Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Nervo Isquiático/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/administração & dosagem , Radiação Cranioespinal , Ciclofosfamida/administração & dosagem , Citarabina/administração & dosagem , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Humanos , Ifosfamida/administração & dosagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/etiologia , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Rituximab/administração & dosagem , Terapia de Salvação , Nervo Isquiático/patologia , Vincristina/administração & dosagemRESUMO
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.
Assuntos
Laringectomia , Imageamento por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Vaselina/efeitos adversos , Pneumonia Lipoide/induzido quimicamente , Pneumonia Lipoide/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Traqueostomia/efeitos adversos , Corticosteroides/efeitos adversos , Idoso , Feminino , Humanos , Pneumonia Lipoide/tratamento farmacológico , Resultado do TratamentoRESUMO
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.