RESUMEN
A 67-year-old man presented with dyspnea, general fatigue, and leg edema. Echocardiography demonstrated a large pericardial effusion with a 5 cm × 3 cm, dense hetero-echogenic tumor in the right atrium. At the time of the operation, the tumor was composed of soft but tough, yellowish, smaller smooth processes, and fragile, reddish, bigger nodules. Pathologic examination revealed that the yellow processes were xanthoma and that the reddish nodules were B-cell lymphoma. This case strongly supports the theory that normolipemic xanthomatosis is a secondary event in the lymphoid tissue neoplasm.
Asunto(s)
Neoplasias Cardíacas/complicaciones , Linfoma de Células B/complicaciones , Xantomatosis/etiología , Anciano , Procedimientos Quirúrgicos Cardíacos/métodos , Diagnóstico Diferencial , Ecocardiografía , Cardiopatías/diagnóstico , Cardiopatías/etiología , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Ventrículos Cardíacos , Humanos , Linfoma de Células B/diagnóstico , Linfoma de Células B/cirugía , Masculino , Xantomatosis/diagnóstico , Xantomatosis/cirugíaRESUMEN
We describe the case of a 36-year-old woman who developed acute encephalo-myelitis after acute viral hepatitis type B. She was admitted to the hospital with a history of general malaise and nausea of 5 days duration. Her serum showed high transaminase levels and positive HBs-Ag and increased IgM HBc-Ab titers. She had urinary dysfunction, myoclonus and postural tremor of her extremities. Several days later, she developed bilateral limb ataxia and alteration of consciousness. The cerebrospinal fluid examinations showed pleocytosis and increased protein. Treatment with high-dose methylprednisolone resulted in a marked improvement of the clinical and CSF examination. Magnetic resonance imaging of the brain and the spinal cord did not disclose abnormal lesions. The symptoms and clinical course were quite similar to those of acute disseminated encephalomyelitis.