Linfangiectasia renal: achado incidental em tomografia computadorizada multicorte e revisão da literatura / Renal lymphangiectasia: incidental finding at multislice computed tomography and literature review

Linfangiectasia renal é uma condição rara, caracterizada por coleções parapiélicas e perirrenais, que pode progredir de assintomática para insuficiência renal crônica. É apresentado um caso de achado incidental em tomografia computadorizada de linfangiectasia renal bilateral em paciente assintomático, com descrição dos principais achados à luz dos métodos de imagem e ampla revisão da literatura.

Renal lymphangiectasia is a rare condition characterized by parapyelic and perirenal fluid collections, which may progress from asymptomatic condition to chronic renal failure. The present report describes a case of incidental computed tomography finding of bilateral lymphangiectasia in an asymptomatic patient, as well as the main imaging findings with a comprehensive literature review.

Coexistence of prostate cancer, gynecomastia, renal failure, melanonychia, and wrist lump.

Although prostate cancer is among the most frequent malignancies in the elderly, this tumor may be under-reported, and it seems that its socioeconomic burden is not well-estimated. Chronic urinary obstruction caused by the cancer may cause renal failure, with hemorrhagic tendency, neurologic disturbances, cutaneous disorders, and diverse fingernail changes. Black or brown nail pigmentation has been associated with benign and malignant conditions, including antineoplastic drugs' side effects, subungual metastases, and melanoma. Metastasis of fingernail melanoma can affect lymph nodes from the wrist to elbow and axillary regions. Coexistent melanonychia and wrist lump, mimicking melanoma with sentinel lymph node is reported. It is recommended to consider the differential diagnosis of nail changes due to chronic renal failure.

Abscesso hepático tardio em paciente com pancreatocistojejunostomia em Y de Roux / Late hepatic abscess in a patient with Roux-en-Y pancreatocysto Jejunostomy

Abscessos hepáticos piogênicos usualmente decorrem de doenças biliares ou infecções hematogênicas. Relata se um caso de abscesso hepático em homem com anastomose em Y de Roux realizada há mais de duas décadas para tratamento de pseudocisto pancreático. O paciente relatou etilismo, hipertensão portal, pancreatite crônica e diabetes. Os estudos microbiológicos e exames histopatológicos não revelaram agentes infecciosos, e o tratamento consistiu de drenagem cirúrgica e antibioticoterapia. Enfatizam-se as dificuldades para estabelecer o diagnóstico etiológico e a possibilidade de um abscesso hepático tardio ocorrer em associação com pancreatocistojejunostomia e anastomose em Y de Roux.

Pyogenic liver abscesses are usually due to biliary diseases or hematogenic infections. A case of liver abscessis reported in a male with a Roux-en-Y anastomosis performed more than two decades before treating a pancreaticpseudocyst. The patient reported alcoholism, portal hypertension, chronic pancreatitis and diabetes. Microbiologic and histopathology studies did not reveal infectious agents and the treatment consisted of surgical drainage and antibiotic course. Diagnostic challenges in etiologic diagnosis and the possible occurrence of a late hepatic abscess associated with pancreatocystojejunostomy and Roux-en-Y anastomosis are emphasized.