Assuntos
Neoplasias do Sistema Digestório/complicações , Neoplasias do Sistema Digestório/terapia , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/terapia , Radiologia , Stents , Idoso , Neoplasias do Sistema Digestório/diagnóstico por imagem , Neoplasias do Sistema Digestório/epidemiologia , Feminino , Obstrução da Saída Gástrica/diagnóstico por imagem , Obstrução da Saída Gástrica/epidemiologia , Hospitais Gerais , Hospitais Universitários , Humanos , Itália/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytic disorder. The diagnosis was based on the relationship between radiologic findings, clinical manifestations, and pathologic features of the bone biopsy. We report a case of ECD with unusual presenting symptoms: a 56 year-old man presented with cough, abdominal pain, and recurrent episodes of headache associated without any seizures. Peculiar computer tomography (CT) findings were key for the diagnostic suspicion. Bone biopsy and other radiological investigations confirmed the diagnosis. CT findings can help raise the suspicion of ECD. CT is easy to perform and widely available in comparison with kinetic cardiac magnetic resonance imaging and nuclear imaging. Therefore, CT findings of ECD can reduce the therapeutic delay between diagnosis and therapy prescription.
RESUMO
Cause specific mortality was investigated in a cohort of insulators employed by a company which operated in various parts of Italy. Follow-up covered the years 1960-1996. The cohort, which included 893 subjects, was derived from company files of relatively poor quality, which resulted in a high rate of lost to follow-up (10.1%) and of deaths with unknown cause (12.4%). The mortality experience of the cohort was contrasted with that of the Italian population. Overall mortality (SMR 141, 90% CI 118-167, 97 observed), and cancer mortality (SMR 165, 90% CI 123-216, 38 observed) were significantly increased. Among neoplasms, significant increases were observed for lung cancer (SMR 202, 90% CI 124-311, 15 observed), pleural neoplasms (SMR 2667, CI 90% 911-6103, 4 observed), and peritoneal neoplasms (SMR 1853, 90% CI 329-5832, 2 observed). The excess mortality for lung cancer was especially pronounced in subjects with latency time longer than ten years (SMR 237.1, 90% CI 140-377, 13 observed).