RESUMEN
From March 1998 to August 2009, 1538 non-respiratory samples collected from 1182 patients, were tested using the Gen-Probe Amplified Mycobacterium Direct Test™ (AMTD). After decontamination procedure, every sample was tested by AMTD and by culture on solid and liquid media. The "Gold-standard" was considered by the combination of culture results and clinical diagnosis. Tuberculosis was present in 17,59 % (208 patients). For theses 1538 non-respiratory samples (225 culture positive samples, 248 AMTD positive), 279 corresponded to tuberculosis. After resolving the discordant results, the sensitivity, specificity, positive and negative values were 89, 99, 99,6 and 97,3 %.
Asunto(s)
Mycobacterium tuberculosis/aislamiento & purificación , Técnicas de Amplificación de Ácido Nucleico , ARN Bacteriano/análisis , Tuberculosis/diagnóstico , Humanos , Técnicas In Vitro , Microscopía , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/crecimiento & desarrollo , Especificidad de Órganos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Manejo de Especímenes , Coloración y EtiquetadoRESUMEN
The purpose of this study was to evaluate the SD Bioline Ag MPT64 Rapid(®) for identification of the Mycobacterium tuberculosis complex. The method uses an immunochromatographic assay and needs 100 µl of sample taken from liquid culture or colonies suspended. The sensitivity was determined using 99 strains of M. tuberculosis complex and the specificity using 10 nontuberculous mycobacteria and 85 strains other than mycobacteria genus. The test showed excellent sensitivity (99%) and specificity (100%). This technique displays several advantages and is destined to spread in all laboratories and particularly in endemic areas.
Asunto(s)
Antígenos Bacterianos/análisis , Cromatografía/métodos , Immunoblotting/métodos , Mycobacterium tuberculosis/inmunología , Tuberculosis/diagnóstico , Anticuerpos Antibacterianos/inmunología , Anticuerpos Inmovilizados , Antígenos Bacterianos/genética , Proteínas Bacterianas/análisis , Proteínas Bacterianas/genética , Enterobacteriaceae/inmunología , Reacciones Falso Positivas , Femenino , Bacterias Grampositivas/inmunología , Humanos , Técnicas In Vitro , Masculino , Mutación , Mycobacterium/genética , Mycobacterium/inmunología , Mycobacterium/aislamiento & purificación , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/aislamiento & purificación , Sensibilidad y Especificidad , Especificidad de la Especie , Suspensiones , Factores de TiempoRESUMEN
Solitary fibrous tumour is unusual, arising most commonly in the pleura and can also occur in a large number of other sites. We report the case of a 34-year-old man with a retroperitoneal solitary-fibrous tumour, revealed by abdominal pain and hypoglycaemia. We describe the histopathological and immunohistochemical features. Solitary-fibrous tumour should be included in the differential diagnosis of spindle cell tumours in this location. Despite complete local excision, local recurrence and metastasis are seen. The behaviour of theses tumours is unpredictable and patients with solitary fibrous tumour require careful and long-term follow-up.
Asunto(s)
Neoplasias Retroperitoneales/patología , Tumores Fibrosos Solitarios/patología , Dolor Abdominal/etiología , Adulto , Humanos , Hipoglucemia/etiología , Masculino , Neoplasias Retroperitoneales/cirugía , Tumores Fibrosos Solitarios/cirugíaRESUMEN
We report a new case of splenoma in a previously healthy adult. A 52-year-old man was admitted for a splenomegaly with thrombocytopenia. The computed tomographic scan showed a tumor which measured 56 mm in diameter. A splenectomy was performed. Histologic examination of the splenectomy specimen revealed a splenoma. Splenoma or splenic hamartoma is a rare primary splenic tumor most often incidentally discovered, radiologically. It can also meet in a particular pathological context, evoking more a coexistence rather than an association or a complication, underlying the role of the pathologist in its diagnosis.
Asunto(s)
Hamartoma/diagnóstico , Enfermedades del Bazo/diagnóstico , Hamartoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Esplenectomía , Enfermedades del Bazo/cirugía , Trombocitopenia/etiologíaRESUMEN
INTRODUCTION: Malignant melanoma most commonly presents as a primary neoplasm of the skin, but has been described in other mucosal sites. Rarely, malignant melanomas have been reported as primary visceral neoplasms, including the lung. Most such lesions have been dismissed as metastases from undocumented or regressed primary cutaneous or ocular melanomas. CASE REPORT: We report an original observation of an 82-year-old man with a pulmonary nodule presenting with chest pain. The diagnosis of melanoma was established on biopsies carried out under computerized tomography scanning and confirmed after right upper lobectomy two months later. DISCUSSION: Melanomas of the respiratory tract are usually metastatic in origin and a primary melanoma in very rare. Strict criteria must be applied before a diagnosis of primary malignant melanoma of lower respiratory tract can be accepted. Melanoma may be confused with more conventional types of lung cancer and other pigmented tumours.
Asunto(s)
Neoplasias Pulmonares , Melanoma , Anciano de 80 o más Años , Biopsia con Aguja , Humanos , Pulmón/patología , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Escisión del Ganglio Linfático , Masculino , Melanoma/patología , Melanoma/cirugía , Neumonectomía , Resultado del TratamientoRESUMEN
Solitary fibrous tumours are unusual mesenchymatous tumours, most often found on the pleura. The authors report five cases hospitalised between 1998 and 2003. With the greatest occurrence in the fifth decade, they are often accidentally found but sometimes associated with a paraneoplastic syndrome such as refractory hypoglycaemia. The diagnosis is based on computed tomography and complete surgical resection is the best treatment. Adjuvant therapy is proposed for the histologically aggressive forms. Because of the possibility of local or distant recurrence and malignant transformation, long-term monitoring is strongly recommended.
Asunto(s)
Tumor Fibroso Solitario Pleural/diagnóstico , Tumor Fibroso Solitario Pleural/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
During a mission in ex-Yugoslavia between 2001 and 2004, three French soldiers were sent home because of right pneumopathy, right pleurisy after appendicectomy, haemoptysis and liver haematoma, respectively. They previously were stationed in Africa and/or South America. The initial diagnosis was quickly modified: pleuropulmonary manifestations of amoebic hepatic abscess in two cases, and pleuropulmonary amoebiasis in the last case. The outcome was favourable with standard anti-amoebic treatment. The reports illustrate the possibility of hepatic amoebiasis with local pleuropulmonary manifestations and an exceptional case of pleuropulmonary amoebiasis with hepatobronchial fistula. The authors report this experience because it demonstrates that amoebiasis in European countries remains an often forgotten diagnosis. Although known for a long time in developing countries, amoebiasis in the military or in tourists should be systematically considered.
Asunto(s)
Fístula Bronquial/parasitología , Entamoeba histolytica , Absceso Hepático Amebiano/diagnóstico , Hígado , Adulto , Amebiasis/diagnóstico , Antiprotozoarios/uso terapéutico , Fístula Bronquial/tratamiento farmacológico , Fístula Bronquial/cirugía , Países en Desarrollo , Fístula del Sistema Digestivo/parasitología , Entamoeba histolytica/aislamiento & purificación , Humanos , Hígado/parasitología , Absceso Hepático Amebiano/tratamiento farmacológico , Absceso Hepático Amebiano/cirugía , Enfermedades Pulmonares Parasitarias/diagnóstico , Masculino , Personal Militar , Derrame Pleural/parasitología , Resultado del TratamientoRESUMEN
Ectopic sebaceous glands have been detected in many tissues of ectodermal origin, but their presence in the esophagus remain, until now, a very rare anomaly. We report two new cases diagnosed by endoscopic biopsy.
Asunto(s)
Coristoma/diagnóstico , Enfermedades del Esófago/diagnóstico , Glándulas Sebáceas/patología , Anciano , Biopsia , Coristoma/patología , Endoscopía Gastrointestinal , Enfermedades del Esófago/patología , Femenino , Gastritis/diagnóstico , Humanos , Pólipos/diagnósticoRESUMEN
Schwannomas are common ubiquitous benign tumours of the nervous sheaths. Among the various histopathological types, the pigmented schwannoma has to be distinguished from melanoma. We report a case of melanotic schwannoma of the cerebellopontine angle in a 52-year-old man with a slowly progressive cerebellar syndrome since 1978, who presented with a posterior cerebral fossa bleeding. Melanotic schwannoma is a rare form of schwannoma. The diagnosis remains difficult and melanotic schwannoma has been described as a part of the Carney complex. Distinguishing melanotic schwannoma from malignant melanoma is of paramount importance in planning the management, but these two tumours are probably sharing the same origin. It must be distinguished from classic schwannoma because its behaviour is unpredictable, requiring long-term follow-up.
Asunto(s)
Ángulo Pontocerebeloso , Neurilemoma/patología , Neoplasias Cutáneas/patología , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Melaninas/análisis , Persona de Mediana Edad , PronósticoRESUMEN
Inflammatory pseudotumor is an uncommon tumor, initially described in the lung, but which can involve various organs. It is a controversial entity. We report the case of a 19-year-old-man with an inflammatory pseudotumor localized in the central nervous system, revealed by epilepsy. Characteristically, the inflammatory pseudotumor is an inflammatory mass leading to manifestations related to its localization. Relatively ubiquitous, this tumor is seldom described in the central nervous system. This uncommon lesion is part of a heterogeneous group of entities which are difficult to diagnose for both surgical pathologists and clinicians.
Asunto(s)
Enfermedades del Sistema Nervioso Central/patología , Granuloma de Células Plasmáticas/patología , Adulto , Enfermedades del Sistema Nervioso Central/complicaciones , Epilepsia/etiología , Fibrosis , Lóbulo Frontal/patología , Granuloma de Células Plasmáticas/complicaciones , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , MasculinoRESUMEN
Peripheral neuroectodermal tumors constitute a large spectrum of small round cell tumors among which Ewing's sarcoma is the most undifferentiated type. They are rare tumors which often concern young people and generally occur in bone tissue. Their metastatic potential is high, generally early, and rarely after five years. We report the case of a 45-year-old woman who presented a mediastinal metastasis eight years after the primitive tumor of tibia. The diagnosis was made on small core biopsies obtained by CT punction, and was based on morphologic analysis, immunohistochemistry, and confirmed by molecular biology. The presence of metastasis is the main prognostic factor. Despite therapeutic progress, the global survival rate of metastatic patients is still poor.
Asunto(s)
Neoplasias Óseas/patología , Neoplasias del Mediastino/diagnóstico , Neoplasias del Mediastino/secundario , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/secundario , Tibia , Neoplasias Óseas/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias del Mediastino/diagnóstico por imagen , Neoplasias del Mediastino/patología , Persona de Mediana Edad , Pronóstico , Radiografía , Sarcoma de Ewing/diagnóstico por imagen , Sarcoma de Ewing/patologíaRESUMEN
INTRODUCTION: An acute viral pericarditis may reveal a congenital pericardial abnormality. CASE HISTORY: We report the case of a young man of 29 years in whom the development of rapidly progressive dyspnoea and fever led to the echocardiographic diagnosis of a pericardial tumour. The thoracic CT scan showed a mass arising in the superior mediastinum with no evidence of spread. Surgical exploration allowed the excision of a soft mutilobular mass adherent only to the aorta. Histological examination revealed an intrapericardial bronchogenic cyst. CONCLUSION: After a review of bronchogenic cysts we point out the properties of this rare intra-pericardial localisation, one of which is the frequently observed secretion of CA 19-9.
Asunto(s)
Quiste Broncogénico/diagnóstico , Pericarditis/etiología , Adulto , Disnea/etiología , Fiebre/etiología , Humanos , MasculinoRESUMEN
A neurohypophyseal granular cell tumor was found in a 60-year-old man who presented diminished visual acuity. Neuronavigation resection via a fronto-pteronial approach removed split up material. The diagnosis was established by histology and immunochemical studies. Granulous cell tumors, which are common, are rarely located in the neurohypophysis. Their origin remains a subject of debate, but unlike the other localizations, these tumors in the sellar and/or supra-sellar area are always considered benign. The clinical course depends on the quality of the surgical resection; there is no consensus on appropriate management.
Asunto(s)
Tumor de Células Granulares/fisiopatología , Enfermedades de la Hipófisis/fisiopatología , Neoplasias Hipofisarias/fisiopatología , Trastornos de la Visión/fisiopatología , Agudeza Visual/fisiología , Tumor de Células Granulares/patología , Tumor de Células Granulares/cirugía , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos , Enfermedades de la Hipófisis/patología , Enfermedades de la Hipófisis/cirugía , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/cirugía , Trastornos de la Visión/etiologíaRESUMEN
We report an observation of angiosarcoma of the pulmonary artery in a 65-year-old man hospitalized for acute dyspnea revealing a left mass hilaire which arose from the pulmonary artery before the development of obstructive endobronchial extension. The therapeutic sequence associated removal of the lobar bronchus obstruction by interventional endoscopy, chemotherapy using ifosfamide-doxorubicin, complete left pneumonectomy and auxiliary chemotherapy with 2 additional cycles. The patient was free of tumor relapse at nearly 3 years follow-up.
Asunto(s)
Hemangiosarcoma/terapia , Neoplasias Pulmonares/terapia , Anciano , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/uso terapéutico , Antineoplásicos Alquilantes/administración & dosificación , Antineoplásicos Alquilantes/uso terapéutico , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Doxorrubicina/uso terapéutico , Endoscopía , Estudios de Seguimiento , Hemangiosarcoma/diagnóstico , Hemangiosarcoma/diagnóstico por imagen , Hemangiosarcoma/tratamiento farmacológico , Hemangiosarcoma/patología , Hemangiosarcoma/cirugía , Humanos , Ifosfamida/administración & dosificación , Ifosfamida/uso terapéutico , Inmunohistoquímica , Pulmón/patología , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Masculino , Neumonectomía , Tomografía de Emisión de Positrones , Radiografía Torácica , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
We report the case of a 36-year-old women with Hodgkin's disease treated with polychemotherapy and bone marrow autograft. Progressive growth of a thymic mass suggested possible relapse four months after treatment withdrawal. This mass did not exhibit gallium-67 uptake but showed strong affinity for 18-FDG (SUV=6.8). Surgical biopsy ruled out recurrence of Hodgkin's disease of the thymus and led to the diagnosis of thymic rebound. The aspect of the thymic compartment returned to normal spontaneously at one year.
Asunto(s)
Enfermedad de Hodgkin/terapia , Hiperplasia del Timo , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Trasplante de Médula Ósea , Femenino , Estudios de Seguimiento , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Tomografía de Emisión de Positrones , Radiografía Torácica , Inducción de Remisión , Hiperplasia del Timo/diagnóstico por imagen , Hiperplasia del Timo/etiología , Hiperplasia del Timo/patología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Trasplante Autólogo , Imagen de Cuerpo EnteroRESUMEN
Pleural lymphomas after a long standing pyothorax due to pleuropulmonary tuberculosis are now well identified, but rarely observed in Europe. We report two new cases in a non-immunocompromised patients. The two cases occurred 5455 years following artificial pneumothorax for pulmonary tuberculosis. The patients presented with a localized pleural tumor mass. Histology revealed high-grade lymphomas, diffuse large B-cell lymphoma and anaplastic lymphoma. Serology for Epstein-Barr virus was positive. Pleural lymphomas are an established complication of artificial pneumothorax. Epstein-Barr virus is known to play a crucial role in the pathogenesis, but despite the large number of artificial pneumothorax operations, these lymphomas remain rare, suggesting additional oncogenic factors.
Asunto(s)
Linfoma no Hodgkin/etiología , Neoplasias Pleurales/etiología , Neumotórax Artificial/efectos adversos , Complicaciones Posoperatorias , Tuberculosis Pleural/cirugía , Tuberculosis Pulmonar/cirugía , Anciano , Anciano de 80 o más Años , Antígenos Virales/sangre , Empiema Tuberculoso/cirugía , Femenino , Herpesvirus Humano 4/inmunología , Humanos , Linfoma de Células B Grandes Difuso/etiología , Linfoma Anaplásico de Células Grandes/etiología , MasculinoRESUMEN
In France, American pulmonary histoplasmosis is an imported deep mycosis, caused by inhalation of Histoplasma capsulatum. Clinical and radiological features of this exotic disease are multiple, simulating tuberculosis or cancer. We report two cases of American histoplasmosis with pseudo-tumoral form, in immunocompetent subjects working in Venezuela, with a multinodular pulmonary presentation.
Asunto(s)
Histoplasmosis/complicaciones , Histoplasmosis/diagnóstico , Neoplasias Pulmonares/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Tuberculosis Pulmonar/diagnóstico , VenezuelaRESUMEN
Five new cases of tracheobronchopathia osteochondroplastica (TBOCP) are reported and clinical, radiological and pathological features are reviewed. TBOCP is a rare disease characterized by cartilaginous and bony nodules lining the mucosa of the trachea and major bronchi. The endoscopic features realize pathological evolution by stadiums. The prognosis is usually favourable. The etiology of TBOCP remains unknown, even though some cases were reported in association with amyloidosis.
Asunto(s)
Enfermedades Bronquiales/diagnóstico , Osteocondrodisplasias/diagnóstico , Enfermedades de la Tráquea/diagnóstico , Enfermedades Bronquiales/diagnóstico por imagen , Enfermedades Bronquiales/patología , Broncoscopía , Humanos , Masculino , Persona de Mediana Edad , Osteocondrodisplasias/diagnóstico por imagen , Osteocondrodisplasias/patología , Radiografía , Enfermedades de la Tráquea/diagnóstico por imagen , Enfermedades de la Tráquea/patologíaRESUMEN
Wuchereria bancrofti gravid adult female worms were detected in a mediastinal lymph node in a 76-year old man. The patient also had lung carcinoma. A blood cell counts did not show any eosinophilia, and three consecutive night blood samples were also negative for microfilariae. Filariasis and neoplasm association was purely coincidental. Epidemiological and histopathological aspects of adult filariasis are described.