RESUMO
OBJECTIVES: Chronic diarrhea of unknown origin is often associated with bile acid malabsorption, the pathogenetic role of which is uncertain. The aim of this study was to identify morphological abnormalities in the ileal and colonic mucosa in patients with this disorder. METHODS: We performed a prospective and blinded histopathological study (between June 1991 and November 1992) of endoscopic biopsies of the distal ileum and colon of 23 patients suffering from chronic diarrhea of unknown origin. In 14, the SeHCAT (75-selena-homo-cholic acid taurine) test was abnormal owing to bile acid malabsorption; in the other nine, the diarrhea control group, the test results were normal. A detailed evaluation of surface epithelium, immune response and inflammatory changes was made. RESULTS: in two patients and two controls, mild villous atrophy was observed; there was also slight inflammation of the ileal and colonic mucosa occurring with the same frequency in both groups. A slight replacement of goblet cells was more evident in the diarrhea control group. CONCLUSIONS: Chronic diarrhea of unknown origin associated with bile acid malabsorption does not involve specific morphological changes of ileal or colonic mucosa, and its pathogenesis must be looked for in dysfunction of the ileum and/or colon.
Assuntos
Ácidos e Sais Biliares/metabolismo , Colo/patologia , Doenças Funcionais do Colo/complicações , Diarreia/patologia , Íleo/patologia , Radioisótopos de Selênio , Ácido Taurocólico/análogos & derivados , Adulto , Idoso , Doença Crônica , Diarreia/etiologia , Diarreia/metabolismo , Feminino , Humanos , Absorção Intestinal , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
An uncommon case of huge pineal germinoma without associated ventricular enlargement is presented. The tumor extended supratentorially in dumb-bell form to affect both cerebral hemispheres, simulating a glioma at neuroradiological examinations. Subtotal removal through a bilateral parieto-occipital approach plus radiation therapy were followed by relief of symptoms for over one year since surgery. The misleading patterns of the tumor and the delayed onset of symptoms in our case are outlined.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Pinealoma/diagnóstico por imagem , Adolescente , Neoplasias Encefálicas/patologia , Angiografia Cerebral , Diagnóstico Diferencial , Humanos , Masculino , Glândula Pineal/patologia , Pinealoma/patologia , Tomografia Computadorizada por Raios XRESUMO
Two cases of paraventricular cavernous angiomas are presented. In one, the cavernous angioma was found in the right wall of the fourth ventricle, and in the other in the right thalamus encroaching upon the third ventricle. Both patients had onset of symptoms suggesting a tumor. Good results were obtained by the microsurgical approach to these malformations. The computerized tomography findings typical of cavernous angiomas are reviewed
Assuntos
Neoplasias Encefálicas/cirurgia , Hemangioma Cavernoso/cirurgia , Adulto , Neoplasias Encefálicas/patologia , Feminino , Hemangioma Cavernoso/patologia , Humanos , Masculino , MicrocirurgiaRESUMO
Five cases of cerebral cavernous angiomas in children are presented. Three children had seizures as the sole manifestation of the lesion, and two had intracerebral bleeding. These malformations are encountered more commonly in adults in the third to fifth decade, and are found most frequently in the white matter of the cerebral hemispheres. Intracranial bleeding, seizures, headaches, and slowly developing focal signs are the usual presenting complaints. In childhood, seizures are the initial symptom of the malformation in many cases. The value of computerized tomography (CT) in the detection of such malformations is stressed, and CT findings that are characteristic of cavernous angiomas are described.
Assuntos
Neoplasias Encefálicas/cirurgia , Lobo Frontal/cirurgia , Hemangioma/cirurgia , Lobo Occipital/cirurgia , Lobo Parietal/cirurgia , Adolescente , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Lobo Frontal/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Humanos , Masculino , Lobo Occipital/diagnóstico por imagem , Lobo Parietal/diagnóstico por imagem , Radiografia , Convulsões/etiologiaAssuntos
Diarreia Infantil/terapia , Enteropatias/diagnóstico , Antibacterianos/uso terapêutico , Resina de Colestiramina/uso terapêutico , Doença Crônica , Cromolina Sódica/uso terapêutico , Diarreia Infantil/etiologia , Disgamaglobulinemia/complicações , Enterocolite Pseudomembranosa/complicações , Humanos , Lactente , Recém-Nascido , Enteropatias/etiologia , Enteropatias/terapia , Síndromes de Malabsorção , Doenças Parasitárias/complicações , Prednisolona/uso terapêutico , Enteropatias Perdedoras de ProteínasRESUMO
A case of sublingual rhabdomyoma (adult type) in a 40-year-old man is reported. A review of the world literature revealed 28 acceptable previous cases.