Several variants of fibrocystic breast changes may be distinguished and may vary in cause and genetic predisposition. Adenosis involves an abnormal count and density of lobular units, while other lesions appear to mainly arise from ductal epithelial origins. Theres evidence that iodine deficiency contributes to fibrocystic breast changes by enhancing breast tissue sensitivity to estrogen. Diagnosis
This is an exclusion diagnosis, mostly done based on the clinical presentation after ruling out breast cancer. Nipple fluid aspiration can be used as a classification cyst type method (and to some extent improve breast cancer risk prediction) but its rarely used in practice. Biopsy or fine needle aspiration are rarely warranted.Fibrocystic breast disease is primarily diagnosed based on the symptoms, clinical breast exam and physical exam. During this examination, the doctor looks for unusual breast areas, both visually and manually. Also, the lymph nodes located in the axilla and lower neck are examined. A complete and accurate medical history is also helpful in the diagnosing process. If the patients medical history and physical exam findings are consistent with normal breast changes, no additional tests are needed; otherwise the patient will be asked to return a few weeks later for reassessment. Women may detect lumps in their breasts during self-examination, if this happens its strongly advised to visit a health professional right away. Imaging
In order to establish whether the lump is a cyst or not, several imaging tests may be performed, these may include: mammography, X-rays, MRIs and ultrasound studies.
However, it is particularly common in premature infants or those of very low birth weight. The cause of IVH in premature infants, unlike that in older infants, children or adults, is rarely due to trauma. Instead it is thought to result from changes in perfusion of the delicate cellular structures that are present in the growing brain, augmented by the immaturity of the cerebral circulatory system, which is especially vulnerable to hypoxic ischemic encephalopathy. The lack of blood flow results in cell death and subsequent breakdown of the blood vessel walls, leading to bleeding. While this bleeding can result in further injury, it is itself a marker for injury that has already occurred. Most intraventricular hemorrhages occur in the first 72 hours after birth. The risk is increased with use of extracorporeal membrane oxygenation in preterm infants. Congenital cytomegalovirus infection can be an important cause. Mechanism
Diagnosis
Diagnosis can be confirmed by the presence of blood inside the ventricles on CT. Infants
In term and preterm infants with IVH, the amount of bleeding varies. IVH is often described in four grades:
Grade I - bleeding occurs just in the germinal matrix
Grade II - bleeding also occurs inside the ventricles, but they are not enlarged
Grade III - ventricles are enlarged by the accumulated blood
Grade IV - bleeding extends into the brain tissue around the ventriclesGrades I and II are most common, and often there are no further complications. Grades III and IV are the most serious and may result in long-term brain injury to the infant.