Russell body duodenitis: a rare condition.

Russell bodies are accumulations of immunoglobulins within hyperstimulated plasma cells of the intestinal mucosa associated with chronic inflammation of benign progression, but may be confused with lymphoplasmacytic lymphoma, MALT lymphoma, multiple myeloma, or "signet-ring" cells, among others. There are few cases of gastric involvement, but duodenal involvement is even rarer with less than 10 published cases. Endoscopic examination with quality biopsies and anatomopathologic analysis with immunohistochemistry are essential to make an adequate differential diagnosis with other more severe processes. In any case, the treatment is that of the underlying disease.

Liposarcoma pleomórfico originado en una localización inusual. Presentación de caso / Pleomorphic liposarcoma arising in an unusual site. A case report

Los liposarcomas son el grupo más común de las neoplasias mesenquimatosas malignas. Suelen aparecer en las extremidades y en el retroperitoneo. Es excepcional su localización intestinal. Se presenta el caso de un varón de 75 años que fue hospitalizado por anemia severa, en cuya TC se objetivó un engrosamiento de asa yeyunal de 5cm sospechoso de neoplasia. Se realizó resección parcial de intestino delgado. Macroscópicamente se identificó una tumoración polipoide ulcerada de 12×6cm. Microscópicamente se observó una neoplasia bien delimitada, ulcerada, de transición abrupta con una mucosa circundante normal, compuesta por lipoblastos pleomórficos sobre un fondo sarcomatoso. Existen muy pocos casos publicados de liposarcomas intestinales, la mayoría de los cuales eran liposarcomas bien diferenciados o desdiferenciados. Se presenta el caso de un liposarcoma pleomórfico de intestino delgado por su excepcional localización y la importancia en su diagnóstico diferencial.(AU)

Liposarcomas are the most common group of malignant mesenchymal neoplasms. They usually occur in the extremities and the retroperitoneum and only rarely in the intestine. We report the case of a 75-year-old man presenting with severe anaemia. A CAT scan revealed a 5cm thickening of the jejunal loop, arousing the suspicion of a neoplasm. A partial resection of the small intestine was performed. Macroscopy showed a 12×6cm ulcerated, polypoid mass. Microscopically, a well circumscribed, ulcerated tumour was seen, which had well-defined margins with the surrounding normal mucosa. It consisted of pleomorphic lipoblasts within a sarcomatous background. Very few cases of intestinal liposarcomas have been published and the majority report well-differentiated or undifferentiated liposarcomas. We present a case of a pleomorphic liposarcoma of the small intestine, which is an unusual location and emphases the importance of a comprehensive differential diagnosis.(AU)

[Pleomorphic liposarcoma arising in an unusual site. A case report]. / Liposarcoma pleomórfico originado en una localización inusual. Presentación de caso.

Liposarcomas are the most common group of malignant mesenchymal neoplasms. They usually occur in the extremities and the retroperitoneum and only rarely in the intestine. We report the case of a 75-year-old man presenting with severe anaemia. A CAT scan revealed a 5cm thickening of the jejunal loop, arousing the suspicion of a neoplasm. A partial resection of the small intestine was performed. Macroscopy showed a 12×6cm ulcerated, polypoid mass. Microscopically, a well circumscribed, ulcerated tumour was seen, which had well-defined margins with the surrounding normal mucosa. It consisted of pleomorphic lipoblasts within a sarcomatous background. Very few cases of intestinal liposarcomas have been published and the majority report well-differentiated or undifferentiated liposarcomas. We present a case of a pleomorphic liposarcoma of the small intestine, which is an unusual location and emphases the importance of a comprehensive differential diagnosis.

Validez de la ecografía abdominal en Atención Primaria para detección de aneurisma de aorta abdominal en varones de entre 65 y 75 años / Validity of the abdominal ecography in primary care for detection of aorta abdominal aneurism in male between 65 and 75 years

Objetivos: Determinar la validez de la ecografía en Atención Primaria (AP) para detección de aneurisma de aorta abdominal (AAA) en varones de 65 a 75 años y la concordancia interobservador en el diagnóstico entre médicos de AP y el referente del área (Cirugía Vascular). Estimar la prevalencia de AAA en dicha población y su relación con factores de riesgo. Diseño: Estudio descriptivo transversal. Emplazamiento: Centros de Salud Coto y Calzada II (Gijón). Participantes: Varones nacidos entre el 1/1/1939 y el 31/12/1950. Intervención: De 2.511 varones se seleccionaron 407 mediante muestreo aleatorizado estratificado. Se realizó medición ecográfica del diámetro aórtico. Se derivaron para segunda medida en Cirugía Vascular a aquellos con ≥ 3 cm y un 20% de los < 3 cm. Variables: Dependiente: presencia/ausencia de aneurisma; independientes: edad, perímetro abdominal, tabaco, hipertensión arterial, diabetes, dislipidemia, antecedentes familiares de AAA, accidente cerebrovascular y enfermedad coronaria. Análisis estadístico: inferencia bayesiana con modelos para proporciones y regresión logística multivariante. Resultados: De 304 ecografías realizadas, fueron derivados 13 sujetos con sospecha de AAA y 63 con ecografía normal. Se obtuvo una sensibilidad del 93,3% y una especificidad del 98,5% con intervalo de credibilidad (ICred) del 95% (75,4-99,9% y 94,3-100%), respectivamente; una prevalencia del 4,6% (ICred95%: 2,5-7,2%) y coeficiente de correlación intraclase entre AP y Cirugía Vascular de 0,88 (ICred95%: 0,79-0,94). Edad, tabaco, hipertensión, dislipidemia y diabetes mostraron incrementar de forma relevante la odds de prevalencia de AAA. Conclusiones: La ecografía en AP realizada por médicos de familia tras una formación básica para detección de AAA muestra muy alta validez diagnóstica. Habría que valorar con estudios más amplios de efectividad la pertinencia de implantar un sistema de detección precoz de AAA en población de riesgo

Objective: To determine the usefulness of ultrasound examination in Primary Care (PC) for the detection of abdominal aortic aneurysm (AAA) in male patients from 65-75 years old, as well as the consistency between observers on the diagnosis between general practitioners and the reference specialty in this area, Vascular Surgery. To estimate the prevalence of AAA in that population and its association with risk factors. Design: Cross-sectional descriptive study. Location: Healthcare Centres of Coto and Calzada II (Gijón, Spain). Participants: Males born between 1 January 1939 and 31 December 1950. Interventions: From the 2,511 males found, 407 were selected using stratified random sampling. Aortic diameter was measured, with those ≥ 3 cm and 20% from the < 3 cm being referred for a second measurement by a vascular surgeon. Variables: Dependent: presence/absence of aneurism. Independent: age, abdominal perimeter, smoking, arterial hypertension, diabetes, dyslipidaemia, familial cases of AAA, cerebrovascular accident, and coronary disease. The analysis was performed using Bayesian inference with models for proportions and a multivariate logistic regression. Results: From 304 ultrasound scans performed, 13 were referred with suspicion of AAA, and 63 with were within normal. The sensitivity was 93.3% and specificity 98.5% with a 95% credibility interval (CredI) of 75.4-99.9%, and 94.3-100%, respectively. The prevalence was 4.6% (95% CredI: 2.5-7.2%, and the intraclass correlation coefficient between PC and Vascular Surgery was 0.88 (95% CredI: 0.79-0.94). Age, smoking, dyslipidaemia, and diabetes tended to increase the odds of prevalence of AAA. Conclusion: The ultrasound performed by GPs for the detection of AAA had high diagnostic validity. Further studies on the effectiveness should be conducted in order to assess the appropriateness of introducing a system of early detection of AAA in the risk population

[Validity of the abdominal ecography in primary care for detection of aorta abdominal aneurism in male between 65 and 75 years]. / Validez de la ecografía abdominal en Atención Primaria para detección de aneurisma de aorta abdominal en varones de entre 65 y 75 años.

OBJECTIVE: To determine the usefulness of ultrasound examination in Primary Care (PC) for the detection of abdominal aortic aneurysm (AAA) in male patients from 65-75 years old, as well as the consistency between observers on the diagnosis between general practitioners and the reference specialty in this area, Vascular Surgery. To estimate the prevalence of AAA in that population and its association with risk factors. DESIGN: Cross-sectional descriptive study. LOCATION: Healthcare Centres of Coto and Calzada II (Gijón, Spain). PARTICIPANTS: Males born between 1 January 1939 and 31 December 1950. INTERVENTIONS: From the 2,511 males found, 407 were selected using stratified random sampling. Aortic diameter was measured, with those ≥3cm and 20% from the <3cm being referred for a second measurement by a vascular surgeon. VARIABLES: Dependent: presence/absence of aneurism. Independent: age, abdominal perimeter, smoking, arterial hypertension, diabetes, dyslipidaemia, familial cases of AAA, cerebrovascular accident, and coronary disease. The analysis was performed using Bayesian inference with models for proportions and a multivariate logistic regression. RESULTS: From 304 ultrasound scans performed, 13 were referred with suspicion of AAA, and 63 with were within normal. The sensitivity was 93.3% and specificity 98.5% with a 95% credibility interval (CredI) of 75.4-99.9%, and 94.3-100%, respectively. The prevalence was 4.6% (95% CredI: 2.5-7.2%, and the intraclass correlation coefficient between PC and Vascular Surgery was 0.88 (95% CredI: 0.79-0.94). Age, smoking, dyslipidaemia, and diabetes tended to increase the odds of prevalence of AAA. CONCLUSION: The ultrasound performed by GPs for the detection of AAA had high diagnostic validity. Further studies on the effectiveness should be conducted in order to assess the appropriateness of introducing a system of early detection of AAA in the risk population.