Asunto(s)
Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Nervio Ciático/diagnóstico por imagen , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Irradiación Craneoespinal , Ciclofosfamida/administración & dosificación , Citarabina/administración & dosificación , Doxorrubicina/administración & dosificación , Etopósido/administración & dosificación , Humanos , Ifosfamida/administración & dosificación , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/etiología , Linfoma de Células B Grandes Difuso/patología , Masculino , Persona de Mediana Edad , Prednisona/administración & dosificación , Rituximab/administración & dosificación , Terapia Recuperativa , Nervio Ciático/patología , Vincristina/administración & dosificaciónRESUMEN
A 67-year-old female ex-smoker was referred to our hospital after chest radiographs revealed a nonresolving opacity in the right lower lung. Her past medical history was significant for laryngeal cancer. A whole-body positron emission tomography/computed tomography (CT) confirmed an ill-defined fluorodeoxyglucose-avid peribronchial opacity in the right middle and inferior lobes. The CT component of the study showed focal areas of low attenuation within the lung opacity; these focal areas followed fat signal intensity on a magnetic resonance study, confirming the suspicion of exogenous lipoid pneumonia. The patient admitted to applying petroleum jelly (Vaseline) to her tracheostomy in order to moisturize the area around the stoma.
Asunto(s)
Laringectomía , Imagen por Resonancia Magnética/métodos , Imagen Multimodal/métodos , Vaselina/efectos adversos , Neumonía Lipoidea/inducido químicamente , Neumonía Lipoidea/diagnóstico , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X , Traqueostomía/efectos adversos , Corticoesteroides/efectos adversos , Anciano , Femenino , Humanos , Neumonía Lipoidea/tratamiento farmacológico , Resultado del TratamientoRESUMEN
In recent years, the use of vertebral cementing techniques for vertebroplasty and kyphoplasty has spread for the treatment of pain associated with osteoporotic vertebral compression fractures. This is also associated with the increased incidence of complications related with these procedures, the most frequent being originated by leakage of cementation material. Cement can escape into the vertebral venous system and reach the pulmonary circulation through the azygous system and cava vein, producing a cement embolism. This is a frequent complication, occurring in up to 26% of patients undergoing vertebroplasty but, since most patients have no clinical or hemodynamical repercussion, this event usually goes unnoticed. However, some serious, and even fatal cases, have been reported. We report the case of a 74-year-old male patient who underwent vertebroplasty for persistent pain associated with osteoporotic L3 vertebral fracture and who developed a cement leak into the cava vein and right pulmonary artery during the procedure. Although he developed a pulmonary cement embolism, the patient remained asymptomatic and did not present complications during follow-up.