Patología pulmonar intersticial / Interstitial lung disease

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Infiltrados pulmonares alveolares difusos: un reto diagnóstico para el clínico / No disponible

La presencia de infiltrados pulmonares bilaterales es un hallazgo radiológico frecuente en la práctica clínica habitual. En un varón de edad media no siempre es indicativo de infección y hay que considerar otras entidades diagnósticas (procesos no infecciosos). La sospecha de metástasis pulmonares debe incluirse dentro de estas entidades, aunque se trate de un diagnóstico clínico poco frecuente. La clínica es variable y depende del tumor primario, la edad del paciente, la situación cardiorrespiratoria del mismo y del mecanismo de diseminación tumoral. La linfangitis carcinomatosa es un patrón poco frecuente de metástasis pulmonares y el diagnóstico diferencial se realiza con procesos infecciosos (como neumonías atípicas) e inflamatorios (neumonía intersticial, neumonitis por hipersensibilidad o eosinofilias pulmonares). El paciente que se presenta debutó con clínica respiratoria e infiltrados pulmonares bilaterales y fue diagnosticado de linfangitis carcinomatosa, cuyo origen era un adenocarcinoma gástrico

The presence of bilateral pulmonary infiltrates is a frequent radiological finding in routine clinical practice. In a middle-aged man is not always indicative of infection and you need to consider other diagnostic entities (non-infectious processes). Suspected pulmonary metastases should be included in these entities, although it is a rare clinical diagnosis. The clinical course is variable and depends on the primary tumor, the patient’s age, cardiopulmonary status thereof and the mechanism of tumor dissemination . Carcinomatous lymphangitis is a rare radiographic pattern of pulmonary metastases and the differential diagnosis includes infectious processes (such as atypical pneumonia) and inflammatory diseases (interstitial pneumonia, hypersensitivity pneumonitis or pulmonary eosinophilia). We report the case of a man with respiratory symptoms and bilateral pulmonary infiltrates who was diagnosed of carcinomatous lymphangitis, whose origin was a gastric adenocarcinoma

Tumor carcinoide bronquial en una mujer de 30 años con sibilancias, tratada inicialmente como asma bronquial / No disponible

Los tumores carcinoides constituyen menos del 5% de todas las neoplasias malignas de pulmón. La clínica asociada con este tumor depende de su localización. Cuando se localiza en la luz bronquial puede producir tos y sibilancias. Presentamos la imagen endoscópica de un tumor carcinoide en una mujer joven que fue diagnosticada inicialmente de asma bronquial con una espirometría con prueba broncodilatadora positiva sin respuesta al tratamiento (AU)

Pulmonary carcinoids represent less than 5% of primary lung tumors. The most common symptoms in bronchial carcinoids are cough and wheezing. We report the case of a young woman who was diagnosed in the first instance of bronchial asthma. The post-bronchodilator test was positive. She didn´t respond to treatment (AU)

Traqueobroncopatía osteocondroplástica: a propósito de dos casos clínicos / Tracheopathia osteochondroplastica: based on two clinical cases

The tracheopathia osteochondroplastica (TO) is a benign and rare disorder, characterized by the deposit of cartilaginous tissue in the submucosa of the larynx, trachea and occasionally the bronchi. Both the etiology and pathogenesis, as well as the incidence and prevalence, of this disease are unknown. In a large series of 16888 bronchoscopies described, the incidence of TO was 1:1299. This is usually an incidental finding when a bronchoscopy is performed for another reason as in the cases presented. Endoscopically, a cobblestone mucosa with yellowish-white nodules protruding into the tracheal lumen and main bronchi is observed. Other symptoms have been hemoptysis and treatment-refractory cough. Despite the low prevalence of this disease, we describe two cases presented in the same hospital, diagnosed by chance when performing a fibrobroncoscopia for the study of a solitary pulmonary nodule (AU)

Fibrosis pulmonar idiopática. Nuevas terapéuticas y evidencia científica / Idiopathic pulmonary fibrosis. New therapies and scientific evidence

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[Pleural empyema associated with endobronchial lipoma]. / Empiema pleural asociado a lipoma endobronquial.

Bronchial benign tumors comprise fewer than 4% of pulmonary neoplasms. Endobronchial lipoma is an extremely rare benign neoplasm accounting for only 0.1% to 0.5% of all lung tumors. Clinical symptoms of lipoma depend on the location of the tumor, the severity of bronchial obstruction, and the functional and anatomical effects on the parenchyma distal to the obstruction. Computed axial tomography usually reveals the adipose composition of the lipomatous tumor. We report the case of an 83-year-old man diagnosed with community-acquired pneumonia that led to complications: pleural empyema caused by Haemophilus influenzae infection and atelectasis of the right middle and lower lobes secondary to a lipomatous endobronchial obstruction. Removal of the bronchial lipoma was performed by laser resection.

Empiema pleural asociado a lipoma endobronquial / Pleural empyema associated with endobronchial lipoma

Los tumores benignos broncopulmonares representan menos del 4% de las neoplasias de origen pulmonar. El lipoma endobronquial es una neoplasia benigna extremadamente rara, cuya incidencia oscila entre el 0,1 y el 0,5% de todos los tumores del pulmón. Los síntomas clínicos dependen de su localización, del grado de obstrucción bronquial y de las consecuencias morfofuncionantes de dicha obstrucción sobre el parénquima distal. La tomografía axial computarizada suele poner de manifiesto el contenido adiposo del tumor. Presentamos el caso clínico de un varón de 83 años diagnosticado de neumonía adquirida en la comunidad, que se complicó con un empiema pleural por Haemophilus influenzae y atelectasia de lóbulos medio e inferior derecho, secundaria a obstrucción endobronquial por lipoma. Se realizó extirpación del lipoma bronquial mediante fotorresección con láser

Bronchial benign tumors comprise fewer than 4% of pulmonary neoplasms. Endobronchial lipoma is an extremely rare benign neoplasm accounting for only 0.1% to 0.5% of all lung tumors. Clinical symptoms of lipoma depend on the location of the tumor, the severity of bronchial obstruction, and the functional and anatomical effects on the parenchyma distal to the obstruction. Computed axial tomography usually reveals the adipose composition of the lipomatous tumor. We report the case of an 83-year-old man diagnosed with community-acquired pneumonia that led to complications: pleural empyema caused by Haemophilus influenzae infection and atelectasis of the right middle and lower lobes secondary to a lipomatous endobronchial obstruction. Removal of the bronchial lipoma was performed by laser resection