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1.
Rom J Ophthalmol ; 63(3): 264-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687629

RESUMO

Objective. To report a rare presentation of solitary retinal capillary hemangioma manifesting with combined retinal detachment as initial presentation and its successful management. Methods. A 35-year-old healthy Indian male presented with combined retinal detachment associated with solitary retinal capillary hemangioma as initial presentation; a clinical entity still not reported in literature. Patient was managed with pars plana vitrectomy combined with retinectomy, endolaser, & silicon oil tamponade with good visual & anatomical recovery. Results. Patient had good clinical outcome with final best-corrected visual acuity (BCVA) of 6/ 24 and well attached retina at last follow-up. Conclusion. Solitary retinal capillary hemangiomas can rarely present with advanced vitreo-retinal complications like combined retinal detachment as initial manifestation that can be effectively managed with skilled & appropriate surgical intervention.


Assuntos
Angiofluoresceinografia/métodos , Hemangioma Capilar/diagnóstico , Descolamento Retiniano/etiologia , Neoplasias da Retina/diagnóstico , Recurvamento da Esclera/métodos , Acuidade Visual , Vitrectomia/métodos , Adulto , Seguimentos , Fundo de Olho , Hemangioma Capilar/complicações , Hemangioma Capilar/cirurgia , Humanos , Masculino , Retina/patologia , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Neoplasias da Retina/complicações , Neoplasias da Retina/cirurgia
2.
Am J Case Rep ; 20: 1551-1557, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31636247

RESUMO

BACKGROUND Pulmonary capillary hemangiomatosis (PCH) and pulmonary veno-occlusive disease (PVOD) are rare diseases that share clinical, X-ray, and histological features. Most patients have poor prognosis due to severe respiratory impairment. Recently, EIF2AK4 mutations were found in some patients with PCH and PVOD, but the role of this mutation is still unknown. We report an autopsy case of PCH and discuss a mechanism of respiratory dysfunction based on an electron microscopy study. CASE REPORT The patient was a Japanese man in his sixties. He suffered from acute exacerbation of dyspnea during treatment of COPD. Respiratory function testing revealed DLCO' 32.1% and DLCO'/VA 23.6%. Echocardiography demonstrated findings consistent with pulmonary hypertension. A CT scan showed mild emphysema and small ground-glass opacity in the lungs. However, we could not find the exact cause of his respiratory failure and he died 28 days after admission. At autopsy, the histology showed multilayering capillary proliferation within the alveolar walls. Electron microscopy examination revealed prominent widening of the air-blood barrier, scarce fusion of the epithelial and capillary basement membranes, and frequent narrowing of the capillary lumen. CONCLUSIONS We reported an autopsy case with PCH with no histological findings of PVOD. Whether PCH and PVOD are 2 different histological patterns of the same disease remains to be verified. The changes in the air-blood barrier detected by electron microscopy may explain the respiratory impairment and pulmonary arterial hypertension.


Assuntos
Autopsia , Hemangioma Capilar/diagnóstico , Microscopia Eletrônica , Idoso , Grupo com Ancestrais do Continente Asiático , Barreira Alveolocapilar/patologia , Evolução Fatal , Hemangioma Capilar/ultraestrutura , Humanos , Masculino , Pessoa de Meia-Idade , Pneumopatia Veno-Oclusiva , Testes de Função Respiratória , Insuficiência Respiratória
3.
Autops. Case Rep ; 9(3): e2019111, July-Sept. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1016910

RESUMO

Pulmonary capillary hemangiomatosis (PCH) is a rare and controversial entity that is known to be a cause of pulmonary hypertension and is microscopically characterized by proliferation of dilated capillary-sized channels along and in the alveolar walls. Clinically, it is mostly seen in adults. Clinical features are characterized by nonspecific findings such as shortness of breath, cough, chest pain, and fatigue. It can be clinically indistinguishable from pre-capillary pulmonary arterial hypertension disorders such as primary pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension. However, the diagnostic distinction, which usually requires a multidisciplinary approach, is crucial in order to avoid inappropriate treatment with vasodilator medications usually used for PAH treatment. Prognosis of PCH remains poor with lung transplant being the only definitive treatment. We report an autopsy case of pulmonary capillary hemangiomatosis unmasked at autopsy that was treated with a prostacyclin analog, usually contraindicated in such patients. We emphasize that this entity should always be on the differential diagnosis in a patient with pulmonary hypertension and requires great vigilance on the part of the clinician, radiologist and pathologist to make the diagnosis and guide appropriate management.


Assuntos
Humanos , Feminino , Idoso , Hemangioma Capilar/diagnóstico , Hemangioma Capilar/patologia , Doença Cardiopulmonar , Autopsia , Pneumopatia Veno-Oclusiva , Evolução Fatal , Diagnóstico Diferencial , Hipertensão Pulmonar
5.
BMJ Case Rep ; 12(8)2019 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-31383685

RESUMO

Conjunctival capillary haemangiomas are very rare above 40 years of age group, with few cases reported in the literature. Adding to the scanty literature of this uncommon vascular tumour, we present the case of a 45-year-old man who presented with a nodular growth in the conjunctiva without any associated systemic diseases or cutaneous lesion. Excisional biopsy of the mass was done. Histopathological examination showed lobulated capillary haemangioma which is very rare in this age group.


Assuntos
Neoplasias da Túnica Conjuntiva/diagnóstico , Hemangioma Capilar/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
6.
Zhonghua Yan Ke Za Zhi ; 55(8): 609-615, 2019 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-31422640

RESUMO

Objective: To discuss the clinical features and treatment of juxtapapillary retinal capillary hemangioma (JRCH). Methods: Retrospective study of the clinical data of 6 patients (7 eyes) who were diagnosed with JRCH, among which 2 eyes were treated by laser therapy (thermotherapy TTT or photodynamic therapy PDT), 2 eyes were treated by intravitreal anti-VEGF injection, 2 eyes with vitreous hemorrhage were treated with vitrectomy (PPV)+ anti-VEGF, and 1 eye was untreated. Results: In the 6 cases, the gender ratio of male to female is 2∶1 with average age of 46 years. Four eyes were associated with macular edema(57.1%), vitreous hemorrhage(n=2, 28.6%), and epiretinal membrane(n=1, 14.2%) in the initial examination. Three patients were associated with von Hippel-Lindau(VHL). During the follow-up period, the visual acuity of the 2 patients treated by TTT decreased. Among the 2 eyes treated by anti-VEGF, the visual acuity of 1 eye associated with macular edema increased, and the visual acuity of 1 eye with macular epiretinal membrane did not change significantly, the visual acuity of both 2 eyes treated by PPV+anti-VEGF improved, the vision of the 1 eye untreated appeared to be stable. Conclusions: Juxtapapillary retinal capillary hemangioma is the orange or red vascular hamartomas that occur on or adjacent to the optic nerve head. It is often associated with macular edema, vitreous hemorrhage, and local subretinal effusion. Symptomatic treatment of complications can effectively improve the visual acuity of patients, while long-term follow-up observation should be organized for patients without complications, laser treatment appears to be ineffective. (Chin J Ophthalmol, 2019, 55:609-615).


Assuntos
Hemangioma Capilar , Fotoquimioterapia , Doenças Retinianas , Feminino , Hemangioma Capilar/diagnóstico , Hemangioma Capilar/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Disco Óptico , Doenças Retinianas/diagnóstico , Doenças Retinianas/terapia , Estudos Retrospectivos
7.
BMC Pulm Med ; 19(1): 133, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337372

RESUMO

BACKGROUND: Pulmonary capillary hemangiomatosis (PCH) is a progressive and refractory vascular disease in the lung. Pulmonary hypertension is frequently combined with PCH when capillary proliferation invades to nearby pulmonary vascular systems. It is difficult to differentiate PCH from other diseases such as pulmonary venoocclusive disease and pulmonary arterial hypertension that cause pulmonary hypertension as they frequently overlap. CASE PRESENTATION: A 29-year-old female who had worked at a bathtub factory presented with progressive exertional dyspnea for the past 2 years. Computed tomography revealed centrilobular, diffusely spreading ground-glass opacities sparing subpleural parenchyma with some cystic lesions and air-trapping in both lungs, suggesting a peculiar pattern of interstitial lung disease with airway involvement. There was not any evidence of right heart failure or pulmonary hypertension on echocardiogram, as well as radiography. Microscopic examination of the lung by thoracoscopic resection showed atypical proliferation of capillary channels within alveolar walls and interlobar septa, without invasion of large vessels. CONCLUSION: We experienced a pathologically diagnosed PCH in a young female complaining progressive dyspnea with prior exposure to occupational silica or organic solvent without elevated right ventricular systolic pressure (RVSP) who showed atypical pattern of radiologic findings.


Assuntos
Hemangioma Capilar/diagnóstico , Neoplasias Pulmonares/diagnóstico , Exposição Ocupacional/efeitos adversos , Dióxido de Silício/efeitos adversos , Adulto , Diagnóstico Diferencial , Dispneia/etiologia , Diagnóstico Precoce , Feminino , Hemangioma Capilar/patologia , Humanos , Hipertensão Pulmonar/etiologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/patologia , Tomografia Computadorizada por Raios X
10.
Pediatr Dermatol ; 36(4): 471-476, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31120143

RESUMO

BACKGROUND: For infantile hemangiomas requiring treatment, existing recommendations advise initiation of propranolol followed by a 2-hour period of blood pressure and heart rate monitoring, resulting in prolonged office visits for both families and clinicians. OBJECTIVES: In order to reduce visit times, we evaluate our current practice of at-home or in-office propranolol administration followed by in-office vital sign monitoring. METHODS: We retrospectively reviewed the medical records of 157 patients with infantile hemangiomas (IH) who initiated propranolol under this outpatient protocol. Blood pressure (BP) and heart rate (HR) were obtained at a baseline visit and 1-2 hours after initial dose administration. We identified potential risk factors for clinically significant decreases in systolic blood pressure (SBP) and HR (defined as decrease of > 20 mm Hg and > 15 bpm, respectively) using logistic regression analysis, and adverse events were recorded. RESULTS: Fifty-five individuals (35.4%) showed a decrease in HR of more than 15 bpm, and 23 individuals (14.7%) showed a decrease in SBP of more than 20 mm Hg. Multivariable logistic regression suggested that younger age, history of preterm birth, and Caucasian race may slightly increase the odds of clinically significant changes in vital signs upon propranolol initiation. However, no clinically symptomatic adverse events occurred upon initiation of propranolol. CONCLUSIONS: Vital sign monitoring may be important when starting propranolol treatment in younger or historically preterm patients. However, routine mandatory in-office vital sign monitoring may not be necessary in healthy infants more than 45 weeks postconceptional age.


Assuntos
Hemangioma Capilar/tratamento farmacológico , Pacientes Ambulatoriais/estatística & dados numéricos , Propranolol/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Assistência Ambulatorial/métodos , Glicemia/análise , Determinação da Pressão Arterial , Bases de Dados Factuais , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Hemangioma Capilar/diagnóstico , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Masculino , Philadelphia , Estudos Retrospectivos , Medição de Risco , Neoplasias Cutâneas/diagnóstico , Resultado do Tratamento
11.
Pediatr Dermatol ; 36(4): 556-557, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30983047

RESUMO

Infantile hemangiomas are the most common tumors of infancy and are often managed with oral beta-blockers to address or prevent associated complications. However, treatment with propranolol can occasionally be associated with sleep disturbances, which in some cases are severe enough to warrant discontinuation or replacement with another agent. We herein report four cases in which treatment with propranolol resulted in significant sleep disturbances prompting substitution with atenolol, which in some cases resolved these issues.


Assuntos
Atenolol/uso terapêutico , Hemangioma Capilar/tratamento farmacológico , Propranolol/efeitos adversos , Neoplasias Cutâneas/tratamento farmacológico , Transtornos do Sono-Vigília/induzido quimicamente , Administração Oral , Substituição de Medicamentos , Feminino , Hemangioma Capilar/diagnóstico , Humanos , Lactente , Segurança do Paciente , Prognóstico , Propranolol/uso terapêutico , Medição de Risco , Amostragem , Neoplasias Cutâneas/diagnóstico , Transtornos do Sono-Vigília/fisiopatologia , Resultado do Tratamento
12.
Ophthalmic Surg Lasers Imaging Retina ; 50(3): e81-e83, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30893462

RESUMO

Retinal capillary hemangioma (RCH) is a benign retinal tumor defined by a vascular proliferation localized in the peripheral retina, juxtapapillary retina, or the intraneural portion of the optic nerve. In most cases, diagnosis of RCH is performed by fundus evaluation and confirmed by fluorescein fundus angiography. Nevertheless, a small RCH localized on or adjacent to the optic nerve head could be difficult to detect by fundus examination. Here, the authors report an atypical case of RCH, not ophthalmoscopically visible, but successfully detected first by optical coherence tomography (OCT) and then by OCT angiography, which confirmed its vascular nature. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e81-e83.].


Assuntos
Técnicas de Diagnóstico Oftalmológico , Angiofluoresceinografia/métodos , Hemangioma Capilar/diagnóstico , Neoplasias da Retina/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto , Feminino , Humanos
13.
Pediatr Dev Pathol ; 22(5): 480-485, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30913983

RESUMO

Infantile hemangioma (IH) is the most common benign vascular tumor of infancy, occurring predominantly in the head and neck. It is characterized by specific endothelial expression of glucose transporter-1 (GLUT-1) and involution with time, spontaneous or on beta-blockers treatment. Although some predisposing factors are known, the exact pathogenesis remains unclear. We report a case of pulmonary IH GLUT-1 positive, initially suspected as a cystic pulmonary airway malformation, in a child presenting with both cardiac and renal malformations. The clinical, radiological, pathological, and genetics findings are discussed with a review of the literature. Although pulmonary IH is a rare lesion, it should be suspected when facing a pulmonary cystic mass in a child.


Assuntos
Anormalidades Múltiplas/genética , Deleção Cromossômica , Hemangioma Capilar/genética , Hemangioma Capilar/patologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/patologia , Cromossomos Humanos Par 14/genética , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Diagnóstico Diferencial , Rim Fundido/genética , Comunicação Interventricular/genética , Hemangioma Capilar/diagnóstico , Humanos , Lactente , Neoplasias Pulmonares/diagnóstico , Masculino , Síndromes Neoplásicas Hereditárias/diagnóstico , Artéria Umbilical Única/genética
14.
J Pediatr Adolesc Gynecol ; 32(1): 80-82, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30107231

RESUMO

BACKGROUND: The differential diagnosis for pediatric prepubertal vaginal bleeding is wide. Rare etiologies include vascular malformations and tumors, such as infantile hemangiomas (IHs), which validate the usefulness of exam under anesthesia, vaginoscopy, and tissue diagnosis. CASE: We report a case of an IH in a 6-year-old girl causing vaginal bleeding requiring transfusion. Vaginoscopy revealed a cervical IH of less than 1 cm. Expectant management and oral propranolol were successful management options. SUMMARY AND CONCLUSION: Rare, even small soft tissue tumors such as IH can lead to impressive blood loss via vaginal bleeding. Accurate tissue diagnosis and a multidisciplinary approach are essential to planning safe, effective treatment, and follow-up.


Assuntos
Colo do Útero/patologia , Hemangioma Capilar/diagnóstico , Síndromes Neoplásicas Hereditárias/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Hemorragia Uterina/etiologia , Antagonistas Adrenérgicos beta/uso terapêutico , Criança , Diagnóstico Diferencial , Endoscopia/métodos , Feminino , Hemangioma Capilar/complicações , Hemangioma Capilar/tratamento farmacológico , Humanos , Síndromes Neoplásicas Hereditárias/complicações , Síndromes Neoplásicas Hereditárias/tratamento farmacológico , Propranolol/uso terapêutico , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/patologia , Hemorragia Uterina/diagnóstico
15.
J Am Acad Dermatol ; 80(2): 493-499, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30293898

RESUMO

BACKGROUND: The proliferative phase of infantile hemangiomas (IHs) is usually complete by 9 months of life. Late growth beyond age 3 years is rarely reported. OBJECTIVE: To describe the demographic and clinic characteristics of a cohort of patients with late growth of IH, defined as growth in a patient >3 years of age. METHODS: A multicenter, retrospective cohort study. RESULTS: In total, 59 patients, 85% of which were female, met the inclusion criteria. The mean first episode of late growth was 4.3 (range 3-8.5) years. Head and neck location (55/59; 93%) and presence of deep hemangioma (52/59; 88%) were common characteristics. Posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, eye abnormalities (PHACE) syndrome was noted in 20 of 38 (53%) children with segmental facial IH. Systemic therapy (corticosteroid or ß-blocker) was given during infancy in 58 of 59 (98%) and 24 of 59 (41%) received systemic therapy (ß-blockers) for late IH growth. LIMITATIONS: The retrospective nature and ascertainment by investigator recall are limitations of the study. CONCLUSION: Late IH growth can occur in children after 3 years of age. Risk factors include head and neck location, segmental morphology, and involvement of deep dermal/subcutaneous tissues.


Assuntos
Hemangioma Capilar/diagnóstico , Hemangioma Capilar/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Corticosteroides/uso terapêutico , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Progressão da Doença , Feminino , Seguimentos , Hemangioma Capilar/congênito , Humanos , Terapia a Laser/métodos , Masculino , Propranolol/uso terapêutico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Neoplasias Cutâneas/congênito , Fatores de Tempo , Resultado do Tratamento , Estados Unidos
16.
BMJ Case Rep ; 11(1)2018 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-30567166

RESUMO

A premature twin infant girl was transferred to a level IV neonatal intensive care unit for recurrent bloody stools, anaemia and discomfort with feeds; without radiographic evidence of necrotising enterocolitis. Additional imaging after transfer revealed a large retroperitoneal mass in the region of the pancreas compressing the inferior vena cava and abdominal aorta, raising suspicion for neuroblastoma. Abdominal exploration and biopsy unexpectedly revealed that the lesion was an infantile capillary haemangioma involving the small bowel, omentum, mesentery and pancreas. The infant was subsequently treated with propranolol, with a decrease in the size of the lesion over the first year of her life and a drastic improvement in feeding tolerance. While cutaneous infantile haemangiomas are common, visceral infantile haemangiomas are less so and may present a significant diagnostic challenge for clinicians. This interesting case demonstrates that such lesions should be considered in the differential diagnosis for unexplained gastrointestinal bleeding or abdominal symptoms in newborns.


Assuntos
Hemorragia Gastrointestinal/diagnóstico , Hemangioma Capilar/diagnóstico , Recém-Nascido Prematuro , Síndromes Neoplásicas Hereditárias/diagnóstico , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/uso terapêutico , Diagnóstico Diferencial , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/cirurgia , Hemangioma Capilar/diagnóstico por imagem , Hemangioma Capilar/tratamento farmacológico , Hemangioma Capilar/cirurgia , Humanos , Recém-Nascido , Imagem por Ressonância Magnética , Síndromes Neoplásicas Hereditárias/diagnóstico por imagem , Síndromes Neoplásicas Hereditárias/tratamento farmacológico , Síndromes Neoplásicas Hereditárias/cirurgia , Propranolol/administração & dosagem , Propranolol/uso terapêutico , Gêmeos
17.
Ann Dermatol Venereol ; 145(12): 749-755, 2018 Dec.
Artigo em Francês | MEDLINE | ID: mdl-30415930

RESUMO

BACKGROUND: Infantile hemangioma (IH) is a common benign vascular tumor in children. In most cases, diagnosis is based entirely on clinical examination. When the diagnosis is uncertain, the first-line complementary examination is Doppler ultrasound. We report 4 cases of atypical infantile hemangiomas with delayed diagnosis and non-contributory imaging. PATIENTS AND METHODS: One child had congenital purple papules and nodules on the back of the foot, the second had inaugural ulceration of the buttocks, and the last two presented telangiectasia, either isolated or on an erythematous macula. In two cases, ultrasound showed no vascular lesions, and in the other two cases, the absence of hyperemia did not allow a diagnosis of IH to be made. For one patient, diagnosis was made on the basis of cutaneous biopsy, and for the other three, on the basis of clinical course. DISCUSSION: We report 4 rare forms of infantile hemangioma resulting in initial diagnostic error. The atypical nature of some IHs may direct the clinician and the radiologist toward other diagnoses that in some cases have no vascular contingent. It is important for the dermatologist to be aware of these rare forms of IH in order to reduce the time to diagnosis and allow early initiation of appropriate management.


Assuntos
Hemangioma Capilar/diagnóstico , Síndromes Neoplásicas Hereditárias/diagnóstico , Neoplasias Cutâneas/diagnóstico , Biópsia , Nádegas , Diagnóstico Tardio , Eritema/etiologia , Neoplasias Faciais/diagnóstico , Neoplasias Faciais/tratamento farmacológico , Feminino , Doenças do Pé/diagnóstico , Hemangioma Capilar/diagnóstico por imagem , Hemangioma Capilar/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Masculino , Síndromes Neoplásicas Hereditárias/diagnóstico por imagem , Síndromes Neoplásicas Hereditárias/tratamento farmacológico , Propranolol/uso terapêutico , Remissão Espontânea , Neoplasias Cutâneas/diagnóstico por imagem , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/etiologia , Telangiectasia/etiologia , Ultrassonografia
18.
BMC Ophthalmol ; 18(1): 277, 2018 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-30367611

RESUMO

BACKGROUND: The present study reported a case of juxtapapillary retinal capillary hemangioma (JRCH) that was successfully treated by two sessions of full-fluence photodynamic treatment (PDT) with good visual outcome. CASE PRESENTATION: A 19-year-old male patient presented progressive deterioration of the vision of right eye due to the presence of exudative macular detachment associated with JRCH. The best-corrected visual acuity (BCVA) had decreased from 1.0 to 0.02. The JRCH was treated with two sessions of full-fluence PDT at an interval of 3 months. After the first PDT, the subfoveal fluid was reduced, albeit not completely disappeared. After the second PDT, the subfoveal fluid was successfully displaced. At the 1.5-year follow-up examination, no subfoveal fluid was observed at the macula, and VA improved from a pretherapy level of 0.02-0.8 at 18 months post-treatment. CONCLUSION: Resolution of the exudative macular detachment, reduction in papillomacular area fluid, and reduction in the size of the JRCH were observed during the follow-up period. No severe adverse events were observed. Therefore, PDT is potential candidate treatment for relieving exudative macular detachment and recovering VA and reduction in the size of the JRCH.


Assuntos
Hemangioma Capilar/tratamento farmacológico , Macula Lutea/patologia , Disco Óptico/patologia , Fotoquimioterapia/métodos , Porfirinas/uso terapêutico , Neoplasias da Retina/tratamento farmacológico , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Hemangioma Capilar/diagnóstico , Humanos , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Neoplasias da Retina/diagnóstico , Tomografia de Coerência Óptica , Acuidade Visual , Adulto Jovem
19.
Lung Cancer ; 124: 227-232, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30268465

RESUMO

OBJECTIVES: Solitary pulmonary capillary hemangioma (SPCH) is a rare lung tumor typically presenting as pure or part-solid ground-glass nodules (GGNs) on computed tomography (CT), which clinically resembles early lung cancer. MATERIALS AND METHODS: In addition to 10 recently diagnosed patients with SPCH, 71 benign lung nodules that were surgically resected between January 2013 and December 2017 were reviewed by thoracic pathologists to identify any previously unrecognized SPCH cases. Finally, 6 tumors (8.5%; 6/71) were determined to be SPCH. Elastic fiber stain (orcein stain) as well as immunohistochemistry for cytokeratin, CD31, and thyroid transcription factor 1 were performed for confirmation. Clinical and radiological data were analyzed. RESULTS: All 16 SPCH lesions were unrecognized or misdiagnosed by general pathologists. The SPCH ranged in size from 3 to 15 mm, and a predominance among women (68.8%; 11/16) was noted. Pathologically, all SPCH lesions were nodular with a higher vascular density than the adjacent lung tissue. Decreased cytokeratin staining and disrupted elastic fibers were clearly observed in all SPCH lesions. CONCLUSIONS: SPCH lesions mimic early lung cancer on CT; they are largely unrecognized by general pathologists and are diagnosed as other nonspecific benign lesions. With careful histologic examination, SPCH can be successfully diagnosed using cytokeratin/CD31 immunohistochemistry and elastic fiber staining.


Assuntos
Tecido Elástico/patologia , Hemangioma Capilar/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmão/metabolismo , Nódulo Pulmonar Solitário/diagnóstico , Adulto , Idoso , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Feminino , Hemangioma Capilar/patologia , Humanos , Queratinas/metabolismo , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Nódulo Pulmonar Solitário/patologia , Tomografia Computadorizada por Raios X , Carga Tumoral
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