[Pulmonary metastasis of Basal cell carcinoma of the skin]. / Metástasis pulmonares de un carcinoma basocelular cutáneo.

Basal cell carcinoma of the skin is a common neoplasm usually considered benign. Rarely, distant metastases can involve organs such as the brain, lung, and bone. We report the case of a 41-year old man diagnosed with lung metastasis secondary to base cell carcinoma. Given that the development of metastasis is associated with short survival and the therapeutic arsenal is scarce, we emphasize the importance of long-term follow up of such patients.

[Lipoid pneumonia related to workplace exposure to paint]. / Neumonía lipoidea en relación con exposición laboral a pinturas.

A 49-year-old man with no known history of pulmonary disease was treated at our hospital after observation of an interstitial pattern on a chest film. The patient was a smoker and professional painter. Computed tomography of the chest showed a diffuse bilateral ground-glass pattern. The lung biopsy showed intra-alveolar lipid accumulation in the form of vacuoles of varying sizes surrounded by numerous focally multinucleated macrophages, establishing a definitive diagnosis of exogenous lipoid pneumonia. Given the patient's profession, he was recommended to avoid workplace exposure to paraffins and oily sprays. The clinical course was favorable after exposure was stopped, with improved lung function and symptoms.

[Diagnosis and treatment of pulmonary arteriovenous fistulas]. / Diagnóstico y tratamiento de las fístulas arteriovenosas pulmonares.

Pulmonary arteriovenous fistulas are rare malformations often associated with Rendu-Osler-Weber (ROW) disease. Morbidity and mortality are significant and arise from hemorrhagic and neurological complications.We report the cases of two patients, mother and son, with earlier diagnoses of ROW disease, who suffered, respectively, a stroke and a brain abscess with massive pulmonary thromboembolism. Helicoid computed axial tomographic scans demonstrated pulmonary arteriovenous fistulas in both. Given these findings, we performed embolotherapy.

[Round atelectasis]. / Atelectasias redondas.

The objective of this study was to analyse the epidemiologic, clinical, radiological and functional characteristics as well as the evolutive pattern of a group of patients diagnosed of round atelectasis (RA). Patients with a radiological diagnosis of RA were retrospectively identified from January 1993 to January 1998. Cases with diagnosis not confirmed by high resolution computerized axial tomography (HRCAT) were excluded. A total of 29 patients were identified, with a mean age of 65 +/- 13 years (27 men and 2 women). At diagnosis 14 patients (34%) were smokers and 14 (49%) ex-smokers. Regarding occupation, 11 individuals (38%) had history of occupational exposure to asbestos. Regarding symptomatology, round atelectasis was a radiological finding in 15 patients (52%) and the most common symptom was chest pain (34%). The most common findings detected in the chest X-ray included pleural thickening (45%), pleural effusion (38%), nodular lesion (34%) and loss of volume (24%). The most common changes detected by HRCAT were pleural thickening (45%) and bronchovascular arch (55%). In two cases magnetic resonance (MR) was performed and in no case did this examination provided additional information for the diagnosis of RA. Functional respiratory examination did not identify and predominant pattern. During the follow-up period (2.2 years) 24 patients (83%) remained radiologically stabilized, one improved and the other four worsened (two due to enlargement and two due to increase in number). Chest X-ray is a good method for the presumptive diagnosis of RA. HRCAT is an excellent technique to confirm the diagnosis and rule out the presence of malignancy. MR provides no additional information in the study of RA. There is a frequent association between RA and asbestos exposure.