Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39
Filtrar
Mais filtros










Intervalo de ano de publicação
3.
J Am Acad Dermatol ; 81(2): 403-411, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30763648

RESUMO

BACKGROUND: Clinical and pathologic criteria to distinguish drug-induced subacute lupus erythematosus (DI-SCLE) from idiopathic (I-SCLE) are controversial. OBJECTIVE: The aim of the survey was a retrospective analysis of a consistent number of iatrogenous and idiopathic SCLE cases, by means of clinical and histopathologic investigation. METHODS: Eleven European university dermatology units collected all diagnosed cases from January 2000 to December 2016. Board-certified dermatopathologists reviewed the histopathologic specimens. Statistical analysis included Student t test, exact test of goodness-of-fit, Fisher's exact test, and the Cochran-Mantel-Haenszel test for repeated measures. RESULTS: Out of 232 patients, 67 (29%) belonged to the DI-SCLE group. Patients with DI-SCLE were significantly older and reported more systemic symptoms than those with I-SCLE. No statistical differences were found for presentation pattern or serology, while histopathology showed a significant association of mucin deposition (P = .000083), direct immunofluorescence positivity for granular immunoglobulin M, and C3 deposits on the basement membrane zone (P = .0041) for I-SCLE and of leukocytoclastic vasculitis (P = .0018) for DI-SCLE. LIMITATIONS: This is a retrospective study. CONCLUSION: An integrated clinical and immunopathologic evaluation is useful to differentiate I-SCLE from DI-SCLE. Older age at onset and more frequent systemic symptoms characterize DI-SCLE. Mucin deposition and immunofluorescence findings are found in I-SCLE, and leukocytoclastic vasculitis is found in DI-SCLE.


Assuntos
Erupção por Droga/metabolismo , Erupção por Droga/patologia , Lúpus Eritematoso Cutâneo/metabolismo , Lúpus Eritematoso Cutâneo/patologia , Adulto , Fatores Etários , Anticorpos Antinucleares/sangue , Membrana Basal/metabolismo , Complemento C3/metabolismo , Erupção por Droga/etiologia , Europa (Continente) , Feminino , Humanos , Imunoglobulina M/metabolismo , Lúpus Eritematoso Cutâneo/etiologia , Masculino , Pessoa de Meia-Idade , Mucinas/metabolismo , Estudos Retrospectivos , Vasculite Leucocitoclástica Cutânea/etiologia
4.
Eur J Endocrinol ; 180(1): 21-29, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30400049

RESUMO

Objective Lymphadenectomy in papillary thyroid carcinoma (PTC) is controversial. It is indicated whenever metastases have been proven before or during surgery and as a prophylactic treatment in high-risk patients. However, 30-50% of cN0 patients become pN1 postoperatively. In PTC, selective-sentinel-lymph-node-biopsy (SLNB) with conventional intraoperative analysis is 8% false negative. One-step nucleic acid amplification (OSNA) is a molecular technique which allows real-time detection of mRNA encoding for cytokeratin 19. OSNA has been introduced in intraoperative analysis of several tumors to reduce false-negative rates and distinguish micrometastasis from macrometastasis. Our objective was to evaluate the impact of the introduction of OSNA in the intraoperative evaluation of the sentinel node (SN) in PTC. Design We analyzed a series of 35 patients subjected to SLNB. Methods All the dissected nodes, SN and non-SN, were evaluated with OSNA and cytology. Results We obtained a total of 110 SN. SLNB proved positive in 14 patients (40%) with cytology and in 23 (65.7%) with OSNA (P < 0.001). In the 29 patients with subsequent lymphadenectomy we obtained 360 lymph nodes ((52 positive in cytology (14.4%) and 107 in OSNA (29.7%)). Lymphadenectomy proved positive in 16 patients according to cytology (55%) and in 24 according to OSNA (83%) (P = 0002). The majority of patients with micrometastasis in SN showed only micrometastasis in lymphadenectomy. Conclusions The present study shows selective-sentinel-lymph-node-biopsy with one-step nucleic acid amplification technique to be feasible in papillary thyroid carcinoma. The quantitative nature of one-step nucleic acid amplification paves the way toward a more personalized surgical approach, limiting lymphadenectomy to patients with intraoperative evidence of macrometastasis in the sentinel node.


Assuntos
Adenocarcinoma Papilar/genética , Metástase Linfática/genética , Técnicas de Amplificação de Ácido Nucleico/métodos , Linfonodo Sentinela/patologia , Neoplasias da Glândula Tireoide/genética , Adenocarcinoma Papilar/patologia , Adulto , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Biópsia de Linfonodo Sentinela , Neoplasias da Glândula Tireoide/patologia
5.
J Am Acad Dermatol ; 79(5): 892-898, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30126736

RESUMO

BACKGROUND: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma of mature cytotoxic T cells. Initially, patients with SPTCL were treated with doxorubicin-based polychemotherapy. OBJECTIVE: To analyze clinical, biologic, immunophenotypical, molecular, imaging, treatment, and outcome data reflecting the current state of knowledge. METHODS: A retrospective multicenter study of 16 patients with SPTCL that was diagnosed between 1996 and 2016. RESULTS: The female-to-male ratio was 1.7. The median age at diagnosis was 46.5 years. Patients presented with multiple nodular or plaque-like lesions preferentially affecting the legs and/or trunk. Histopathology typically showed a lobular panniculitis with individual adipocytes surrounded by atypical lymphocytes, usually with a CD3+, CD4-, CD8+, CD56-, TIA1 cytotoxic granule associated RNA binding protein 1-positive phenotype and high proliferation rate. SPTCL was associated with autoimmune diseases in 25% of patients, and with the development of hemophagocytic syndrome in 18% of patients. Oral steroids alone or in combination with low-dose methotrexate or cyclosporine A were the most common initial treatment, achieving a complete response in 85% of the treated patients. The median follow-up time was 14 months. The 5-year disease-specific survival rate was 85.7%. LIMITATIONS: This was a retrospective study. CONCLUSIONS: SPTCL has an excellent prognosis. Immunosuppressive agents can be considered for first-line treatment.


Assuntos
Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/terapia , Linfoma de Células T/patologia , Linfoma de Células T/terapia , Paniculite/patologia , Paniculite/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Adulto , Idoso , Quimiorradioterapia/métodos , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Linfoma de Células T/diagnóstico por imagem , Linfoma de Células T/mortalidade , Linfoma Cutâneo de Células T/diagnóstico por imagem , Linfoma Cutâneo de Células T/mortalidade , Masculino , Pessoa de Meia-Idade , Paniculite/diagnóstico por imagem , Paniculite/mortalidade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Estudos Retrospectivos , Medição de Risco , Amostragem , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/mortalidade , Espanha , Análise de Sobrevida , Adulto Jovem
6.
JAMA Dermatol ; 154(3): 341-346, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29322178

RESUMO

Importance: Neurofibromatosis type 2 (NF2) is a devastating genetic condition characterized by the development of multiple tumors of the nervous system. An early diagnosis of individuals with NF2 would facilitate treatment and reduction of disease impact because most severe effects of the disease do not usually develop before adolescence. Little attention has traditionally been paid to dermatological signs in NF2. However, skin plaques are commonly seen in patients with NF2, normally appearing either at birth or early childhood, providing an opportunity for early NF2 detection and testing. Objective: To determine the clinical utility of skin plaque identification and characterization in children for reaching an early diagnosis of patients with NF2 and to evaluate their molecular pathogenesis and their use in the genetic diagnostics of NF2. Design, Setting, and Participants: Diagnostic test study by the histological and genetic characterization of skin plaques from patients with NF2. Patients were 7 individuals with NF2 or clinical suspicion of NF2 treated at the Spanish Reference Center on Phakomatoses. Main Outcomes and Measures: Histological evaluation of all skin plaques was performed. Fresh skin plaques were cultured to obtain Schwann cells and the NF2 gene was genetically analyzed. For all 7 patients, NF2 clinical history was reviewed. Results: In all 7 patients (4 male and 3 female), all skin plaques analyzed were histologically characterized as plexiform schwannomas. Genetic analysis of primary Schwann cell cultures derived from them allowed the identification of a constitutional and a somatic NF2 mutation. Genetic testing allowed the early diagnosis of NF2 in a child only exhibiting the presence of skin plaques. Most of the patients with NF2 analyzed had an early presentation of skin plaques and a severe NF2 phenotype. Conclusions and Relevance: This work emphasizes the clinical utility of a careful dermatological inspection and the correct identification of skin plaques in children for an early diagnosis of NF2. We show for the first time that Schwann cells derived from skin plaque plexiform schwannomas bear the double inactivation of the NF2 gene and thus constitute an excellent source of tissue for genetic testing, especially in the context of mosaicism.


Assuntos
Genes da Neurofibromatose 2 , Neurilemoma/genética , Neurofibromatose 2/diagnóstico , Neurofibromatose 2/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Pré-Escolar , Feminino , Testes Genéticos , Humanos , Masculino , Mutação , Neurilemoma/patologia , Células de Schwann , Neoplasias Cutâneas/patologia
7.
Semin Nucl Med ; 47(2): 102-109, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28236998

RESUMO

Pediatric Nuclear Medicine (PNM) offers to the pediatrician noninvasive procedures, with high clinical impact and low dosimetry. New techniques have been adapted to children, diminishing doses, always looking for less dosimetry, higher sensitivity and higher resolution images. PNM is and will remain a minority subspecialty, but highly complex for general NM physicians due to the different diagnostics in children and due to the higher technical complexity of the examinations. General NM physicians have to be trained and regularly receive CME in this field.


Assuntos
Medicina Nuclear/métodos , Pediatria/métodos , Humanos , Internacionalidade , Sociedades Médicas
8.
BMC Med Genomics ; 8: 2, 2015 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-25739810

RESUMO

BACKGROUND: A clinical overlap exists between mosaic Neurofibromatosis Type 2 and sporadic Schwannomatosis conditions. In these cases a molecular analysis of tumors is recommended for a proper genetic diagnostics. This analysis is challenged by the fact that schwannomas in both conditions bear a somatic double inactivation of the NF2 gene. However, SMARCB1-associated schwannomas follow a four-hit, three-step model, in which both alleles of SMARCB1 and NF2 genes are inactivated in the tumor, with one of the steps being always the loss of a big part of chromosome 22 involving both loci. CASE PRESENTATION: Here we report a 36-year-old woman who only presented multiple subcutaneous schwannomas on her right leg. To help discriminate between both possible diagnoses, an exhaustive molecular genetic and genomic analysis was performed on two schwannomas of the patient, consisting in cDNA and DNA sequencing, MLPA, microsatellite multiplex PCR and SNP-array analyses. The loss of a big part of chromosome 22 (22q12.1q13.33) was identified in both tumors. However, this loss involved the NF2 but not the SMARCB1 locus. SNP-array analysis revealed the presence of the same deletion breakpoint in both schwannomas, indicating that this alteration was actually the first NF2 inactivating hit. In addition, a distinct NF2 point mutation in each tumor was identified, representing independent second hits. In accordance with these results, no deletions or point mutations in the SMARCB1 gene were identified. None of the mutations were present in the blood. Two of the patient's children inherited chromosome 22 deleted in schwannomas of the mother, but in its wild type form. CONCLUSIONS: These results conclusively confirm the segmental mosaic NF2 nature of the clinical phenotype presented.


Assuntos
Perna (Membro) , Técnicas de Diagnóstico Molecular , Neurilemoma/genética , Neurofibromatose 2/diagnóstico , Neurofibromatose 2/genética , Adulto , Sequência de Bases , Proteínas Cromossômicas não Histona/genética , Proteínas de Ligação a DNA/genética , Diagnóstico Diferencial , Feminino , Genes da Neurofibromatose 2 , Humanos , Repetições de Microssatélites/genética , Neurilemoma/diagnóstico , Polimorfismo de Nucleotídeo Único , Proteína SMARCB1 , Fatores de Transcrição/genética
9.
Eur J Nucl Med Mol Imaging ; 40(11): 1645-55, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23907326

RESUMO

PURPOSE: Lymphadenectomy in papillary thyroid carcinoma (PTC) continues to be controversial. A better staging method is needed to provide adequate individual surgical treatment. SPECT/CT lymphoscintigraphy and sentinel lymph node (SLN) biopsy may improve lymphatic staging and surgical treatment. Our main objectives were to describe the lymphatic drainage of PTC using lymphoscintigraphy, to evaluate the lymphatic spread (comparing SLN and lymphadenectomy results) and to analyse the impact of SLN identification in surgery. METHODS: We prospectively studied 24 consecutive patients with PTC (19 women; mean age 52.7 years, range 22-81 years). The day before surgery, lymphoscintigraphy with ultrasound-guided intratumoral injection ((99m)Tc-nanocolloid, 148 MBq) was performed, obtaining planar and SPECT/CT images. All patients underwent total thyroidectomy, SLN biopsy (hand-held gamma probe) with perioperative analysis, central compartment node dissection, or laterocervical lymphadenectomy if perioperative stage N1b or positive SLNs in this lymphatic basin. RESULTS: Lymphoscintigraphy revealed at least one SLN in 19 of 24 patients (79 %) on planar and SPECT/CT images, and in 23 of 24 patients (96 %) during surgery using a hand-held gamma probe. Lymph node metastases were detected with classical perioperative techniques (ultrasound guidance and surgical inspection) in 3 of 24 patients, by perioperative SLN analysis in 10 of 23, and by definitive histology in 13 of 24. The false-negative (FN) ratio for SLN was 7.7 % (one patient with bulky lymph nodes). The FN ratio for perioperative frozen sections was 15.4 % (two patients, one with micrometastases, the other with bilateral SLN). Lymphatic drainage was only to the central compartment in 6 of 24 patients (3 of the 6 with positive SLNs for metastases), only to the laterocervical basin in 5 of 24 patients (all unilateral, 2 of 5 positive SLNs) and to the central and laterocervical compartments in 12 of 24 patients (6 of 12 and 3 of 12 positive SLNs, respectively). CONCLUSION: Lymphoscintigraphy reveals the lymph node drainage in a high proportion of patients. It detects laterocervical drainage in a significant percentage of patients, allowing the detection of occult lymph node metastases and improving the surgical management in PTC.


Assuntos
Carcinoma/diagnóstico por imagem , Excisão de Linfonodo , Biópsia de Linfonodo Sentinela , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/diagnóstico , Carcinoma/patologia , Carcinoma/cirurgia , Carcinoma Papilar , Feminino , Humanos , Metástase Linfática/diagnóstico , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Estadiamento de Neoplasias , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
11.
Pediatr Dermatol ; 30(5): e98-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23437890

RESUMO

Childhood granulomatous periorificial dermatitis (CGPD) is a condition included in the spectrum of rosacea and perioral dermatitis that affects prepubescent children. It is characterized by papular eruptions located around the mouth, nose, and eyes that histopathologically show a granulomatous pattern. We report a 9-year-old girl with CGPD who required treatment with an oral antibiotic. Oral metronidazole was administered because of its known efficacy in adult rosacea and its safety in children. The patient responded well to this therapy, showing resolution of the lesions.


Assuntos
Anti-Infecciosos/uso terapêutico , Dermatite/tratamento farmacológico , Granuloma/tratamento farmacológico , Metronidazol/uso terapêutico , Doenças da Boca/tratamento farmacológico , Biópsia , Criança , Dermatite/patologia , Feminino , Granuloma/patologia , Humanos , Doenças da Boca/patologia , Resultado do Tratamento
12.
Eur J Hum Genet ; 21(7): 769-73, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23188051

RESUMO

Neurofibromatosis type 2 (NF2) is an autosomal-dominant disorder affecting about 1:33 000 newborns, mainly characterized by the development of tumors of the nervous system and ocular abnormalities. Around 85% of germline NF2 mutations are point mutations. Among them, ∼25% affect splicing and are associated with a variable disease severity. In the context of our NF2 Multidisciplinary Clinics, we have identified a patient fulfilling clinical criteria for the disease and exhibiting a severe phenotype. The patient carries a deep intronic mutation (g. 74409T>A, NG_009057.1) that produces the insertion of a cryptic exon of 167pb in the mature mRNA between exons 13 and 14, resulting in a truncated merlin protein (p.Pro482Profs*39). A mutation-specific antisense phosphorodiamidate morpholino oligomer was designed and used in vitro to effectively restore normal NF2 splicing in patient-derived primary fibroblasts. In addition, merlin protein levels were greatly recovered after morpholino treatment, decreasing patient's fibroblasts in vitro proliferation capacity and restoring cytoeskeleton organization. To our knowledge, this is the first NF2 case caused by a deep intronic mutation in which an in vitro antisense therapeutic approximation has been tested. These results open the possibility of using this approach in vivo for this type of mutation causing NF2.


Assuntos
Morfolinos/administração & dosagem , Neurofibromatose 2/genética , Neurofibromatose 2/terapia , Neurofibromina 2/genética , Adolescente , Células Cultivadas , Fibroblastos/citologia , Fibroblastos/efeitos dos fármacos , Mutação em Linhagem Germinativa/genética , Humanos , Íntrons/genética , Morfolinos/genética , Morfolinos/uso terapêutico , Neurofibromatose 2/patologia , RNA Antissenso/genética
17.
Med. cután. ibero-lat.-am ; 38(3): 109-116, mayo-jun. 2010. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-95607

RESUMO

La identificación de los autoanticuerpos en el suero de los pacientes con enfermedades autoinmunes del tejido conectivo puede tener un importante interés en el diagnóstico, el tratamiento y el pronóstico de estos procesos, muchos de ellos con gran expresión en la piel. Sin embargo, la interpretación de los resultados dependerá del tipo de anticuerpo y de la enfermedad que se trate. Algunos de estos autoanticuerpos resultan muy específicos para una enfermedad y, por tanto, tienen un gran valor diagnóstico (este es el caso de los anticuerpos anti-DNA de doble cadena y anti-Sm para el diagnóstico del lupus eritematoso sistémico), pero en la mayoría de las ocasiones los autoanticuerpos resultan poco específicos. Es por ello que comprenderlos conceptos como la validez y la seguridad de las distintas técnicas disponibles en los laboratorios para identificar estos autoanticuerpos(sensibilidad y especificidad, valores predictivos positivo y negativo) así como conocer las bases técnicas de estas pruebas, tienen un gran interés a la hora de interpretar el significado clínico de un determinado anticuerpo así como la relación coste-beneficio de las diferentes técnicas. Las técnicas de radioinmunoensayo o inmunoelectroforesis fueron muy utilizadas en el pasado. Las de inmunotransferencia (o “inmunoblot”) e inmunofluorescencia siguen teniendo un importante valor en nuestros días, si bien ambas están siendo lentamente sustituidas, en especial la primera, por técnicas más novedosas que se basan en métodos inmuno enzimáticos como la técnica de ELISA. Esta es una técnica rápida y de sencilla realización pero menosespecífica por lo que los resultados deben interpretarse con cautela. La determinación clásica de los ANAs continúa siendo clave en el ámbito de las enfermedades autoinmunes del tejido conectivo pero es preciso conocer sus limitaciones con el fin de tomar las decisiones clínicas y terapéuticas adecuadas (AU)


The identification of autoantibodies in the sera of patients with autoimmune connective tissue diseases can be of significant value in the diagnosis,management and prognosis of these conditions, most of them with important cutaneous expression. However, the interpretation of the results depends on the type of antibody and the specific autoimmune connective tissue disease. Some autoantibodies have considerable disease specificityand thus can be of great diagnostic value (for example, anti-double-stranded DNA and Sm for systemic lupus erythematosus), but most autoantibodiesfall into the disease non-specific category. So, basic understanding of key technical issues and concepts such as sensitivity, specificity, positive predictive value and negative predictive value, are important when considering the clinical significance of an antibody and the cost-benefit ratio of the various types of laboratory testing currently available for autoimmune diseases. Radioimmunoassay and immunoelectrophoresis were commonly usedin the past. Immunoblot and immunofluorescence remain of important value although both, especially the former, are being slowly replaced by newertechniques such as the enzyme-linked immunosorbent assay (ELISA). ELISA is cheaper, less labor intensive, but is less specific and results need to be interpreted with caution. The classical ANA assay continues to be of great value into the world of autoimmune connective tissue diseases and understanding of its limitations is critically important to clinical and therapeutic decision-making (AU)


Assuntos
Humanos , Autoanticorpos/isolamento & purificação , Autoimunidade/imunologia , Doenças Autoimunes/imunologia , Imunofluorescência , Ensaio de Imunoadsorção Enzimática , Immunoblotting
18.
Am J Dermatopathol ; 32(1): 19-23, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20098080

RESUMO

Perniosis are inflammatory cutaneous lesions, located on acral skin, which present in association with cold exposure. They can appear as an idiopathic dermatosis or with an underlying autoimmune disease. The use of cutaneous biopsy to distinguish between both types is controversial. We analyze the histological findings in 9 cases of idiopathic perniosis (IP) and compare them with those obtained from 11 cases of perniosis associated with an autoimmune disease (autoimmune perniosis). The most frequent histopathological features observed in cases of IP were a lymphocytic infiltrate with perivascular (8 cases, 89%) and perieccrine distribution (6 cases, 66%), dermal edema (5 cases, 55%), and necrotic keratinocytes (5 cases, 55%), whereas those found in perniosis associated with an autoimmune disease were lymphocytic infiltrate with perivascular distribution (11 cases, 100%) but without perieccrine distribution (3 cases, 27%), vacuolation of the basal layer (7 cases, 63%), and necrotic keratinocytes (5 cases, 45%). The only significant difference between both groups was the perieccrine distribution of the lymphocytic infiltrate in cases of IP, which, as mentioned in previous studies, could be considered a histopathological clue to differentiate both types of perniosis.


Assuntos
Pérnio/patologia , Lúpus Eritematoso Discoide/patologia , Síndrome de Sjogren/patologia , Pele/patologia , Adolescente , Adulto , Idoso , Biópsia , Pérnio/complicações , Pérnio/imunologia , Diagnóstico Diferencial , Glândulas Écrinas/imunologia , Glândulas Écrinas/patologia , Edema/complicações , Edema/imunologia , Edema/patologia , Feminino , Dedos/patologia , Humanos , Queratinócitos/imunologia , Queratinócitos/patologia , Lúpus Eritematoso Discoide/complicações , Lúpus Eritematoso Discoide/imunologia , Linfócitos/imunologia , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Necrose , Estudos Retrospectivos , Síndrome de Sjogren/complicações , Síndrome de Sjogren/imunologia , Pele/imunologia , Dedos do Pé/patologia , Adulto Jovem
19.
Med. clín (Ed. impr.) ; 133(9): 339-343, sept. 2009. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-73268

RESUMO

Fundamento y objetivo: Analizar el perfil clínico del carcinoma diferenciado de tiroides (CDT) y su relación con el pronóstico de la enfermedad. Pacientes y método: Se realizó un análisis retrospectivo de 80 niños con CDT. A todos se les practicó una tiroidectomía total y subtotal. Setenta y cinco niños recibieron dosis de yodo-131. Todos se controlaron anualmente mediante seguimiento clínico, analítico y pruebas de imagen. Resultados: De los 80 pacientes, 52 eran mujeres (edad media de 13,43 y desviación estándar [DE] de 3,6 años). El 87,5% presentó un aumento del diámetro cervical como primer síntoma, que correspondía en un 65% a un nódulo tiroideo y era más frecuente en el sexo femenino. La forma histológica papilar (84%) se presentó más frecuentemente que la folicular y se asoció a mayor presencia de adenopatías y metástasis. El 56,4% de los pacientes presentó enfermedad avanzada en el momento del diagnóstico. Nueve pacientes tenían antecedentes de irradiación previa. Un 32,5% de los pacientes presentó complicaciones posquirúrgicas. Al final del seguimiento (media de 10,79; DE de 5,69 años) sólo 9 pacientes persistían con enfermedad, variable asociada significativamente con el estadio 4. Conclusiones: El CDT en niños se presenta con mayor incidencia en el sexo femenino. La forma de inicio habitual es la presencia de un nódulo cervical. El tipo histológico predominante es el papilar, con elevada frecuencia, en forma de diseminación ganglionar y metastásica (AU)


Background and objective: The objective was to analyze the clinical profile of Differentiated Thyroid Carcinoma in children (DTC) and the predisposing factors to suffering the disease. Material and method: Eighty children with DTC were studied retrospectively. They all underwent total/near total thyroidectomy and 75 cases underwent ablative iodine therapy. Patients were controlled periodically with clinical, laboratory and imaging tests follow-up. Results: Twenty eight patients were male and 52 female (mean age: 13.43±3.6y). The 87.5% of patients had an increased cervical perimeter as the first clinical symptom, 65% of them corresponding to a thyroid nodule with a predominance of females. The papillary histological pattern was more frequent than the follicular pattern, and it was associated with the presence of lymph involvement and metastasis. About 56.4% of patients showed advanced disease at the time of diagnosis. 9 patients had previous irradiation. Surgical complications appeared in 32.5% of patients. At the end of follow-up (mean: 10.79±5.69y) 9 patients had persistent disease with a significant relation with stage 4. Conclusions: DTC presents a higher incidence in females than in males. Cervical node is the most frequent form of initial presentation. The papillary type is more prevalent than the follicular type, and it is frequently associated with lymph node involvement and metastatic spread (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Carcinoma/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Carcinoma/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tireoidectomia/efeitos adversos , Complicações Pós-Operatórias , Estadiamento de Neoplasias
20.
Med Clin (Barc) ; 133(9): 339-43, 2009 Sep 12.
Artigo em Espanhol | MEDLINE | ID: mdl-19464706

RESUMO

BACKGROUND AND OBJECTIVE: The objective was to analyze the clinical profile of Differentiated Thyroid Carcinoma in children (DTC) and the predisposing factors to suffering the disease. MATERIAL AND METHOD: Eighty children with DTC were studied retrospectively. They all underwent total/near total thyroidectomy and 75 cases underwent ablative iodine therapy. Patients were controlled periodically with clinical, laboratory and imaging tests follow-up. RESULTS: Twenty eight patients were male and 52 female (mean age: 13.43+/-3.6 y). The 87.5% of patients had an increased cervical perimeter as the first clinical symptom, 65% of them corresponding to a thyroid nodule with a predominance of females. The papillary histological pattern was more frequent than the follicular pattern, and it was associated with the presence of lymph involvement and metastasis. About 56.4% of patients showed advanced disease at the time of diagnosis. 9 patients had previous irradiation. Surgical complications appeared in 32.5% of patients. At the end of follow-up (mean: 10.79+/-5.69 y) 9 patients had persistent disease with a significant relation with stage 4. CONCLUSIONS: DTC presents a higher incidence in females than in males. Cervical node is the most frequent form of initial presentation. The papillary type is more prevalent than the follicular type, and it is frequently associated with lymph node involvement and metastatic spread.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA