops around cholesterol deposits. As an outcome, severe fibrosis occurs with retraction of the skin of the gland and breast nipple.

The etiology of the disease is unknown. There is a known tendency to the occurrence of the disease in women with multiple births who did not breast-feed their children. However, the disease also occurs in nulliparous women. It is believed that in the pathogenesis of duct ectasia, an important role is played by a connection with pituitary adenomas or an increased level of prolactin secretion.

Fat necrosis. Focal necrosis of adipose tissue, developing with inflammatory lesions, is a very rare isolated unilateral process. Many patients have a history of chest injury. At first, a pathological focus can be represented only by hemorrhage. Then, a zone of wet necrosis of adipose tissue is gradually formed in it. This grayish-white zone of dense tissue may contain in the center a pulp of a bright white color or hemorrhagic appearance. Under the microscope, you can see how the necrotic center is surrounded by macrophages filled with fat droplets, as well as a dense neutrophil infiltrate. In the future, only lipid crystals and hemosiderin can remain in the center of the focus for a long time. Crystals cause the appearance of giant cells of foreign bodies and a granulomatous reaction. Over time, the focus is replaced by scar tissue, less often a cyst with fibrous walls.

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Inflammatory and necrotic diseases

  1. 3. The consequences of inflammatory diseases.
    Long-existing infectious diseases are often the cause of a woman’s emotional instability. They also bring disharmony into sex life. In the end, all inflammatory diseases of the female genital organs lead to serious reproductive health problems. The consequences of untreated inflammatory diseases are very diverse and extensive. But, in any
  2. Inflammatory diseases
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  3. Idiopathic inflammatory bowel disease
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  4. Cancer and inflammatory bowel disease
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  5. Idiopathic inflammatory bowel disease.
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