RESUMEN
The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudotumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the presurgical work-up and postsurgical follow-up.
Asunto(s)
Neoplasias Cardíacas/diagnóstico , Aumento de la Imagen , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Diagnóstico Diferencial , Atrios Cardíacos/patología , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/secundario , Neoplasias Cardíacas/cirugía , Tabiques Cardíacos/patología , Válvulas Cardíacas/patología , Ventrículos Cardíacos/patología , Humanos , Hallazgos Incidentales , Lipoma/diagnóstico , Lipoma/patología , Lipoma/cirugía , Liposarcoma/diagnóstico , Liposarcoma/patología , Liposarcoma/cirugía , Mesotelioma/diagnóstico , Mesotelioma/patología , Mesotelioma/cirugía , Mixoma/diagnóstico , Mixoma/patología , Mixoma/cirugía , Sarcoma/diagnóstico , Sarcoma/patología , Sarcoma/cirugía , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: Superior vena cava obstruction is an urgent complication of lung cancer. Superior vena cava stent insertion can be considered to provide rapid relief of the symptoms. METHODS: To estimate the efficiency and the complications of this procedure, we retrospectively analyzed 41 consecutive patients treated during the last 5 years by self-expanding nitinol stent insertion for superior vena cava obstruction due to lung cancer. It was combined with anticoagulation and corticosteroids. RESULTS: 41 patients benefited from this treatment (30 men and 11 women) with an average age of 59 years. Etiologies of the vena cava obstruction were: small cell carcinoma (11), adenocarcinoma (8), squamous cell carcinoma (9), large cell carcinoma (9) and others (4). All patients were symptomatic. The average period between the onset of symptoms and the vascular stenting was 14 days. Specific treatment was chemotherapy (18 patients), radiotherapy (1 patient), or both (14 patients), and no specific treatment for 6 patients. The procedure consisted of the insertion of 1 (73%) or 2 (27%) stents, with an average length and caliber of 7.5 cm and 14 mm respectively. No major complication was reported in short and long-term follow up. Symptomatic improvement was observed for all the patients within 48 hours. Median survival after the stenting was of 6.7 months. CONCLUSION: In our study, vascular stenting for malignant superior cava vena obstruction allows a rapid improvement of the symptoms with very few complications, suggesting a possible role as first line treatment for chemo or radio-resistant tumours.
Asunto(s)
Adenocarcinoma/complicaciones , Implantación de Prótesis Vascular , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Carcinoma de Células Escamosas/complicaciones , Neoplasias Pulmonares/complicaciones , Carcinoma Pulmonar de Células Pequeñas/complicaciones , Stents , Síndrome de la Vena Cava Superior/cirugía , Adulto , Anciano , Interpretación Estadística de Datos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Síndrome de la Vena Cava Superior/etiología , Síndrome de la Vena Cava Superior/mortalidad , Síndrome de la Vena Cava Superior/terapia , Factores de TiempoRESUMEN
The authors report a case of an X-linked-adrenoleukodystrophy (ALD) in a young adult presenting with hemianopsia. Adult onset cerebral ALD is rare and represents only 3% of cases of ALD. The observation describes clinical data, as well as conventional and spectroscopic MR imaging and related value in prognosis evaluation.
Asunto(s)
Adrenoleucodistrofia/diagnóstico , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Adulto , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Colina/metabolismo , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
Percutaneous and endovascular techniques have shown their efficacy in the treatment of a great variety of pathologies. The advances in diagnostic imaging as well as the development of new materials have made it possible to carry out new procedures that were unthinkable not many years ago. The irruption of this new form of treating patients has had, is having, and will have a clear impact on the multidisciplinary approach to numerous diseases.
Asunto(s)
Pierna/irrigación sanguínea , Enfermedades Vasculares/terapia , Adulto , Anciano , Angiografía , Angioplastia , Angioplastia de Balón , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/tratamiento farmacológico , Arteriopatías Oclusivas/cirugía , Arteriopatías Oclusivas/terapia , Oclusión con Balón , Prótesis Vascular , Implantación de Prótesis Vascular , Estenosis Carotídea/terapia , Embolización Terapéutica , Femenino , Hemorragia Gastrointestinal/terapia , Hemostasis Endoscópica , Hemostasis Quirúrgica , Humanos , Hipertensión Portal/terapia , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Stents , Enfermedades Vasculares/diagnóstico por imagen , Enfermedades Vasculares/tratamiento farmacológico , Enfermedades Vasculares/cirugíaRESUMEN
The authors report the association of organizing pneumonia (OP) and a Pneumocystis jiroveci infection in a woman who benefited from a kidney transplant 13 years before and was under corticoids, cyclosporine and mycophenolate mofetil. The diagnosis was based on progressive dyspnoea with fever with an alteration in the general state associated with diffuse micronodular pneumopathy suggesting bronchiolitis. The conformation was obtained by the analysis of the alveolar bronchial washings and the histological examination of the distal biopsies revealing endo-alveolar vegetant fibromas. Transbronchial biopsies may be used for the diagnosis and thereby, avoid an invasive surgical pulmonary biopsy. The aetiology of OP may be related to the immunosuppressant treatment or infection by Pneumocystis jiroveci. The evolution in this case was favourable with trimethoprime and sulfamethoxazole associated with a transient increase in the corticoid treatment. This association is rarely described in patients undergoing solid organ transplants.
Asunto(s)
Neumonía en Organización Criptogénica/diagnóstico , Trasplante de Riñón , Infecciones Oportunistas/diagnóstico , Pneumocystis carinii , Neumonía por Pneumocystis/diagnóstico , Biopsia , Broncoscopía , Neumonía en Organización Criptogénica/patología , Diagnóstico Diferencial , Quimioterapia Combinada , Femenino , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Pulmón/patología , Persona de Mediana Edad , Infecciones Oportunistas/patología , Neumonía por Pneumocystis/patología , Complicaciones Posoperatorias/diagnóstico , Alveolos Pulmonares/patología , Tomografía Computarizada por Rayos XRESUMEN
Las técnicas percutáneas y endovasculares han demostrado su eficacia en el tratamiento de una gran variedad de patologías. Los avances en la imagen diagnóstica así como en el desarrollo de nuevos materiales han posibilitado la realización de nuevos procedimientos, impensables hace no mucho años. La irrupción de esta nueva forma de tratar a los pacientes ha tenido, tiene y tendrá, aún más, un claro impacto en el enfoque multidisciplinar de múltiples enfermedades
Percutaneous and endovascular techniques have shown their efficacy in the treatment of a great variety of pathologies. The advances in diagnostic imaging as well as the development of new materials have made it possible to carry out new procedures that were unthinkable not many years ago. The irruption of this new form of treating patients has had, is having, and will have a clear impact on the multidisciplinary approach to numerous diseases