[National guidelines of diagnosis and treatment of the non-Hodgkin lymphoma]. / Guías nacionales de diagnóstico y tratamiento de linfoma no Hodgkin.

Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.

Extranodal nasal NK/T-cell lymphoma with dissemination to the central nervous system: a case report.

BACKGROUND: Lymphomas that infiltrate the nervous system in children correspond to those of precursor B cells, such as lymphoblastic and Burkitt's lymphoma. In adults, infiltration occurs in mature B-cell lymphomas, such as mantle cell lymphoma, and, rarely, in Hodgkin's lymphoma or peripheral NK/T-cell lymphomas. CASE: We report the case of a 48-year-old man, who two years before death was diagnosed with extranodal nasal NK/T-cell lymphoma nasal in the left nostril. He received radiotherapy and a year later presented tumor activity. He also presented infiltration to the bone marrow and underwent chemotherapy. Afterward, he presented paresthesia and paresis of the lower extremities, difficulty walking, loss of sphincter control, and seizures. Infiltration to the central nervous system was revealed by computed axial tomography, and cytologic study of cerebrospinal fluid revealed malignant lymphoid cells; he then received intrathecal chemotherapy. He died 3 months later. CONCLUSION: In Mexico, extranodal nasal NK/T-cell lymphoma occurs frequently. It is highly destructive and tightly related with the Epstein-Barr virus. Infiltration to the central nervous system is rare, and the neoplastic cells can be confused with other tumors, such as metastatic carcinomas.

Diagnosis of thymolipoma with fine needle aspiration biopsy. Report of a case initially misdiagnosed as liposarcoma.

BACKGROUND: Thymolipomas are the most outstanding mesenchymal mediastinal tumors although they represent only a small percentage of thymic neoplasms. Their histogenesis remains unsolved, and they are usually benign. Fine needle aspiration biopsy (FNAB) has become the method of choice for the study of mediastinal tumors, including thymolipomas. Making the correct diagnosis depends on the availability of all thymic and lipomatous components as well as on the correct application of a differential diagnosis with other lipomatous tumors. CASE: A 24-year-old woman had a 3-month history of coughing with sputum, fever, asthenia, adynamia, headaches and anemia. Physical examination revealed a bilateral pulmonary condensation syndrome. Imaging studies showed a well-defined, large mass occupying both hemithoraxes and the mediastinum. FNAB revealed an admixture of atypical adipocytes, nonneoplasic lymphoid tissue and capillaries with prominent endothelium. An initial diagnosis of well-differentiated liposarcoma was made. A 2.8-kg, encapsulated, yellowish gray mediastinal tumor was surgically removed. Mature adipose tissue intermingled with abundant thymic tissue containing numerous Hassall's corpuscles were seen histologically. Immunohistochemical markers for thymic epithelium, lymphoid tissue and adipocytes were all positive. Thymolipoma was the final diagnosis. The anemia subsided with resection of the tumor, and the patient was disease free 2.5 years after surgery. CONCLUSION: To the best of our knowledge, this is the second report of a thymolipoma studied with FNAB. The criteria for the differential diagnosis between thymolipomas and other lipomatous tumours should be kept in mind.

Fibrosis hepática congénita. Presentación de un caso y revisión de la literatura / Congenital hepatic fibrosis. Report of a case and review of the literature

Se presenta un caso de fibrosis hepática congénita en un paciente adulto de sexo femenino de 32 años de edad, que curso con síndrome de hipertensión porta e insuficiencia renal crónica; la paciente fallecio a consecuencia de hemorragia masiva por várices esofágicas rotas. Se revisa la literatura referente al tema y se hace énfasis en el diagnóstico diferencial .