Cribado de neoplasia intraepitelial anal en pacientes con infección por virus de la inmunodeficiencia humana / Anal intraepithelial neoplasia screening in patients with human immunodeficiency virus infection

Introducción: la incidencia de cáncer anal ha aumentadoen los últimos años, por lo que el cribado y la detecciónprecoz de la neoplasia intraepitelial anal (AIN) en pacientesde riesgo son una necesidad.Métodos: se realizó un estudio observacional descriptivode pacientes homosexuales (HSH) o mujeres con neoplasiacervical intraepitelial grado III (CIN III), con infección porvirus de la inmunodeficiencia humana (PVIH), incluidos enun programa de cribado de detección de AIN entre marzode 2016 y septiembre de 2019.Resultados: se realizaron 695 citologías anales, 156 conresultados de lesión de bajo grado (LSIL) o lesión de altogrado (HSIL) (22,4 %), y 116 anoscopias de alta resolución(HRA), el 75,3 % de los pacientes con citología alterada. Sehan obtenido 403 biopsias, el 84 % de ellas patológicas; 197biopsias evidenciaron AIN I (49 %) y 96, AIN II y III (24 %); 44eran condilomas (11 %); y el 16 %, mucosa normal.Conclusión: la alta prevalencia de lesiones premalignas y lamejoría del estadiaje de las lesiones tras tratamiento recomienda dicho protocolo. (AU)

Anal intraepithelial neoplasia screening in patients with human immunodeficiency virus infection.

INTRODUCTION: the incidence of anal cancer has increased in recent years, making screening and early detection of anal intraepithelial neoplasia (AIN) a necessity in patients at risk. METHODS: a descriptive observational study of homosexual patients (MSM) or women with cervical intraepithelial neoplasia (CIN) III, with human immunodeficiency virus (HIV) infection, included in an AIN detection screening program was carried out between March 2016 and September 2019. RESULTS: we have performed 695 anal smears, 156 with results of LSIL (low-grade lesion) or HSIL (high-grade lesion) (22.4 %), and 116 high resolution anoscopy (HRA), 75.3 % of patients with altered cytology. We have 403 biopsies, being 84 % pathological, 197 biopsies of AIN I (49 %), 96 of AIN II and III (24 %), 44 condylomas (11 %) and the rest (16 %), normal mucosa. CONCLUSION: the high prevalence of premalignant lesions and the improvement in the staging of lesions after treatment recommend this protocol.

Invasive ductal adenocarcinoma arising from heterotopic pancreas in the jejunum: case report and literature review / Adenocarcinoma ductal invasivo sobre páncreas heterotópico en yeyuno: caso clínico y revisión de la literatura

Although the presence of pancreatic tissue outside of the usual anatomical location of the pancreas is not an uncommon incidental finding, the risk of malignancy is extremely low. We report a case of ductal adenocarcinoma arising within a focus of heterotopic pancreas, occurring in the jejunum of an 81 year old woman. The patient presented with a history of progressive gastrointestinal occlusive symptoms. Computerized tomography showed a mass in the jejunum, which was surgically removed. Histopathology revealed an invasive pancreatic ductal adenocarcinoma from pancreatic tissue with no connection with the original gland (Heinrich type II). At the 12-month follow-up, there were no signs of recurrence. Despite the low risk of malignancy in heterotopic pancreas, adenocarcinoma is the most frequent histological type, and the prognosis is still not clear. Lesions incidentally detected during surgery and in symptomatic patients need to be removed by conservative procedures in order to exclude malignant disease

Aunque la presencia de tejido pancreático fuera del páncreas es un hallazgo incidental no infrecuente, el riesgo de malignidad es extremadamente bajo. Presentamos el caso de una mujer de 81 años de edad con historia progresiva de síntomas oclusivos gastrointestinales, que presentó en el estudio por tomografía computarizada una lesión oclusiva localizada en yeyuno. El estudio histológico reveló la presencia de un adenocarcinoma ductal invasivo de tipo pancreático sobre tejido pancreático sin conexión con la glándula original (Heinrich tipo II). En el seguimiento posterior de la paciente a 12 meses, no se observaron signos de recurrencia. A pesar de que el riesgo de malignización del páncreas heterotópico es raro, el tipo histológico más frecuente es el adenocarcinoma. El pronóstico es aún incierto. Es necesaria la resección quirúrgica de estas lesiones en el momento del diagnóstico con el fin de descartar la presencia de enfermedad maligna

Invasive ductal adenocarcinoma arising from heterotopic pancreas in the jejunum: Case report and literature review.

Although the presence of pancreatic tissue outside of the usual anatomical location of the pancreas is not an uncommon incidental finding, the risk of malignancy is extremely low. We report a case of ductal adenocarcinoma arising within a focus of heterotopic pancreas, occurring in the jejunum of an 81 year old woman. The patient presented with a history of progressive gastrointestinal occlusive symptoms. Computerized tomography showed a mass in the jejunum, which was surgically removed. Histopathology revealed an invasive pancreatic ductal adenocarcinoma from pancreatic tissue with no connection with the original gland (Heinrich type II). At the 12-month follow-up, there were no signs of recurrence. Despite the low risk of malignancy in heterotopic pancreas, adenocarcinoma is the most frequent histological type, and the prognosis is still not clear. Lesions incidentally detected during surgery and in symptomatic patients need to be removed by conservative procedures in order to exclude malignant disease.

Hemobilia due to intracholecystic papillary neoplasm.

We report the case of a 39-year-old patient who presented an episode of upper gastrointestinal bleeding due to hemobilia. The imaging tests showed the gallbladder occupied by solid tissue, with a diagnosis of intracholecystic papillary neoplasm after the cholecystectomy. The intracholecystic papillary neoplasm of the gallbladder is a newly established entity and it is considered a subtype of intraductal papillary neoplasm of the bile duct. Its presentation in the form of hemobilia has barely been described in the literature.

Hemobilia por neoplasia papilar intracolecística / Hemobilia due to intracholecystic papillary neoplasm

Exponemos el caso de un paciente de 39 años que presentó un episodio de hemorragia digestiva alta secundario a hemobilia. Mediante las pruebas de imagen realizadas se objetivó ocupación de la vesícula biliar por tejido sólido, que tras colecistectomía se diagnosticó de neoplasia papilar intracolecística. Se trata una entidad recientemente establecida y se considera un subtipo de la neoplasia papilar intraductal de la vía biliar. La presentación en forma de hemobilia apenas ha sido descrita en la literatura (AU)

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Adenocarcinoma gástrico asociado a Helicobacter pylori en pediatría / Gastric adenocarcinoma associated with Helicobacter pylori in the pediatric setting

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Collagenous gastritis in the pediatric age.

Collagenous gastritis (CG) is an uncommon condition known in the pediatric age. It is characterized by the presence of subepithelial collagen bands (> 10 microm) associated with lymphoplasmacytic infiltration of the stomach's lamina propria. Symptoms manifested by patients with CG may be common with many other disorders. It typically manifests with epigastralgia, vomiting, and iron deficiency during pre-adolescence. This condition's pathophysiology remains unclear. In contrast to adults, where association with collagenous colitis and other autoimmune conditions is more common, pediatric involvement is usually confined to the stomach. Drugs of choice include proton pump inhibitors and corticoids. A case is reported of a 12-year-old girl with abdominal pain and ferritin deficiency who was diagnosed with CG based on gastric biopsy and experienced a favorable outcome.

Gastritis colágena en la edad pediátrica / Collagenous gastritis in the pediatric age

La gastritis colágena (GC) es una entidad poco frecuente y conocida en edad pediátrica. Se caracteriza por la presencia de bandas de colágeno subepiteliales (> 10 μm) asociadas a infiltrado linfoplasmocitario en la lámina propia del estómago. La sintomatología que presentan los pacientes afectos de GC puede ser común a muchas otras patologías. Se manifiesta típicamente con epigastralgia, vómitos y ferropenia en la pre-adolescencia. La fisiopatología de esta entidad no está del todo clara. La afectación suele ser únicamente gástrica, a diferencia del adulto, más asociado a colitis colágena y otras entidades autoinmunes. Los fármacos de elección son los inhibidores de la bomba de protones (IBP) y los corticoides. Se presenta un caso clínico de una niña de 12 años con abdominalgia y ferritinopenia diagnosticada de GC por las biopsias gástricas con evolución clínica favorable

Collagenous gastritis (CG) is an uncommon condition known in the pediatric age. It is characterized by the presence of subepithelial collagen bands (> 10 μm) associated with lymphoplasmacytic infiltration of the stomach's lamina propria. Symptoms manifested by patients with CG may be common with many other disorders. It typically manifests with epigastralgia, vomiting, and iron deficiency during pre-adolescence. This condition's pathophysiology remains unclear. In contrast to adults, where association with collagenous colitis and other autoimmune conditions is more common, pediatric involvement is usually confined to the stomach. Drugs of choice include proton pump inhibitors and corticoids. A case is reported of a 12-year-old girl with abdominal pain and ferritin deficiency who was diagnosed with CG based on gastric biopsy and experienced a favorable outcome

Síndrome obstructivo congénito de las vías aéreas altas (síndrome de CHAOS). Causa infrecuente de hídrops fetal / Congenital high airway obstruction syndrome (CHAOS syndrome). An infrequent cause of fetal hydrops

La obstrucción congénita de las vías respiratorias altas corresponde a una malformación rara e infrecuente, cuyo diagnóstico prenatal ya ha sido descrito con anterioridad. Reconocerlo prenatalmente nos va a permitir ofrecer a la paciente las posibles opciones que haya que seguir, como conducta prenatal, opciones que van a poder mejorar sustancialmente los resultados finales, respecto a los casos no diagnosticados anteparto, en los que tendremos que aplicar maniobras de urgencia obligada, que presentarán un resultado imprevisible. Actualmente, la mayoría de los casos descritos en la literatura científica corresponden a embarazos con diagnóstico prenatal, lo que ha permitido la práctica de una cesárea programada llevada a cabo mediante el sistema EXIT (tratamiento intraparto ex útero), obteniendo resultados óptimos en alguno de ellos

Congenital high airway obstruction syndrome (CHAOS) is an uncommon malformation. Prenatal diagnosis of this malformation by ultrasound has previously been described. Prenatal identification will allow us to offer patients the possibility of prenatal counseling and to substantially improve perinatal outcomes in comparison with those in fetuses without a prenatal diagnosis, in which emergency maneuvers must be performed with unpredictable results. Currently, most of the cases described in the literature correspond to pregnancies with a prenatal diagnosis, which has allowed cesarean section to be successfully performed with the EXIT procedure (ex utero intrapartum treatment). Excellent results have sometimes been obtained