Quiste de duplicación gástrica de epitelio respiratorio: una lesión infrecuente de difícil diagnóstico diferencial / Gastric duplication cyst with respiratory epithelium: An uncommon injury that has a difficult diferential diagnosis

No disponible

¿Somos lo que comemos? Un estudio sobre la composición tisular y microbiológica de la carne picada de vacuno / Are we what we eat? A study of the tissue composition and microbiology of minced beef

En los últimos años en nuestro país se ha incrementado el consumo de carne picada, como reflejo de la actual crisis económica. Con el objeto de conocer la composición tisular y microbiológica de estos preparados cárnicos, se diseñó un estudio en el que se adquirieron siete envases de carne picada de vacuno en grandes superficies elegidas al azar, en el territorio de la comunidad de Madrid. Estos casos fueron procesados de forma convencional (fijación en formol e inclusión en parafina) para realizar un examen de su composición tisular y evaluar su estado de preservación con métodos convencionales de microscopía óptica. Se procedió a realizar antes de la fijación tisular, un cultivo microbiológico adicional. Los datos obtenidos reflejan en general la existencia de productos alimentarios de baja calidad y mal preservados, contaminados frecuentemente con flora bacteriana de tipo fecal (AU)

During recent years, probably due to the economic crisis, there has been an increase in the consumption of minced beef in Spain. A study was carried out to determine the tissue and microbiological composition of the minced beef on sale. Seven packets were bought randomly from shops throughout the region of Madrid and their contents processed with formalin fixation and paraffin embedding and examined by optical microscopy to examine tissue composition and the state of preservation. A microbiological study was also carried out. We found that these meat products were of poor quality, badly preserved and frequently contaminated with faecal bacteria (AU)

Hiperplasia nodular regenerativa hepática como complicación tardía de la artritis idiopática juvenil de inicio sistémico / Nodular regenerative hyperplasia of the liver as a complication of long-standing systemic-onset juvenile idiopathic arthritis

No disponible

Paniculitis mesentérica como causa de dolor abdominal crónico / Mesenteric panniculitis as a cause of chronic abdominal pain

No disponible

Factors associated to temporal artery biopsy result in suspects of giant cell arteritis: a retrospective, multicenter, case-control study.

PURPOSE: To evaluate the positivity rate of temporal artery biopsies (TAB) performed in suspects of giant cell arteritis (GCA) and to study the epidemiological and clinical factors associated to the biopsy result. METHODS: A retrospective, multicenter, case-control study was performed, including three hundred and thirty-five patients who underwent TAB for a suspicion of GCA from 2001 to 2010. Clinical, epidemiological and pathology data were recovered from the patients' clinical records. Histologic diagnosis of GCA was made when active inflammation or giant cells were found in the arterial wall. RESULTS: Eighty-one biopsies (24.2%) were considered positive for GCA. Clinical factors independently associated to TAB result in a logistic regression analysis were temporal cutaneous hyperalgesia (OR = 10.8; p < 0.001), jaw claudication (OR = 4.6; p = 0.001), recent-onset headache (OR = 4.4; p = 0.001), decreased temporal pulse (OR = 2.8; p = 0.02), pain and stiffness in neck and shoulders (OR = 2.3; p = 0.05), unintentional weight loss (OR = 1.33; p = 0.003) and age (OR = 1.085; p = 0.004). Other factors such as length of the surgical specimen (OR = 1.079; p = 0.028) and erythrocyte sedimentation rate (OR = 1.042; p < 0.001) were also statistically significant. The model was accurate (C-index = 0.921), reliable (pHosmer-Lemeshow = 0.733) and consistent in the bootstrap sensitivity analysis. No significant association was detected between TAB result and number of days of previous systemic corticosteroid treatment (p = 0.146). However, an association was observed between TAB result and the total accumulated dose of previous systemic corticotherapy (p = 0.043). CONCLUSIONS: Exhaustive anamnesis and clinical examination remain of paramount importance in the diagnosis of GCA. To improve the yield of TAB, it should be performed specially in older patients with GCA-compatible clinic. TAB could be avoided in patients with an isolated elevation of acute phase reactants, without GCA-compatible clinic.

Cutaneous nodules as a diagnostic clue in multiple myeloma.

Cutaneous plasmacytomas are monoclonal proliferations of plasma cells which can be classified into primary (with no other concomitant bony or extramedullary disease) or secondary (generally associated with multiple myeloma (MM), extramedullary plasmacytoma, or plasma cell leukemia). Cutaneous plasmacytomas can appear in some patients with MM and, rarely, the skin lesions suppose the first clinical manifestation of the disease. Their development is considered as a poor prognostic sign, associated with a life expectancy of less than 12 months after diagnosis. An unusual case of MM is described, in which the histopathological study of a skin nodule provided invaluable information for diagnosis.

Acute hemorrhage in a colloid cyst of the third ventricle: A rare cause of sudden deterioration.

BACKGROUND: Acute neurological deterioration and death in a patient harboring a colloid cyst of the third ventricle remains a poorly understood phenomenon. Sudden neurological derangement caused by spontaneous bleeding within a colloid cyst is a rare and potentially fatal event, usually requiring immediate diagnosis and emergency surgical treatment. CASE DESCRIPTION: A 47-year-old male presented with acute right-sided hemiparesis and speech impediment, followed by rapid deterioration of consciousness. Neuroimaging studies showed a rounded mass at the roof of the anterior third ventricle, causing biventricular hydrocephalus along with a left-sided basal ganglia hematoma. The lesion showed scattered foci of a recent hemorrhage which extended into the left lateral ventricle. Surgical treatment involved emergency external ventricular drainage followed by the prompt elective total resection of the lesion via a transcallosal route. Pathological findings confirmed the diagnosis of a colloid cyst with focal areas of vascular congestion and blood extravasation within its wall. CONCLUSIONS: Spontaneous bleeding into a colloid cyst of the third ventricle may cause acute obstructive hydrocephalus and intracranial hypertension due to rapid enlargement of the lesion. This event may account for the sudden neurological deterioration and/or death observed in a previously asymptomatic patient. The diagnosis of hemorrhagic phenomena within a colloid cyst represents a challenge due to the variable signal usually displayed by these lesions on computed tomography (CT) and magnetic resonance imaging (MRI). Emergency ventricular drainage followed by elective tumoral removal constitutes a valid and safe treatment strategy.

Neoplasias mucinosas papilares intraductales de páncreas: presentación de dos casos / Intraductal papillary mucinous neoplasm of the pancreas: a report of two cases

Las neoplasias mucinosas papilares intraductales de páncreas (NMPI) constituyen una entidad bien reconocida, relativamente rara, entre las neoplasias pancreáticas. La OMS las define como neoplasias papilares productoras de mucina que se desarrollan en el conducto de Wirsung o en sus ramas principales. Presentamos 2 casos de NMPI. El primero corresponde a un varón de 69 años que presenta una tumoración única de 7,5cm en cabeza de páncreas con dilatación del conducto de Wirsung que se diagnosticó como NMPI de tipo intestinal. El segundo se trataba de una mujer de 60 años con una tumoración quística multifocal en cabeza de páncreas de 2cm y afectación del borde de resección del cuerpo y la cola del páncreas que se diagnosticó como NMPI de tipo foveolar. En el estudio inmunohistoquímico, las tumoraciones presentaron una expresión diferente para citoqueratinas, siendo la NMPI de tipo intestinal positivo para CK-7 y CK-20 y negativo para CK34βE12; y el foveolar, positivo para CK-7 y CK34βE12 y negativo para CK-20. Estas neoplasias tienen un pronóstico excelente tras la cirugía en ausencia de componente invasor. La diferente expresión de citoqueratinas encontradas en nuestro estudio puede ser útil para determinar el tipo de neoplasia en biopsias de pequeño tamaño(AU)

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a well known but relatively infrequent entity. The World Heath Organization defines it as a papillary mucin producing neoplasm developing in the duct of Wirsung or in its principal branches. We present two cases of IPMN of the pancreas. The first was diagnosed as an intestinal type IPMN occurring in a 69 year old male who presented with a single, 7.5cm tumour in the head of the pancreas with a dilated duct of Wirsung. The second case was a foveolar type IPMN found in a 60 year old woman with a 2cm, multifocal, cystic tumour in the head of the pancreas involving the resection margins in the body and tail of the pancreas. The immunohistochemistry revealed a different expression of cytokeratins in each case; the intestinal type IPMN was positive for CK7 and CK20 and negative for CK34βE12, whilst the foveolar type tumour was positive for CK7 and CK34βE12 but negative for CK20. The post operative prognosis is excellent when no invasion has occurred. The difference in cytokeratin expression found in the reported cases could prove useful in the diagnosis of small biopsy samples(AU)