Asunto(s)
Enfermedad de la Arteria Coronaria , Embolia , Infarto del Miocardio , Humanos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Angiografía Coronaria/métodos , Tomografía , Vasos Coronarios/diagnóstico por imagen , Factores de RiesgoAsunto(s)
Aneurisma de la Aorta , Rotura de la Aorta , Insuficiencia de la Válvula Aórtica , Defectos del Tabique Interventricular , Seno Aórtico , Humanos , Seno Aórtico/diagnóstico por imagen , Seno Aórtico/cirugía , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/etiología , Insuficiencia de la Válvula Aórtica/cirugía , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/cirugíaRESUMEN
Sepsis is a clinical syndrome caused by a dysregulated host response to infection that can lead to multiple organ dysfunction and death. Cardiovascular abnormalities are frequent in sepsis and may result in myocardial injury unrelated to coronary artery disease. Myocardial calcification is a rare complication of sepsis, which shows rapid-onset extensive myocardial calcifications. We present a case of a 67-year-old man who developed severe sepsis complicated with shock, acute renal failure, and acute respiratory distress syndrome. Initial chest computed tomography (CT) on admission showed normal left ventricular (LV) myocardial attenuation. However, serial chest CT demonstrated a gradual increase of the LV myocardial attenuation, which ultimately resulted in extensive myocardial calcification within 6 weeks. Sepsis-related myocardial calcification is usually found in patients with severe sepsis complicated with hemodynamic failure requiring vasopressors, acute renal failure necessitating renal replacement therapy, and acute respiratory distress syndrome. Although the prognostic significance of this pathology is unclear, it may be a precursor to long-term irreversible cardiomyopathy or an arrhythmogenic substrate that induces life-threatening arrhythmias. Therefore, patients who have survived the acute phase of severe sepsis need to be monitored carefully for signs of this complication by an imaging modality such as CT.
Asunto(s)
Fístula Arterio-Arterial/diagnóstico , Aneurisma Coronario/diagnóstico , Vasos Coronarios/diagnóstico por imagen , Imagen Multimodal/métodos , Arteria Pulmonar/anomalías , Anciano , Fístula Arterio-Arterial/complicaciones , Angiografía por Tomografía Computarizada , Aneurisma Coronario/complicaciones , Ecocardiografía , Femenino , Humanos , Arteria Pulmonar/diagnóstico por imagenAsunto(s)
Biopsia/métodos , Cardiomiopatías , Angiografía por Tomografía Computarizada/métodos , Hipertensión Pulmonar Primaria Familiar , Ventrículos Cardíacos , Hipertrofia Ventricular Derecha , Tabique Interventricular , Anciano , Autopsia , Cardiomiopatías/etiología , Cardiomiopatías/patología , Cardiomiopatías/fisiopatología , Ecocardiografía/métodos , Hipertensión Pulmonar Primaria Familiar/complicaciones , Hipertensión Pulmonar Primaria Familiar/diagnóstico , Hipertensión Pulmonar Primaria Familiar/fisiopatología , Resultado Fatal , Femenino , Fibrosis/diagnóstico por imagen , Fibrosis/etiología , Fibrosis/patología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertrofia Ventricular Derecha/diagnóstico por imagen , Hipertrofia Ventricular Derecha/etiología , Hipertrofia Ventricular Derecha/patología , Hipertrofia Ventricular Derecha/fisiopatología , Tabique Interventricular/diagnóstico por imagen , Tabique Interventricular/patologíaAsunto(s)
Cardiomiopatías/diagnóstico , Electrocardiografía , Sarcoidosis/diagnóstico , Biopsia , Cardiomiopatías/fisiopatología , Femenino , Humanos , Imagen por Resonancia Cinemagnética , Persona de Mediana Edad , Miocardio/patología , Sarcoidosis/fisiopatología , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón ÚnicoAsunto(s)
Angiografía de Substracción Digital/métodos , Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Reestenosis Coronaria/diagnóstico , Vasos Coronarios/diagnóstico por imagen , Intervención Coronaria Percutánea/efectos adversos , Stents/efectos adversos , Anciano , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/cirugía , Humanos , Masculino , Valor Predictivo de las Pruebas , Falla de PrótesisRESUMEN
Left ventricular (LV) involvement in the advanced stage of arrhythmogenic right ventricular cardiomyopathy (ARVC) is a well recognized phenomenon. T wave inversion in the lateral leads has been reported to be an electrocardiographic marker of LV involvement. Variants of ARVC that preferentially affect the left ventricle (left-dominant subtype of arrhythmogenic cardiomyopathy) have recently been recognized. We herein report a case in which an initial electrocardiogram that was similar to the left-dominant subtype of arrhythmogenic cardiomyopathy progressed to definitive ARVC over a period of 7 years. This case supports the hypothesis that LV involvement in ARVC may precede the evident onset of significant RV dysfunction.
Asunto(s)
Displasia Ventricular Derecha Arritmogénica/fisiopatología , Disfunción Ventricular Izquierda/fisiopatología , Arritmias Cardíacas/fisiopatología , Displasia Ventricular Derecha Arritmogénica/diagnóstico , Cardiomiopatías/fisiopatología , Progresión de la Enfermedad , Electrocardiografía/métodos , Estudios de Seguimiento , Sistema de Conducción Cardíaco/fisiopatología , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Disfunción Ventricular Izquierda/diagnósticoRESUMEN
An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.
RESUMEN
BACKGROUND: Nuclear protein in testis (NUT) midline carcinoma (NMC) is a rare, aggressive malignancy. Only two pediatric and three adult cases of pulmonary NMCs have been documented. In more than two-thirds of NMC cases, a gene fusion between NUT and BRD4 or BRD3 has been documented; other fusions are rare. CASE PRESENTATION: A 36-year-old woman was admitted because of a rapidly progressing tumor of the lung with metastases to the breast and bone. A biopsy from the lung tumor revealed an undifferentiated neoplasm exhibiting round to oval nuclei with vesicular chromatin, prominent nucleoli, and scant cytoplasm. Immunohistochemical staining demonstrated focal EMA, cytokeratin AE1/AE3, cytokeratin CAM 5.2, p63, CD138, and vimentin positivity. Finally, the nuclear staining pattern for NUT confirmed a histopathological diagnosis of NMC. A 5'- rapid amplification of the cDNA end (RACE) procedure successfully identified the partner of the NUT translocation as NSD3, a recently discovered partner. Fluorescence in situ hybridization confirmed the NSD3-NUT gene rearrangement, whereas a BRD3/4-NUT fusion gene was not detected. CONCLUSION: We herein describe the first case of an NSD3-NUT-expressing NMC of the lung. The further accumulation of variant NMCs should provide clues to the establishment of new individualized therapy for NMCs.