[T-gamma lymphocytosis associated with two solid neoplasms in a patient with rheumatoid arthritis]. / Linfocitosis T-gamma asociada a dos neoplasias sólidas en un paciente con artritis reumatoide.

T gamma lymphocytosis is an infrequent entity, generally benign and distinct of the spectrum of the T cell chronic lymphoproliferative syndromes, that it not need or need short therapy, with a prolongated survival. T gamma lymphocytosis is expressive in the most of the occasions of a monoclonal lymphocytic proliferation and it is frequently associated to Rheumatoid Arthritis. We present the case of a patient with T gamma lymphocytosis, developed after several years of evolution of Rheumatoid Arthritis and that it was coincident with two solid neoplasms, an infiltrate carcinoma of the larynx and recurrent urothelial carcinoma, without previous chemotherapy. The death in this patients, is generally due a progressive lymphoproliferation and sepsis relationed with the neutropenia.

[Vesicoureteral tuberculosis. Apropos of a case]. / Tuberculosis vesicoureteral. A propósito de un caso.

A case of vesicoureteral tuberculosis is described. The clinical onset was like a tumor of this localization, with overlapping of clinical symptoms and radiologic findings. The histological study and the histochemical stains was the key to the diagnosis. We think that the coincidence of both clinical and radiologic findings, justified the interest of the case in de differential diagnosis.

[Eosinophilic gastroenteritis, apropos a new case]. / Gastoenteritis eosinofílica, a propósito de un nuevo caso.

Eosinophilic gastroenteritis is an uncommon disorder, characterised by eosinophilic infiltration of gut wall, with variable clinical features, depending affected layer of the wall and digestive area, but usually consisting in abdominal pain, diarrhoea, and vomiting. Etiopathogenesis is unknown, with a frequent allergic condition and good response to corticosteroids therapy. Although the existence of eosinophilic gastroenteritis may be suggested by abdominal manifestations, an allergic history with laboratory date and ESR normal, only the antral or intestinal biopsy might to confirm the diagnostic. We report a case of a patient with eosinophilic gastroenteritis and history of bronchial asthma, without evidence of intestinal parasitosis, and a spectacular response to corticosteroids therapy.

[Amyloid intestinal pseudo-obstruction as initial manifestation of IgA multiple myeloma]. / Seudo-obstrucción intestinal amiloidea como manifestación inicial de mieloma múltiple IgA.

Amyloidosis is a well known complication of Multiple Myeloma. Although involvement of the gastrointestinal tract is common in patients with Amyloid, severe symptoms are no frequent, nevertheless vascular deposits may produce gastrointestinal ischemia and bleeding and perforation. Injured mucosae of the intestinal well may produce malabsorption and the neuromuscular infiltration determine alterations of gastrointestinal motility. Although renal and cardiac disfunction is the most frequently cause of death in these patients, intestinal pseudo-obstruction bears a serious prognosis. We present a case of a patients who was operated because of a presumptive diagnosis of intestinal obstruction, which small bowel was infiltrated with Amyloid and which bone marrow demonstrated multiple myeloma.

Idiopathic granulomatous vasculitis: response to immunosuppressive therapy.

A case of idiopathic granulomatous vasculitis (disseminated visceral giant cell arteritis) is described in an old woman, the seventh case of this rare disorder reported to date. The main organ affected was the liver and, to our knowledge, this is the first patient to be diagnosed while still alive and the only case to have received medical treatment. It is also the first time that muscular involvement has been documented in this condition. Cyclophosphamide treatment resulted in disappearance of symptoms and increase in weight. The patient died of an unrelated condition.

[An evaluation of the clinical significance of gastric dysplasia: a histological follow-up study]. / Evaluación del significado clínico de la displasia gástrica: estudio de seguimiento histológico.

To evaluate the clinical and prognostic significance of gastric dysplasia, we have carried out a study on 59 patients with histologic data obtained in a sequential way. The initial diagnosis was mild dysplasia in 24 patients, moderate in 18 cases and severe in 17 cases. The length of the follow up varied from one month to 13 years. The results suggest that, whereas cases of mild and moderate intensity tend to stability or regression, severe dysplasia is a reliable marker of high risk of gastric cancer. However, in our series as well as in the experience of others, the time elapsed between the diagnosis of severe dysplasia and the development of gastric carcinoma is usually very short. Because of this, we conclude that a carcinoma was probably already present when the initial biopsy was made. This conclusion emphasizes its diagnostic rather than its prognostic value in most occasions. Of 12 cases in our series which evolved to gastric carcinoma, 4 were diagnosed in an early stage (intramucosal). This fact confirms the importance of the recognition of gastric dysplasia for the early detection and control of these patients.

[Chondrosarcoma of the larynx. Needle biopsy diagnosis by computed tomography]. / Condrosarcoma de laringe. Diagnóstico mediante punción aspiración biopsia guiada por tomografía computarizada.

Chondrosarcoma of the larynx is the most frequent sarcoma at this site. The growth rate is very slow, so that the first symptoms, dyspnea and hoarseness, may be insidious. Chondrosarcomas are usually of low-grade malignance and rarely metasize. Surgical resection is the treatment of choice. We present a case of diagnostic FNA using computed tomography.

[Castleman's lymphoma of the neck]. / Enfermedad de Castleman en el cuello.

We present a case of Castleman's disease (hyaline-vascular type) localized in the neck, confirmed by histopathological examination. A review of the illness is also reported.