Assuntos
Síndrome de Churg-Strauss/diagnóstico , Colite/etiologia , Idoso , Azatioprina/uso terapêutico , Síndrome de Churg-Strauss/complicações , Síndrome de Churg-Strauss/tratamento farmacológico , Síndrome de Churg-Strauss/patologia , Colonoscopia , Feminino , Humanos , Imunossupressores/uso terapêutico , Derrame Pericárdico/etiologia , Prednisona/uso terapêuticoAssuntos
Doenças Autoimunes/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Idoso , Doenças Autoimunes/complicações , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/patologia , Biópsia com Agulha de Grande Calibre , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Endossonografia , Feminino , Humanos , Biópsia Guiada por Imagem , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Pancreatite/complicações , Pancreatite/tratamento farmacológico , Pancreatite/patologia , Tomografia Computadorizada por Raios XRESUMO
The onset of umbilical nodules with no previous abdominal surgeries or known endometriosis in other locations characterizes primary umbilical endometriosis. We present a 43-year-old woman with a painful umbilical nodule for several months. We report this case to emphasize the importance of the differential diagnosis of umbilical nodules, especially in women during the reproductive period.
Assuntos
Endometriose/patologia , Umbigo/patologia , Adulto , Diagnóstico Diferencial , Feminino , HumanosRESUMO
OBJECTIVES: We present a case of prostatitis with acute urinary retention as a rare initial manifestation of Wegener' Granulomatosis. METHODS: The case was a 48-year-old male with symptoms of prostatitis over ten days. The patient presented urinary retention, with partial response to antibiotic treatment. High levels of cytoplasmic antineutrophil cytoplasmic antibody and a prostatic biopsy were compatible with Wegener' Granulomatosis. RESULTS: After starting treatment with glucocorticoids and cyclophosphamide, a significant improvement to the point of disappearance of symptoms was observed. At 3 months pulmonary and upper airway symptoms began, requiring higher doses of cyclophosphamide to control symptoms. CONCLUSIONS: Wegener's Granulomatosis is a multisystem entity whose presentation as prostatitis with urinary retention is rare.
Assuntos
Granulomatose com Poliangiite/diagnóstico , Prostatite/etiologia , Retenção Urinária/etiologia , Doença Aguda , Granulomatose com Poliangiite/complicações , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Pustulose Exantematosa Aguda Generalizada/patologia , Combinação Amoxicilina e Clavulanato de Potássio/efeitos adversos , Celulite (Flegmão)/tratamento farmacológico , Toxidermias/patologia , Síndrome de Stevens-Johnson/patologia , Pustulose Exantematosa Aguda Generalizada/etiologia , Antibacterianos/efeitos adversos , Diagnóstico Diferencial , Toxidermias/etiologia , Humanos , Síndrome de Stevens-Johnson/etiologiaRESUMO
The term "multiple eruptive dermatofibromas" usually refers to a clinical situation characterized by the development of between five and eight dermatofibromas during a period of up to four months. It is usually linked to immunodeficiency associated conditions as autoimmune disorders, hematologic malignancies, HIV infection, and transplants. We report three patients with Down syndrome. One patient had psoriatic arthritis under treatment with methotrexate, one had Graves-Basedow disease, and one had hypercholesterolemia. All three patients developed multiple eruptive dermatofibromas. We suggest that the immunologic disturbances associated with Down syndrome, together with other underlying conditions present in these patients, could trigger the development of cutaneous lesions.
Assuntos
Síndrome de Down/complicações , Histiocitoma Fibroso Benigno/etiologia , Hospedeiro Imunocomprometido , Neoplasias Primárias Múltiplas/etiologia , Neoplasias Cutâneas/etiologia , Adulto , Artrite Psoriásica/complicações , Artrite Psoriásica/tratamento farmacológico , Síndrome de Down/imunologia , Feminino , Doença de Graves/complicações , Doença de Graves/imunologia , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/imunologia , Histiocitoma Fibroso Benigno/patologia , Histiocitoma Fibroso Benigno/cirurgia , Humanos , Hipercolesterolemia/complicações , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Metotrexato/efeitos adversos , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/imunologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Crohn's disease (CD) can be associated with respiratory involvement. Multiple pulmonary nodules are an infrequent finding in patients with CD. When they are found, histology usually shows sterile necrobiotic nodules, which are spherical aggregates of neutrophils, which frequently cavitate. We report a patient with inactive CD treated with mesalazine, who presented with multiple pulmonary nodules. Transthoracic biopsy of one of the nodules disclosed a benign, nongranulomatous inflammatory lymphoid infiltration. The radiographic abnormalities responded well to oral prednisone. Focal, nongranulomatous lymphoid infiltration thus must be considered in the differential diagnosis of multiple pulmonary nodules in patients with CD.
Assuntos
Doença de Crohn/complicações , Doença de Crohn/patologia , Pneumopatias/complicações , Idoso , Feminino , Humanos , Linfócitos/patologiaRESUMO
We present an uncommon case of a large solitary perirenal metastasis from a malignant peripheral nerve sheath tumour (MPNST) mimicking a primary renal tumour. A metastatic MPNST to the perirenal space is unusual and, in this rare location, is difficult to differentially diagnose from a primary renal tumour.
Assuntos
Neoplasias Renais/secundário , Neurilemoma/secundário , Neoplasias de Tecidos Moles/patologia , Idoso , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Rim/diagnóstico por imagem , Neoplasias Renais/diagnóstico , Neurilemoma/diagnóstico , Coxa da Perna , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To focus on the need of including tuberculosis among differential diagnoses of any epidymo-testicular mass, especially if its evolution is torpid. METHODS/RESULTS: A 73-year-old man who presented with scrotum abscess underwent surgical drainage and antibiotic treatment, but suppuration relapsed through cutaneous fistulae. A epipidymectomy was then performed, which demonstrated tuberculous granulomas. Torax Rx showed a cystic apical pulmonary wound which was treated with 3 antituberculostatics for 12 months. Sputum culture was positive for Micobacterium Bovis. CONCLUSIONS: Aspirative punction under sonographic control is a valuable technique to avoid mutilating surgeries and to permit an almost always effective treatment, before the appearance of permanent lesions which lead to sterility.
Assuntos
Epididimite/microbiologia , Mycobacterium bovis/isolamento & purificação , Doenças Profissionais/microbiologia , Tuberculose dos Genitais Masculinos/microbiologia , Abscesso/microbiologia , Idoso , Criação de Animais Domésticos , Animais , Antibacterianos , Antituberculosos/uso terapêutico , Bovinos , Quimioterapia Combinada/uso terapêutico , Epididimite/diagnóstico , Epididimite/tratamento farmacológico , Humanos , Isoniazida/uso terapêutico , Masculino , Doenças Profissionais/diagnóstico , Doenças Profissionais/tratamento farmacológico , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Escroto , Tuberculose Bovina , Tuberculose dos Genitais Masculinos/diagnóstico , Tuberculose dos Genitais Masculinos/tratamento farmacológicoAssuntos
Dor Abdominal/diagnóstico , Febre/diagnóstico , Dor Abdominal/complicações , Idoso , Febre/complicações , Infecções por HIV/complicações , Humanos , Masculino , Baço/cirurgia , Esplenomegalia/diagnóstico , Fatores de Tempo , Tuberculose Miliar/diagnóstico , Tuberculose Esplênica/diagnóstico , Redução de PesoRESUMO
OBJECTIVE: To describe two cases of unilateral renal agenesis complicated by the association of a urothelial carcinoma and review the literature. METHODS: After reviewing our series of transitional cell carcinoma, we found two cases with associated unilateral renal agenesis. Case 1: A 46-year-old male with grade III stage C transitional cell carcinoma of the urinary bladder that was treated sequentially by transurethral resection of the bladder, systemic neoadjuvant polychemotherapy (gemcitabin, taxol and cisplatin) before radical cystectomy and Bricker urinary diversion were performed. Due to the extent of the tumor, complementary adjuvant therapy was administered, but the patient died 10 months after cystectomy due to disease progression. Case 2: An asymptomatic 71-year-old male in whom renal agenesis and ureteral pelvic filling defect, which was treated by ureterectomy, were incidentally discovered during a routine abdominal study. At one year follow-up, no evidence of tumor recurrence has been observed. RESULTS: 23 patients with unilateral renal agenesis in association with different endocrine or genitourinary cancers have been reported in the literature. In unilateral renal agenesis anomalies of some of the genes involved in renal development occur and may lead to dysplastic growth of the embryologically related organs and an increased risk of developing tumors. CONCLUSIONS: 93% of the tumors reported in patients with unilateral renal agenesis were found to arise from the genitourinary organs.