Dermatosis acantolítica papular del área genitocrural: ¿ forma localizada de Darier o Hailey-Hailey? / Papular Acantholytic Dermatosis in the Genito-Crural Region: A Localized Form of Darier Disease or Hailey-Hailey Disease?

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Abdominal pain in a young woman (2009: 8b).

Juxtapapillary duodenal diverticula and their possible complications are not frequent findings. We present the case of a woman with a giant juxtapapillary diverticulum, complicated by diverticulitis and areas of perforation of the wall that required urgent surgical treatment. We present the preoperative findings on computed tomography and magnetic resonance imaging.

[Metastasis in the palatine tonsil as the first sign of a gastric adenocarcinoma]. / Metastasis en la amígdala palatina como primera manifestación de un adenocarcinoma gástrico.

Gastric adenocarcinomas rarely give rise to metastases in the palatine tonsils; twelve such cases have been published. In two of them the tonsillar tumour was the first sign of the disease. We present a patient with a tumour of the palatine tonsil and cervical lymph node involvement who was diagnosed as having an adenocarcinoma of "signet ring" cells in the histopathology and cytology studies. Finding such cells directed us to the stomach in our search for the primary.

Metástasis en la amígdala palatina como primera manifestación de un adenocarcinoma gástrico / Metastasis in the palatine tonsil as the first sign of a gastric adenocarcinoma

Los adenocarcinomas gástricos raramente metastatizan en las amígdalas palatinas, habiéndose publicado 12 casos. En 2 de ellos, la tumoración amigdalar fue la primera manifestación de la enfermedad. Presentamos un paciente, con un tumor de amígdala palatina y afectación ganglionar cervical, que fue diagnosticado de adenocarcinoma de células en "anillo de sello" en el estudio histopatológico y citológico. El hallazgo de estas células nos orientó hacia el estómago en la búsqueda del primario (AU)

Gastric adenocarcinomas rarely give rise to metastases in the palatine tonsils; twelve such cases have been published. In two of them the tonsillar tumour was the first sign of the disease. We present a patient with a tumour of the palatine tonsil and cervical lymph node involvement who was diagnosed as having an adenocarcinoma of "signetring" cells in the histopathology and cytology studies. Finding such cells directed us to the stomach in our search for the primary (AU)

[Ochronotic arthropathy: the value of bone scintigraphy in alkaptonuria]. / Artropatía ocronótica: utilidad diagnóstica de la gammagrafía ósea en la alcaptonuria.

We report the case of a 62 year old man diagnosed of alkaptonuria who was referred to our department to undergo bone scintigraphy for polyarthralgia. The patient had a history of pain in lumbar and thoracic spine, right shoulder and left knee. Bone scintigraphy showed multiple joint disease with increased uptake in both shoulders, knees and spine. Higher uptake stood out in painful right shoulder and left knee joints. Ochronotic arthropathy that is developed in alkaptonuric patients is a degenerative joint disease. X-ray studies in this patient showed marked degenerative arthrosis in knees and shoulders, without more intense involvement in the symptomatic joints. Lumbar spine X-rays showed intervertebral disk calcification with disk collapse and fusion of the vertebral bodies with relative sparing of sacroiliac joint, which is a classic feature of ochronotic arthropathy. This case highlights the utility of bone scintigraphy in the evaluation of joint involvement as well as its correlation with clinical course and potential usefulness in the follow-up of this disease.

Artropatía ocronótica: utilidad diagnóstica de la gammagrafía ósea en la alcaptonuria / Ochronotic arthropathy: the value of bone scintigraphy in alkaptonuria. A case report

Presentamos el caso de un varón de 62 años diagnosticado de alcaptonuria remitido a nuestro servicio solicitando un estudio gammagráfico óseo para valoración de su poliartralgia. El paciente refería dolor dorso-lumbar, en hombro derecho y rodilla izquierda. La gammagrafía ósea mostró una afectación poliarticular con hipercaptaciones en ambos hombros, rodillas y columna vertebral. Destacaba la elevada intensidad de captación en las articulaciones dolorosas del hombro derecho y rodilla izquierda. La artropatía ocronótica que desarrollan los pacientes alcaptonúricos es de tipo degenerativo, presentando las radiografías del paciente signos evidentes de degeneración artrósica en rodillas y hombros; sin que existiera una afectación más intensa en las articulaciones sintomáticas. En el estudio radiológico lumbar que se le practicó resalta la calcificación de los espacios intervertebrales con colapso y fusión de los cuerpos vertebrales, junto a la relativa indemnidad de las articulaciones sacroilíacas, hallazgo considerado clásico en la artropatía ocronótica. Este caso destaca la utilidad de la gammagrafía ósea en el diagnóstico de extensión de la afectación articular, así como su correlación con la sintomatología clínica, apuntando su potencial utilidad en la monitorización del seguimiento evolutivo (AU)

We report the case of a 62 year old man diagnosed of alkaptonuria who was referred to our department to undergo bone scintigraphy for polyarthralgia. The patient had a history of pain in lumbar and thoracic spine, right shoulder and left knee. Bone scintigraphy showed multiple joint disease with increased uptake in both shoulders, knees and spine. Higher uptake stood out in painful right shoulder and left knee joints. Ochronotic arthropathy that is developed in alkaptonuric patients is a degenerative joint disease. X-ray studies in this patient showed marked degenerative arthrosis in knees and shoulders, without more intense involvement in the symptomatic joints. Lumbar spine X-rays showed intervertebral disk calcification with disk collapse and fusion of the vertebral bodies with relative sparing of sacroiliac joint, which is a classic feature of ochronotic arthropathy. This case highlights the utility of bone scintigraphy in the evaluation of joint involvement as well as its correlation with clinical course and potential usefulness in the follow-up of this disease (AU)

[Cerebral astroblastoma: report of a case and literature review]. / Astroblastoma cerebral: a propósito de un caso y revisión de la literatura.

We report a new case of low grade astroblastoma of pure type and consider the definition and the clinical, neuroimaging, intraoperative and pathological characteristics of this type of uncommon intracranial tumour. We analyse the differences found in the literature concerning the immunochemistry, genetics and electron microscopy. We point out the lack of protocols for treatment of this type of intracranial tumour, and comment the various hypothesis of its origin.

Astroblastoma cerebral: a propósito de un caso y revisión de la literatura / Cerebral astroblastoma: report of a case and literature review

Se describe un nuevo caso de astroblastoma cerebral puro de bajo grado, considerándose la definición y las características clínicas, de neuroimagen, intraoperatorias y anatomopatológicas de este tipo de tumor poco frecuente. Analizamos las diferencias encontradas en la literatura respecto a los hallazgos inmunohistoquímicos, genéticos y de microscopía electrónica. Llamamos la atención sobre la ausencia de consenso en cuanto al tratamiento de este tipo de tumor. Finalmente citamos las diferentes hipótesis sobre su origen (AU)

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[An ischiorectal abscess due to Actinomyces]. / Absceso isquio-rectal por Actinomyces.

Actinomycosis is a chronic granulomatous inflammatory disease, with fistulization tendency, caused by Actinomyces. The clinical observation in presented of a patient with intermittent fever of three weeks duration, associated to pain and functional impotence of the right hip, observing with CT Scan an ischium-rectal abscess. After spontaneous fistulization, Actinomyces israelii was isolated in the biopsy sample by culture in anaerobic medium, confirming the diagnosis by anatomo-pathology. The patient was treated with intravenous penicillin for six weeks, followed by six months of oral treatment with which the symptoms disappeared and the radiological images normalized. Bone infection ranges between 1 and 15% of total actinomycosis.