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Breast J ; 27(6): 550-552, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33619768


Breast cancer may be associated with other primary cancers via germline mutations; however, sporadic occurrences of other malignancies are rare. With increased use of advanced breast cancer imaging, including MRI and PET/CT, other incidental synchronous cancers are increasingly identified. Such cases can represent unique diagnostic and treatment challenges. Here, we present a case of a young woman diagnosed with primary breast cancer who underwent imaging studies identifying an incidental primary peritoneal mesothelioma.

Neoplasias da Mama , Mesotelioma Maligno , Mesotelioma , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Mesotelioma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
Case Rep Crit Care ; 2021: 8848013, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33532098


In the most severe cases, novel coronavirus (SARS-CoV-2) infection leads to Acute Respiratory Distress Syndrome which may be refractory to standard medical interventions including mechanical ventilation. There are growing reports of the use of venovenous (VV) extracorporeal membrane oxygenation (ECMO) in these cases. A subset of critically ill COVID-19 patients develops cardiomyopathy as well, manifested by cardiogenic shock with reduced ejection fraction, dysrhythmias, and subsequent increase in mortality. One strategy for managing ARDS with an element of cardiogenic shock is venoarteriovenous (VAV) ECMO. Less than 1% of the cases in the worldwide ELSO COVID-19 database employed any form of hybrid cannulation. To date, there has only been one reported case of patient salvage with arterial or partial arterial support. We present a case that demonstrates the potential role of VAV ECMO in the case of concomitant severe ARDS with cardiomyopathy in the setting of COVID-19 infection.

Hum Pathol ; 79: 116-121, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29803813


Extended prostate needle core biopsies are standard of care for the diagnosis of prostatic carcinoma. Subsequent biopsies may be performed for a variety of indications. Knowledge of biopsy characteristics indicating risk for progression may have utility to guide therapeutic management. Prostate needle core biopsies performed between 2008 and 2014 were reviewed. Patients with at least 1 subsequent biopsy were identified. Cases were categorized by worst initial diagnosis. Gleason ≤6 carcinoma was further classified as significant or insignificant with insignificant defined as follows: ≤2 cores with carcinoma, sites with ≤50% carcinoma, and unilateral carcinoma. A total of 329 men underwent repeat biopsies. Gleason ≤6 insignificant carcinoma, high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation, and negative biopsies had a similar rate of Gleason ≥7 upon repeat biopsy (16%, 17%, 14%; P = .91). Initial biopsy diagnoses of Gleason ≤6 significant carcinoma had a higher rate of Gleason ≥7 on repeat biopsy compared with initial biopsies of Gleason ≤6 insignificant carcinoma (39%, 16%; P = .003). Within initial diagnoses of Gleason ≤6, 1 core compared with more than 1 core positive had a lower rate of Gleason ≥7 on repeat biopsy (17%, 30%), although this difference was not significant (P = .08). An initial biopsy diagnosed as Gleason ≤6 insignificant carcinoma, HGPIN and/or atypical small acinar proliferation, or negative had a similar substantial risk of Gleason ≥7 carcinoma upon subsequent biopsy. Our findings support the continued stratification of Gleason ≤6 and thus the diagnostic workup of all atypical foci to provide an accurate, thorough number of involved cores.

Células Acinares/patologia , Carcinoma/patologia , Proliferação de Células , Neoplasia Prostática Intraepitelial/patologia , Neoplasias da Próstata/patologia , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Carcinoma/terapia , Tomada de Decisão Clínica , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes , Neoplasia Prostática Intraepitelial/terapia , Neoplasias da Próstata/terapia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco