RESUMO
Hypercalcemia is a rare metabolic disorder in course of B cell lymphoma. The mechanism of hypercalcemia in patients with malignancy may include the increased extrarenal production of vitamin D from tumoral cells or neighboring macrophages, i-PTH or PTHrP from tumoral cells. In this case we reported a 34 years old caucasian woman with acute renal failure and hypercalcemia as onset of splenic lymphoma in absence of abnormal levels of serum vitamin D and PTHrP. Because of dramatic recovery of renal function and hypercalcemia after splenectomy, we can speculate that main mechanism of hypercalcemia is related to vitamin D production from neighboring lymphoma macrophages.
Assuntos
Injúria Renal Aguda/etiologia , Hipercalcemia/etiologia , Linfoma Difuso de Grandes Células B/complicações , Neoplasias Esplênicas/complicações , Injúria Renal Aguda/sangue , Adulto , Biomarcadores/sangue , Biópsia , Calcitriol/sangue , Cálcio/sangue , Quimioterapia Adjuvante , Creatinina/sangue , Feminino , Humanos , Hipercalcemia/sangue , Linfoma Difuso de Grandes Células B/sangue , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/cirurgia , Hormônio Paratireóideo/sangue , Esplenectomia , Neoplasias Esplênicas/sangue , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND/AIMS: This study was designed to evaluate the effectiveness of radical surgery for liver hydatid disease. MATERIALS AND METHODS: Hospital charts of 104 consecutive patients with liver hydatidosis observed in our unit during the period 1982-1994 were reviewed. A total of 121 cysts in 89 patients were treated surgically: with cystopericystectomy in 66 and liver resection in 23. RESULTS: The overall incidence of postoperative complications was 19%: 19.7% and 17.1% after cystoperi-cystectomy and liver resection respectively (p = 0.32). Overall postoperative mortality was 1%. Among the 72 patients available for follow-up, only one (1%) had a local recurrence of the disease. CONCLUSIONS: Results suggest the safety and efficacy of radical procedures in the surgical management of liver hydatid disease. Total cystopericystectomy is the treatment of choice but liver resection is justified in selected cases.
Assuntos
Equinococose Hepática/cirurgia , Adulto , Transfusão de Sangue , Equinococose Hepática/diagnóstico por imagem , Equinococose Hepática/patologia , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Humanos , Incidência , Cuidados Intraoperatórios , Tempo de Internação , Masculino , Complicações Pós-Operatórias , Recidiva , Estudos Retrospectivos , Segurança , Esfinterotomia Endoscópica , Taxa de Sobrevida , Fatores de Tempo , Ultrassonografia de IntervençãoRESUMO
The authors describe various applications of scintigraphy with labeled leukocytes and its value in the diagnosis of gut diseases such as Crohn's disease, ulcerative colitis and related complications. Furthermore, the study of vascular prosthesis infection, cryptogenetic fever and abdominal sepsis, three cases of which are herein reported, is facilitated. The method, in conjunction with endoscopy and traditional radiology, revealed to be of great value in terms of sensitivity and specificity for the diagnosis of the aforementioned diseases. Therefore, the use of such method is encouraged in all those cases of abdominal sepsis of uncertain interpretation and in the evaluation of vascular prosthesis infection.