Aproximación de la tomografía computarizada de alta resolución a la histología de la enfermedad pulmonar intersticial difusa / Approximation of high resolution computerized tomography to the histology of diffuse interstitial lung disease

Introducción: el diagnóstico de muchos casos de enfermedad pulmonar intersticial difusa (EPID), se realiza por biopsia de pulmón. Elobjetivo del estudio es analizar el valor predictivo de la tomografía computarizada de alta resolución (TCAR) de pulmón en relación con los hallazgos histológicos en el diagnóstico de esta entidad clínica. Material y método: se han recogido las historias clínicas de los pacientes ingresados en nuestro hospital, desde el año 2000 hasta el2006, con el diagnóstico de EPID demostrado por biopsia pulmonar realizada por videotoracoscopia, al no llegar al diagnóstico por otras técnicas menos cruentas. Posteriormente se ha correlacionado el diagnóstico por TCAR, realizado previamente, con el diagnóstico histológico de la biopsia pulmonar. Resultados: de los 51 pacientes estudiados, en 19 la biopsia pulmonar demostró signos de neumonía intersticial usual, diagnosticándose los pacientes de fibrosis pulmonar idiopática (FPI), en 8casos se encontró neumonía organizativa criptogenética (NOC),en 3 casos sarcoidosis, en 5 casos neumonía intersticial no específica y en 4 neumonitis por hipersensibilidad. En los casos restantes, la biopsia pulmonar demostró una miscelánea de otras patologías del intersticio del pulmón. En el conjunto de los 51 pacientes el diagnóstico fue sugerido por el TCAR en 22 casos, que se corresponde con el 43 %de los casos. En el grupo de las FPI, el TCAR sugirió correctamente el diagnóstico en el 37% de los pacientes,mientras que en el grupo de las NOC, el TCAR sugirió este diagnóstico en el 87% de los casos, y en el grupo de sarcoidosis en el100% de los 3 pacientes con esta enfermedad. Conclusiones: El resultado de este estudio, se asemeja a lo que se (..) (AU)

Introduction: the diagnosis of many cases of diffuse interstitial lung disease (DILD) is performed by means of a lung biopsy. The aim of the study is to analyze the predictive value of a high resolution computerized tomography (HRCT) of the lung in relation to the histological findings in the diagnosis of this clinical pathology. Materials and methods: the clinical history of those patients admitted to our hospital between 2000 and 2006, diagnosed with DILD using a lung biopsy performed by video assisted thoracoscopy–as the diagnosis was not obtained by less invasive techniques–were compiled. Subsequently, the diagnosis was correlated by HRCT, carried out previously, with the histological diagnosis of the lung biopsy. Results: of the 51 patients studied, the lung biopsy demonstrated signs of the usual interstitial pneumonia in 19 of these patients; the patients being diagnosed with idiopathic lung fibrosis (ILF), cryptogenic organizing pneumonia (COP) was found in eight cases, sarcoidosis in three, non-specific interstitial pneumonia in five and pneumonitis due to hypersensitivity in four cases. In the remaining cases, the lung biopsy demonstrated miscellaneous pathologies of the lung interstice. In the group of 51 patients, the diagnosis was suggested by the HRCT in 22 cases, which corresponds to 43% of the cases. In the ILF group, the HRCT correctly suggested the diagnosis in 37% of the patients, while in the COP group the HRCT suggested this diagnosis in 87% of the cases, and in the sarcoidosis group in 100% of the 3 patients with this disease. Conclusions: the results of this study resemble those mentioned in (..) (AU)

[Delay between diagnosis and surgical treatment of lung cancer in Virgen Macarena Hospital area]. / Demora desde el diagnóstico hasta el tratamiento quirúrgico del cáncer de pulmón en el área hospitalaria Virgen Macarena de Sevilla.

OBJECTIVE: Lung cancer is the most common cause of death due to cancer in the world. Prognosis depends very much on a precocious diagnosis and treatment, being surgery the one that brings the best life expectancy. We studied the time between the diagnosis and the surgical treatment of lung cancer in the hospital area of Virgen Macarena, Sevilla. Making this way a determination of the surgical delay in the treatment. MATERIAL AND METHODS: We analyzed retrospectively the patients who went under surgical treatment in our area between January 2003 and September 2004. And estimating the time in days, between the dates we obtained the first diagnostic specimen of lung cancer in this patients and the date the surgical treatment was performed. RESULTS: We obtained a median of 31 days with a (recorrido intercuartílico) of 60, and a media of 46.16 with a standard deviation of 34.51. CONCLUSIONS: When we compared the results obtained with that we found published, they were similar to those found in the literature.

Exacerbación aguda de un caso de neumonitis intersticial descamativa tras biopsia pulmonar por videotoracoscopia / Acute exacerbation of desquamative interstitial pneumonia after thoracoscopy lung biopsy

No disponible

[Variability among pathologists in the histological diagnosis of diffuse interstitial lung diseases]. / Variabilidad entre patólogos en el diagnóstico histológico de las enfermedades intersticiales difusas del pulmón.

OBJECTIVE: Diffuse interstitial lung diseases (DILD) form a group of diseases which affect the alveolar interstitial space and share very similar clinical, radiological, and functional features, making lung biopsy essential for establishing diagnosis, prognosis, and treatment in many cases. We aimed to see whether there was agreement in histopathological diagnosis among different groups of pathologists in their assessment of these diseases. MATERIAL AND METHODS: Biopsies were studied from 33 patients suffering from noninfectious, nontumorous DILD. The biopsies had been assessed by 2 groups of pathologists: one specializing in this type of disease and another which was not a specialist group. RESULTS: There was disagreement in the histology reports of 10 out of the 33 cases studied (30.3%): 9 cases in the group of 22 cases of idiopathic interstitial pneumonia (40.9%) and 1 in the group of 3 DILD with known or associated causes. No discrepancies were found, however, in the diagnosis of primary DILD or DILD associated with other, less well-defined processes. CONCLUSIONS: We believe that idiopathic interstitial pneumonias are the DILD which pose most problems for pathologists. Therefore, the study of DILD requires specific dedication by pathologists and other professionals and specialists.

Variabilidad entre patólogos en el diagnóstico histológico de las enfermedades intersticiales difusas del pulmón / Variability among pathologists in the histological diagnosis of diffuse interstitial lung diseases

Objetivo: Las enfermedades pulmonares intersticiales difusas (EPID) son un conjunto de enfermedades que afecta al espacio alveolointersticial, con manifestaciones clínicas, radiológicas y funcionales muy similares, por lo que en muchos casos el estudio de la biopsia pulmonar será fundamental para el diagnóstico, pronóstico y tratamiento. Hemos querido ver si hay o no concordancia histopatológica diagnóstica, entre diferentes grupos de patólogos, en la valoración de estas enfermedades. Material y métodos: Se han estudiado las biopsias de 33 pacientes afectados de EPID no infecciosa ni tumoral, las cuales han sido valoradas por 2 grupos de patólogos: uno con especial interés por este tipo de enfermedades, y otro grupo no dedicado especialmente a esta enfermedad. Resultados: Al confrontar posteriormente los resultados, observamos en los informes histológicos una discordancia en el diagnóstico de 10 de los 33 casos estudiados (30,3%), 9 de ellos en el grupo de las 22 neumonías intersticiales idiopáticas (40,9%) y un caso en el grupo de las 3 EPID de causas conocidas o asociadas. Sin embargo, no encontramos ninguna discrepancia en el grupo de EPID primarias o asociadas a otros procesos no bien conocidos. Conclusiones: Creemos que las neumonías intersticiales idiopáticas son el grupo de EPID que más problemas de diagnóstico histológico pueden plantear al patólogo. Por tanto, es fundamental una especial dedicación por parte de estos profesionales y de los distintos especialistas que están relacionados con el estudio de las EPID

Objective: Diffuse interstitial lung diseases (DILD) form a group of diseases which affect the alveolar interstitial space and share very similar clinical, radiological, and functional features, making lung biopsy essential for establishing diagnosis, prognosis, and treatment in many cases. We aimed to see whether there was agreement in histopathological diagnosis among different groups of pathologists in their assessment of these diseases. Material and methods: Biopsies were studied from 33 patients suffering from noninfectious, nontumorous DILD. The biopsies had been assessed by 2 groups of pathologists: one specializing in this type of disease and another which was not a specialist group. Results: There was disagreement in the histology reports of 10 out of the 33 cases studied (30.3%): 9 cases in the group of 22 cases of idiopathic interstitial pneumonia (40.9%) and 1 in the group of 3 DILD with known or associated causes. No discrepancies were found, however, in the diagnosis of primary DILD or DILD associated with other, less well-defined processes. Conclusions: We believe that idiopathic interstitial pneumonias are the DILD which pose most problems for pathologists. Therefore, the study of DILD requires specific dedication by pathologists and other professionals and specialists

Demora desde el diagnóstico hasta el tratamiento quirúrgico del cáncer de pulmón en el área hospitalaria Virgen Macarena de Sevilla / Delay between diagnosis and surgical treatment of lung cancer in Virgen Macarena hospital area

Objetivo: El cáncer de pulmón es la causa más frecuente de muerte por cáncer en el mundo, dependiendo su pronóstico de la precocidad del diagnóstico y del tratamiento, siendo la cirugía la que mejores probabilidades de supervivencia aporta. Hemos estudiado cual sería el tiempo transcurrido entre el diagnóstico y el tratamiento quirúrgico del cáncer del pulmón en el área hospitalaria Virgen Macarena de Sevilla, para así determinar la demora quirúrgica en el tratamiento. Material y métodos: Hemos analizado retrospectivamente los pacientes operados en nuestra área entre enero del 2003 y septiembre del 2004 y calculando el tiempo transcurrido en días entre la fecha del primer espécimen diagnóstico de cáncer de pulmón en estos pacientes y la fecha de la intervención quirúrgica. Resultados: Obtuvimos una mediana de 31 días con un recorrido intercuartílico de 60 y una media de 46,16 con una desviación estándar de 34.51. Conclusiones: Tras comparar nuestros resultados con los ya publicados, la demora entre el diagnóstico y el tratamiento quirúrgico del cáncer de pulmón en nuestro hospital viene siendo similar a los resultados de la literatura

Objective: Lung cancer is the most common cause of death due to cancer in the world. Prognosis depends very much on a precocious diagnosis and treatment, being surgery the one that brings the best life expectancy. We studied the time between the diagnosis and the surgical treatment of lung cancer in the hospital area of Virgen Macarena, Sevilla. Making this way a determination of the surgical delay in the treatment. Material and methods: We analyzed retrospectively the patients who went under surgical treatment in our area between January 2003 and September 2004. And estimating the time in days, between the dates we obtained the first diagnostic specimen of lung cancer in this patients and the date the surgical treatment was performed. Results: We obtained a median of 31 days with a (recorrido intercuartílico) of 60, and a media of 46.16 with a standard deviation of 34.51. Conclusions: When we compared the results obtained with that we found published, they were similar to those found in the literature

Absceso de pulmón como manifestación de una neoplasia de esófago / Lung Abscess like manifestation of an esophagus neolasia

No disponible

[Disparity between cytohistopathological results of diagnostic specimens and the resected tumor piece in bronchopulmonary carcinoma]. / Disparidad entre los resultados citohistopatológicos de los especímenes diagnósticos y la pieza tumoral resecada en el carcinoma broncopulmonar.

In 88 patients diagnosed and intervened of lung carcinoma, we evaluate the security of the Diagnostic method--cytology: sputum, brushed bronchial, bronchial aspiration, puncture pulmonary aspiration and histology of the bronchial biopsy--when we correlate them with the histology of the dried up tumour. From the 88 patient, in 11 (12.5%) there was a disparity between some specimen and the piece tumour. If we analyze the specimen: the bronchial biopsy, was different in 3 cases, (4.8%); the brushed and the bronchial biopsy, aspiration in 2, (2.7% and 2.3% respectively); the puncture pulmonary aspiration in 6, (26%) and the cytology of sputum in 2 cases, (2.4%). In 8 patients (9%), the outputs of some specimen were not conclusive, if we remove these we find that: the bronchial biopsy was not conclusive in 2 cases, (3.2%), the brushed bronchial in 5, (6.8%); the bronchial aspiration in 9 (10.2%) and the cytology of sputum in 2 cases, (2.4%). With this data we could infer that sometimes the positive outputs of the specimen have no correlation with the histology of the tumour dried up. This disparity has not been observed in the oat-cells. Therefore when we send the specimens to the pathologist, it would always be advisable for him to inform us if there are any different cells belonging to the principal group of the tumor.