RESUMO
The causes of colonic obstruction are protean. Less common is the diagnosis of eosinophilic gastroenteritis (EGE). EGE is more common as a cause of more proximal bowel obstruction. To our knowledge, this case represents one of the only reported cases of such a lesion causing obstruction in the cecum.
Assuntos
Doenças do Ceco/diagnóstico , Eosinofilia/diagnóstico , Gastroenterite/diagnóstico , Obstrução Intestinal/diagnóstico , Idoso , Doenças do Ceco/patologia , Doenças do Ceco/cirurgia , Ceco/patologia , Ceco/cirurgia , Eosinofilia/patologia , Eosinofilia/cirurgia , Feminino , Gastroenterite/patologia , Gastroenterite/cirurgia , Humanos , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgiaRESUMO
Two children are reported with hemangioendothelioma of the hepatobiliary system. One patient, a 7-month-old girl, presented with classic symptomatology of hepatomegaly and congestive heart failure, but did not have any cutaneous lesions. She was treated with systemic steroids and supportive therapy and did very well. The other patient, a 22-month-old boy, is the first patient reported with exclusive involvement of the extrahepatic biliary tree. His symptoms included hepatomegaly and obstructive jaundice. He was evaluated with an endoscopic retrograde cholangiopancreatogram and a transhepatic cholangiogram. He did very well after resection of the lesion and Roux-en-Y drainage of the proximal biliary tree and remains asymptomatic 2 years after surgery.
Assuntos
Neoplasias do Sistema Biliar/complicações , Colestase/etiologia , Hemangioendotelioma/complicações , Hepatomegalia/etiologia , Neoplasias Hepáticas/complicações , Neoplasias do Sistema Biliar/diagnóstico , Neoplasias do Sistema Biliar/terapia , Feminino , Insuficiência Cardíaca/etiologia , Hemangioendotelioma/diagnóstico , Hemangioendotelioma/terapia , Humanos , Lactente , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapiaRESUMO
The microgranular form of acute promyelocytic leukemia (APL) was described in the late 1970s and adopted by the French, American, and British classification system in the early 1980s. Morphologically, this form shows distinct differences from the classic form of APL, but clinically it shares many of the same traits. Among these is the predilection for coagulopathies, including disseminated intravascular coagulation (DIC). This DIC has been associated with one previously reported case of fatal hepatic vein thrombosis (Budd-Chiari syndrome), in association with an untreated case of APL. The authors present a case of the microgranular variant of acute promyelocytic leukemia (FAB-M3V), with autopsy and electron microscopic evidence in support. It is important to recognize this variant form of APL and its association with hepatic vein thrombosis, because any successful attempt at therapy must be instituted early in the course of the disease.
Assuntos
Síndrome de Budd-Chiari/complicações , Leucemia Promielocítica Aguda/complicações , Adulto , Medula Óssea/patologia , Medula Óssea/ultraestrutura , Síndrome de Budd-Chiari/patologia , Coagulação Intravascular Disseminada/complicações , Feminino , Humanos , Leucemia Promielocítica Aguda/patologia , Microscopia EletrônicaRESUMO
Giant intraluminal polyps of the esophagus are relatively rare. Their diagnosis often presents a confusing picture; radiographic studies are frequently misinterpreted as achalasia, and the endoscopic picture is often difficult to interpret. This report describes the case histories of three patients with giant intraluminal polyps of the esophagus. Each presents slightly different clinical features. The signs and symptoms are discussed in terms of the pathophysiology. Common pitfalls in diagnosis are reviewed. Suggestions to enable more accurate identification of these lesions are given. Finally, a systemic approach to treatment is outlined which offers the patient symptomatic relief while minimizing surgical complications and morbidity.