RESUMEN
El pseudolinfoma de la mama es una entidad considerada como un proceso patológico benigno cuya naturaleza puede ser un proceso reactivo; suele presentarse habitualmente como una tumoración de superficie irregular, con bordes definidos, indolora y de crecimiento lento. Morfológicamente se asemeja al linfoma, con el cual debe hacerse su principal diagnóstico diferencial, ya que el pronóstico y el tratamiento de estas 2 entidades varían considerablemente. Presentamos el caso de una mujer en la quinta década de la vida, con una lesión nodular en la mama derecha de 2 años de evolución, al momento del diagnóstico, sin evidencia de compromiso sistémico. Los hallazgos radiológicos orientaban hacia un proceso tumoral/inflamatorio, por lo que para su diagnóstico fue necesario un estudio anatomopatológico, inmunohistoquímico y molecular (AU)
Pseudolymphoma of the breast is considered a benign lesion, perhaps a reactive process, and usually presents as a slow growing, painless tumour with well-defined borders and an irregular surface. The morphological appearance resembles that of lymphoma and therefore a careful differential diagnosis should be made as the prognosis and treatment of these two entities vary considerably. We report the case of a woman in the fifth decade of life, who presented with a two year history of a nodular lesion in her right breast. There was no evidence of systemic disease. Radiological imagery suggested a tumour or inflammatory process and a biopsy was necessary for further histopathological, immunohistochemical and molecular studies (AU)
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Seudolinfoma/patología , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Corticoesteroides/uso terapéutico , Granuloma/diagnóstico , Granuloma/patología , Linfoma Folicular/complicaciones , Linfoma Folicular/patología , Inmunohistoquímica/métodos , Inmunohistoquímica , Enfermedad de Castleman/complicaciones , Enfermedad de Castleman/patología , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodosRESUMEN
Las histiocitosis de células de Langerhans (HCL) son una entidad infrecuente con una prevalencia de 0,5/100.000 casos al año, que afecta principalmente a pacientes de edad pediátrica. A diferencia de la histiocitosis congénita autolimitada (reticulohistiocitosis) que está limitada a la piel, la histiocitosis de células de Langerhans tiene afectación sistémica (hueso, hígado, bazo...). El pronóstico y el tratamiento varían en función de la edad del paciente, extensión y disfunción de órganos afectos. Se presenta un caso poco frecuente de histiocitosis de células de Langerhans en un paciente varón de 36 años con placas ulceradas en muslo derecho sin afectación sistémica asociada. Las lesiones involucionaron espontáneamente tras 4 semanas, permaneciendo asintomático un año después del diagnóstico (AU)
Langerhans cell histiocytosis is rare; its prevalence is only 0,5/100,000 cases per year and these are predominatly children. As opposed to congenital self-healing histiocytosis (reticulohistiocytosis) which has affects the skin, Langerhans cell histiocytosis can present systemic manifestations (bone, liver, spleen, etc.). The prognosis and the treatment depend especially on the age of the patient, extent of the lesion and the number and dysfunction of the organs involved. We report an unusual case of LCH in an adult male with only cutaneous pathology and a self-limiting evolution (AU)
Asunto(s)
Humanos , Masculino , Adulto , Histiocitosis de Células de Langerhans/diagnóstico , Histiocitosis de Células de Langerhans/patología , Biopsia/métodos , Histiocitosis de Células de Langerhans/complicaciones , Pronóstico , Úlcera Cutánea/complicaciones , Úlcera Cutánea/patología , Muslo/patología , Diagnóstico Diferencial , Inmunohistoquímica/métodos , InmunohistoquímicaRESUMEN
UNLABELLED: Non-invasive techniques aim to be an alternative to endoscopy in the assessment of postsurgical recurrence of Crohn's disease (CD). The object of this study was to evaluate the accuracy of abdominal ultrasonography (AUS) and (99m)Tc-hexamethylpropylene amineoxime ((99m)Tc-HMPAO)-labelled leucocyte scintigraphy (LLS) compared with endoscopy in the diagnosis and grading of postsurgical recurrence of CD. Between January 2006 and May 2007, all patients with CD and resection with ileocolic anastomosis were included prospectively. Within three days they underwent an ileocolonoscopy, AUS with evaluation of bowel wall thickness and the presence of Doppler flow, and LLS. Forty patients who met the study conditions were included; 5 patients did not agree to have the ileocolonoscopy and it was not possible to assess the anastomosis in 2 patients. Endoscopic recurrence was detected in 26 patients (78.8%), in 15 of whom it was moderate-severe. For the diagnosis of recurrence, both AUS and LLS showed acceptable sensitivity and positive predictive value, with an accuracy of 72.7% and 78.1%, respectively. The results of the AUS and LLS for diagnosing moderate-severe recurrence were better, with an accuracy of 78.8% and 81.3%, respectively. The best assessment of the severity of the recurrence was obtained with the combination of both techniques (sensitivity, specificity, positive and negative predictive values, accuracy and kappa index were, respectively: 93.3%, 72.2%, 73.7%, 92.9%, 81.8% and 0.64). The variables evaluated, both sonographic and scintigraphic, had areas under the curve that were similar and significantly different from 0.5. CONCLUSION: Abdominal ultrasonography and (99m)Tc-HMPAO-labelled leucocyte scintigraphy are two useful non-invasive techniques for the assessment of postsurgical recurrence of Crohn's disease.