RESUMEN
The diagnostic of the laryngeal cartilage neoplastic invasion plays an important role in the accurate staging of the laryngeal carcinoma and its treatment. To evaluate the accuracy of the CT diagnosing cartilage involvement, the present study is reported. 127 patients with carcinoma of the larynx and hipopharynx T3-T4, surgical treated between 1993 and 1997 at Ciudad Sanitaria y Universitaria de Bellvitge, are retrospectively studied. TC presents an a accuracy of 78%, a specificity of 91% and a sensitivity of 54% in the diagnostic of laryngeal cartilage invasion of the laryngeal and hipopharyngeal carcinoma.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Cartílago/diagnóstico por imagen , Cartílago/patología , Neoplasias Laríngeas/diagnóstico por imagen , Neoplasias Laríngeas/patología , Tomografía Computarizada por Rayos X , Anciano , Carcinoma de Células Escamosas/cirugía , Cartílago/cirugía , Humanos , Neoplasias Laríngeas/cirugía , Estadificación de Neoplasias , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
HYPOTHESIS: Rhinosinusitis is common during HIV infection; its prevalence is uncertain and could probably be related to clinical features, immunoallergological status, and diagnostic criteria METHODS: Seventy-four patients hospitalized with HIV infection were prospectively evaluated for the presence of rhinosinusitis based on clinical findings, nasal endoscopy, or paranasal sinus computed tomography (CT). Immune status, nasal smear, features of atopy (based on the prick test), and its contribution to sinusal inflammatory pathology were also evaluated. RESULTS: Most patients were severely immunosuppressed: CD4+ 155+/-201 cells/mL and 12+/-11% (mean +/- SD). Thirty-five percent of the patients presented at least two criteria of rhinosinusitis (clinical findings, nasal endoscopy, and CT: 35%; clinical findings and CT: 50%; nasal endoscopy and CT: 15%). CT scan showed multiple sinus involvement, opacification over 25% of the total volume of the maxillary sinus in 50% of patients, and opacification of the sphenoidal sinus in 40% of cases. Atopy was present in 18% of patients, a figure which reflects the expected prevalence in our geographic area. Two independent predictors were associated with a higher probability of rhinosinusitis: bilateral absence of maxillary infundibular patency (odds ratio, 7.5; 95% CI = 2.03-27.9) and low total count (odds ratio, 0.99; 95% CI = 0.99-1.00) or percentage of CD4+ (odds ratio, 0.93; 95% CI = 0.88-1.00). CONCLUSIONS: There is a high prevalence of rhinosinusitis in HIV-infected individuals. This finding is related to a decreased cellular immunity, but it does not appear to be related to IgE-related immediate hypersensitivity. Nasal endoscopy should be the first-step diagnostic test. However, when clinical suspicion exists and endoscopy fails to explain symptoms, CT scan is a valuable adjunct to establish this diagnosis.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/etiología , Infecciones por VIH/complicaciones , Hipersensibilidad/etiología , Rinitis/etiología , Sinusitis/etiología , Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Adulto , Femenino , Infecciones por VIH/inmunología , Humanos , Hipersensibilidad/inmunología , Hipersensibilidad/virología , Masculino , Valor Predictivo de las Pruebas , Estudios Prospectivos , Rinitis/diagnóstico por imagen , Rinitis/inmunología , Rinitis/virología , Sinusitis/diagnóstico por imagen , Sinusitis/inmunología , Sinusitis/virología , Tomografía Computarizada por Rayos XRESUMEN
Osteolytic lesions of the skull are an unusual complication in patients with AIDS. We report a case of multiple cranial abscesses as the major manifestation of a disseminated infection due to Mycobacterium kansasii in a patient with AIDS.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Mycobacterium no Tuberculosas/complicaciones , Mycobacterium kansasii/aislamiento & purificación , Osteomielitis/complicaciones , Cráneo , Absceso , Adulto , Humanos , Masculino , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Osteomielitis/microbiologíaRESUMEN
We report a case of MFH of the mandible in a 16-year-old girl. The mandible is a rare location of MFH of bone, with only 21 cases described in the literature. Clinical, pathologic, and radiologic features are discussed, with special emphasis on the unusual pathologic and radiographic features.
Asunto(s)
Histiocitoma Fibroso Benigno/diagnóstico , Neoplasias Mandibulares/diagnóstico , Adolescente , Biopsia , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Radiografía Panorámica , Cintigrafía , Medronato de Tecnecio Tc 99m , Tomografía Computarizada por Rayos XRESUMEN
Amyloidomas involving bone are rare. The 67-year-old man reported here had a large amyloidoma of the left frontal, parietal, sphenoid (greater wing) and temporal bones causing neural compression. Plain radiographs CT and MRI are shown.