Diagnóstico y manejo del derrame pleural maligno / Diagnosis and management of the malignant pleural. Efussion

El derrame pleural maligno es una entidad frecuente y debilitante, manifestación de la enfermedad neoplásica avanzada. Su presencia empeora la calidad de vida del paciente e implica una esperanza de vida reducida a unos pocos meses. Previo a iniciar un tratamiento, se debe diagnosticar el derrame pleural como maligno mediante una citología de líquido pleural y/o una histología de pleura positiva para malignidad, lo que a veces requiere emplear varios procedimientos diagnósticos.Una vez diagnosticado, se plantean una serie de consideraciones que el facultativo debe tener en cuenta a la hora de desarrollar una estrategia terapéutica. Factores, como el estado general del paciente y su índice de calidad de vida, parámetrosradiológicos y bioquímicos del derrame y las distintas opciones terapéuticas deben considerarse para conseguirel objetivo principal del tratamiento que es aliviar la sintomatología, así como evitar la reaparición del derrame. La pleurodesis con talco (mediante talco en slurry o talco poudrage) es la técnica más empleada y que ofrece mejores resultados aunque no está exenta de posibles complicaciones

TMalignant pleural effusion is a frequent and weakening entity, manifestation of advanced neoplastic disease. Its presence deteriorates the patient's quality of life and implies a life expectancy that is reduced to a few months. Prior to initiating treatment, the pleural effusion should be diagnosed as malignant by means of a pleural fluid cytology and/or histologyof pleura positive for malignancy. This often requires the use of several diagnostic procedures. Once diagnosed, a series of consideration that the professional should take into account when planning a therapeutic strategy are established.These are factors such as the patient's general condition and quality of life index, radiological and biochemical parameters of the effusion. Furthermore, the different therapeutic options should be considered to achieve the primary objective of the treatment, this being to relieve the symptoms and avoid the reappearance of the effusion. Talc pleurodesis (via slurry or poudrage) is the technique used most and the one that offers the best results, although it is not exemptof possible complications (AU)

Carcinoma arising in the pleural cavity following pneumonectomy for hydatid disease.

We report a case of carcinoma following 42 years of chronic empyema in a patient who underwent surgery for a hydatid cyst at the age of 3. At the time of diagnosis, an esophageal fistula was observed and treated with cyanoacrylate. We hypothesize that chronic inflammation of the pleura, caused by decades of empyema, associated with the presence of heterotopic squamous epithelium due to a long-standing esophago-pleural fistula, led to neoplastic transformation.

Plasmocitoma costal solitario / Solitary plasmacytoma in a rib

No disponible

Elastofibroma bilateralde la pared torácica / Bilateral elastofibroma of the thoracic wall

No disponible

Seudoaneurisma arterial pulmonarsecundario a cateterismo coronario / Pulmonary artery pseudoaneurysm secondary to coronary catheterizarion

No disponible

Lipoma mediastínico y síndrome de vena cava superior / Mediastal lipoma and superior vena cava syndrome

No disponible

Enfisema grave con disnea incapacitante: ¿cirugía de reducción de volumen o trasplante pulmonar? / Severe emphysema with incapacitating dyspnea: lung volume reduction surgery or transplantation?

No disponible

[Mediastinal epithelioid hemangioendothelioma]. / Hemangioendotelioma epitelioide mediastínico.

The epitheloid hemangioendothelioma (EH) is a rare tumor of vascular origin, which exceptionally manifestates as a mediastinic mass. We present a new case of location at the upper cava vein and we review the clinical, histological and therapeutic characteristics of the EH.

[Osteochondroplastic tracheopathy. Diagnostic confirmation. Experience with 8 cases]. / Traqueopatía osteocondroplásica. Confirmación diagnóstica. Experiencia en 8 casos.

We report our experience in 8 patients with osteochondroplastic tracheopathy and consider the importance of its diagnosis y biopsy in order to confirm histology and if possible etiology, because specific treatment could change the course of the disease. Methods such as radiology, CT-scan, respiratory function tests only give diagnostic suspicion, which is a previous step before confirmation by bronchoscopy with biopsy. To date, with the exception of a few cases, the diagnosis is made by necropsy. Thus, this justifies our emphasis in the diagnosis of this rare disease when it is suspected in living patients.

[Correlations between PRL and 17-beta-E in human breast cancer]. / Correlaciones entre PRL y E. 17 beta en el cáncer de mama humano.

The authors study the correlation existing between prolactin and E-17-beta in breast cancer. In both premenopausal and post-menopausal patients prolactin may be useful as an evolutive marker. Prolactin increases particularly as a consequence of the metastatic growth. E-17-beta shows no variation when studied during the luteal phase, diminishes after the extirpation of the primitive tumor, and augments again with metastases development. After chemotherapy the amount of E-17-beta becomes almost undetectable. No correlation was found between prolactin and E-17-beta; apparently, the prolactin increase does not depend directly from the amount of circulating estradiol, but relies on the activity of the hypothalamic-hypophyseal system. With regard to E-17-beta, this product also augments after ovariectomy, suggesting an ectopic production starting on adrenal gland precursors, perhaps modulated by prolactin.