ABSTRACT
Metastatic infiltration is most frequent than primary pericardiac tumors. Most frequent tumors are adenocarcinoma and lymphomas. A retrospective analysis of 18 oncological patients with significant pericardiac effusion (SPE) is carried out. The conclusions of the study are: SPE can be the first manifestation of a neoplasm; frequently, pericardiac tamponade (PT) has a neoplastic origin; thorax is the most frequent localization of the primary tumor; pericardiac fluid (PF) cytology analysis has low diagnostic yield; most useful diagnostic tests are thoracocentesis, thorax computerized tomography (CT) and bronchoscopy; SPE in a neoplasm suggest poor short-term prognosis; poor prognosis variables in this series were primary tumor unfavorable histology, advanced tumor disease and (probably) presentation as PT.
Subject(s)
Neoplasms/complications , Pericardial Effusion/etiology , Adult , Aged , Cardiac Surgical Procedures , Cardiac Tamponade/etiology , Cardiac Tamponade/mortality , Cardiac Tamponade/pathology , Female , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms/mortality , Neoplasms/pathology , Pericardial Effusion/pathology , Pericardial Effusion/therapy , Retrospective Studies , Survival AnalysisABSTRACT
Seventy-three patients with significant pericardiac effusion (SPE) are analyzed retrospectively. The results concerning etiology, clinical findings, evolution, echocardiography findings and pericardiac effusion (PE) findings are summarized. Conclusions drawn are: 1) the pericardiac effusion (PE) is a difficult diagnosis without the assistance of the echocardiogram; 2) the echocardiogram signs of hemodynamic alterations have prognostic value; 3) the most frequent causes of SPE are: tumors, idiopathic acute pericarditis, and iatrogenesis; 4) in an important percentage of DPS patients the cause is not identified; 5) the clinical presentation as pericardiac tamponade (PT) is most frequent in the tumors; 6) the analysis of the PE has a low yield, which means that diagnostic pericardicentesis is not justified in all patients with SPE; 7) the pericardiac biopsy hasa low diagnostic yield; 8) the predictive mortality factors are: presentation as PT and tumor etiology, and 9) because of the dynamic character of the SPE, it is important to carry out a progress follow-up of it.
Subject(s)
Cardiac Tamponade/etiology , Pericardial Effusion/etiology , Pericarditis/complications , Pericardium/pathology , Adolescent , Adult , Aged , Cardiac Surgical Procedures , Cardiac Tamponade/mortality , Cardiac Tamponade/surgery , Cause of Death , Clinical Trials as Topic , Echocardiography , Female , Humans , Male , Middle Aged , Pericardial Effusion/mortality , Pericardial Effusion/therapy , Pericarditis/epidemiology , Pericarditis/therapy , Pericardium/diagnostic imaging , Pericardium/surgery , Retrospective Studies , Spain/epidemiologyABSTRACT
La linfadenitis histiocítica necrotizante (LHN) o enfermedad de Kikuchi-Fujimoto es una entidad anatomoclínica poco frecuente; afecta preferentemente a mujeres jóvenes e individuos de razas orientales y se caracteriza por fiebre, adenopatías preferentemente cervicales, afectación sistémica y, ocasionalmente, extraganglionar.Se presentan dos casos de LHN en mujeres jóvenes con afectación cutánea y en uno de los casos con meningitis linfocitaria.Se discuten los aspectos etiológicos, la relación de la LHN con las enfermedades colágeno-vasculares (fundamentalmente el lupus eritematoso sistémico [LES]), los problemas del diagnóstico anatomopatológico y las posibilidades terapéuticas (AU)
Subject(s)
Female , Humans , Monocytes , Neck , Histiocytic Necrotizing Lymphadenitis , Anti-Inflammatory Agents, Non-Steroidal , Drug Therapy, Combination , Diagnosis, Differential , Drug Therapy, Combination , Connective TissueABSTRACT
Necrotizing histiocytic lymphadenitis (NHL) or Kikuchi-Fujimoto disease is an infrequent seen clinicopathologic entity that affects most frequently young women and individuals of eastern races, and that is characterized by fever and adenopathies (basically cervical) and systemic disease even though occasional patients present extranodal disease. We present two young women with NHL and cutaneous affectation, and with lymphocytic meningitis in one of the patients. We discuss the etiology of NHL, the relation of NHL with collagen-vascular diseases (basically systemic erythematous lupus) the problem of the pathologic diagnosis, and the therapeutic possibilities in these patients.
Subject(s)
Connective Tissue/pathology , Histiocytic Necrotizing Lymphadenitis/pathology , Anti-Bacterial Agents , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination/therapeutic use , Female , Histiocytic Necrotizing Lymphadenitis/drug therapy , Humans , Monocytes/pathology , NeckABSTRACT
Escanear (AU)
Subject(s)
Adult , Male , Female , Humans , Spinal Cord Diseases , Tuberculosis, Meningeal , Thoracic Vertebrae , HIV Infections , Arachnoiditis , Cervical VertebraeABSTRACT
No disponible
Subject(s)
Adult , Female , Humans , Lymphocytes , Inflammation , Still's Disease, Adult-Onset , Pituitary DiseasesABSTRACT
Radiculomyelitis (arachnoiditis) (RMA) is a severe complication of tuberculous meningitis (TM). Two patients with HIV infection and TM are here reported. These patients developed RMA. In Spain only four cases of RMA have previously been reported (only one of them was HIV-positive). Clinical manifestations (subacute paraplegia, radicular pain, sensitive level and neurogenic bladder) are reported. Cerebrospinal fluid had inflammatory features, wit predominance of mononuclear cells and remarkable increase in protein content. Magnetic resonance imaging (MRI) is the most suitable diagnostic method. The therapeutic possibilities of this complication are discussed.
Subject(s)
Arachnoiditis/microbiology , HIV Infections/complications , Spinal Cord Diseases/microbiology , Tuberculosis, Meningeal/complications , Adult , Cervical Vertebrae , Female , Humans , Male , Thoracic VertebraeABSTRACT
No disponible
Subject(s)
Aged , Aged, 80 and over , Male , Humans , Paresthesia , Adenocarcinoma , Hypocalcemia , Heart Failure , Prostatic NeoplasmsABSTRACT
Propósito: Los linfomas MALT de bajo grado suelen estar localizados y ello condiciona, en parte, su buen pronóstico. Material y métodos: Describimos un paciente con un linfoma MALT gástrico de bajo grado, que debutó con un entropion bilateral, estando en estadio IV en el estudio de extensión. Su respuesta al Clorambucil fue excelente, sobreviviendo 8 años. Resultados: El estudio morfológico e inmunofenotípico de la biopsia conjuntiva¡ fueron claves para el diagnóstico. El estudio de extensión, incluyendo otros territorios extranodales, mostraron el tumor primario, su multicentricidad y diseminación. Conclusiones: Los linfomas MALT primarios pueden debutar en otro territorio extranodal y ser asintomáticos. Un estadio avanzado no siempre implica un mal pronóstico (AU)
Subject(s)
Aged , Male , Humans , Lymphoma, B-Cell, Marginal Zone/diagnosis , Lymphoma, B-Cell, Marginal Zone/complications , Entropion/etiology , Lymphoma, B-Cell, Marginal Zone/drug therapy , Chlorambucil/therapeutic useABSTRACT
OBJECTIVE: To underscore the difficulty and importance of early diagnosis in tuberculous epididymo-orchitis. METHODS: Herein we describe a male patient with a history of fever for a long period, constitutional symptoms and retinal exudates that had been diagnosed and treated as systemic candidiasis instead of miliary tuberculosis. Six years later the patient presented with acute epididymo-orchitis. One year thereafter he developed contralateral epididymo-orchitis with a more torpid course. The patient did not respond to conventional treatment. Sterile pus was detected in urine; cultures and bacilli studies were negative. Testicular US findings were compatible with the condition and disclosed an abscessed area which was functioned and the diagnosis was made. RESULTS: The patient was treated with pirazinamide for two months and isoniacid and rifampicin for 12 months. However, the patient developed sterility. CONCLUSIONS: Tuberculous epididymo-orchitis can present acutely and can be confused with infection from other more common pathogens, or subacutely and confused with tumors. In many cases there is no previous patient or family history and chest x-ray, bacilloscopies and cultures can be negative. Tuberculosis must be considered due to its increasing incidence. US-guided fine needle punction-aspiration biopsy is very useful for diagnosis, which has to be made as early as possible to avoid sterility.
Subject(s)
Epididymitis/diagnosis , Orchitis/diagnosis , Tuberculosis, Male Genital/diagnosis , Tuberculosis, Miliary/diagnosis , Adult , Combined Modality Therapy , Epididymitis/etiology , Epididymitis/therapy , Humans , Male , Orchitis/etiology , Orchitis/therapy , Recurrence , Time Factors , Tuberculosis, Male Genital/etiology , Tuberculosis, Male Genital/therapy , Tuberculosis, Miliary/complications , Tuberculosis, Miliary/therapySubject(s)
Anuria/chemically induced , HIV Protease Inhibitors/adverse effects , Indinavir/adverse effects , Adult , Humans , MaleABSTRACT
Paget's disease is a common entity but osteosarcoma arising in Paget's disease is an infrequent complication. Primary osteosarcomas are typically long bone tumours and the skull is rarely affected. A case with malignant transformation of Paget's disease of the skull and an unusual clinical presentation is reported. Computed tomography scans of the tumour area show interesting results. Main features are: an intensive sclerotic reaction of the host bone, an inner and outer spiculation of the calvarium, radial ossifications in the soft extracranial mass, and spotty calcifications and ossifications of the osteosarcomatous portion infiltrating the brain.
