Utility of ultrasound in the diagnostic approach to lymphoma with splenic involvement.

This paper describes the clinical case of a patient diagnosed with diffuse large B-cell lymphoma with splenic involvement, focusing on the role of abdominal ultrasound (US) in this context. The patient experienced dyspepsia and progressive asthenia over several months so an abdominal US was performed. The US showed multiple heterogeneous and hypoechogenic focal splenic lesions together with a moderate left pleural effusion. Lymphoma was suspected due to these findings and the diagnosis was then confirmed with the performance of a CT scan and a biopsy that revealed the presence of a diffuse large B-cell lymphoma with metastatic disease. Chemotherapy containing rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone was administered and the patient is currently on clinical remission. This study highlights the role of abdominal ultrasound as a useful technique in the non-invasive assessment of this entity, considering an appropriate clinical context and mainly after detecting multiple hypoechogenic splenic lesions in the US.

Hospital-based screening outperforms primary care screening as a means of achieving hepatitis C virus micro-elimination.

AIM: To assess the respective performances of a HCV screening program in a hospital setting and a HCV screening model applied concomitantly in a primary care centre. METHODS: Adult patients consecutively admitted to hospital for ambulatory surgery were screened for anti-HCV antibodies (hospital screening cohort, HPSC), as were patients receiving blood tests for medical reasons in a primary care centre (primary care screening cohort, PCSC). Serum anti-HCV and HCV RNA levels were tested by ELISA and real-time PCR, respectively. RESULTS: Seroprevalence of HCV infection was 2.2 % in the HPSC and 1.4 % in the PCSC (p = 0.044). All viraemic patients (0.2 % in HPSC and 0.1 % in PCSC) were treated with direct-acting antivirals and 85.7 % experienced a sustained virological response. CONCLUSIONS: Hospital-based HCV screening outperformed primary care-centered screening, significantly increasing HCV case findings.

Colitis ulcerosa asociada a pancreatitis autoinmune, sialoadenitis y vasculitis leucocitoclástica / Ulcerative colitis associated with autoimmune pancreatitis, sialadenitis and leukocytoclastic vasculitis

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Potencial de la ultrasonografía ecopotenciada en la caracterización de las lesiones focales hepáticas / Potential impact of contrast-enhanced ultrasonography in the study of focal liver lesions

La ultrasonografía es la técnica de elección para el estudio inicial de los pacientes con sospecha de lesión focal hepática (LFH). Sin embargo, presenta una menor sensibilidad y especificidad que la tomografíacomputarizada y la resonancia magnética porque no empleamedios de contraste intravenoso. Los medios de contraste ecográfico pueden aumentar de forma muy importante la sensibilidad y especificidad de la ecografía en el diagnóstico de las LFH. El estudio en tiempo real del comportamiento dinámico de las LFH en la fase vascular, mediante el empleo de los medios de contrasteecográfico, permite la caracterización de las LFH con una eficacia similar a la tomografía computarizada y la resonancia magnética, sin las limitaciones de estas técnicas

Ultrasonography is the first choice for screening patients with suspected liver lesions. However, due to lack of contrast agents, ultrasonographyis less sensitive and specific compared with computed tomography and magnetic resonance imaging. The advent of microbubble contrast agents increases both sensitivity and specificity dramatically. Real-time evaluation of the vascular phase can currently be achievedby combining new microbubble specific methods with second-generation contrast agents. The enhancement pattern in the vascular phase, combined with the behavior in the liver-specific late phase, allows thecharacterization of the most frequent focal liver lesions, with an accuracy similar to those of dynamic computed tomography and magnetic resonance imaging