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Linfoma intravascular tratado con anticuerpos monoclonales anti CD20: Descripción de un caso clínico / Intravascular lymphoma treated with anti CD20 monoclonal antibodies: Report of one case  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english We report a 78 year old male with prostatism, that was subjected to a prostate biopsy. The pathological study showed a microvascular lymphocytic infiltration. Four months later, the patients presentd with reduced alertness, cough, dyspnea, fever and elevation of lactic dehydrogenase and erythrocyte [...] sedimentation rate. Chest and abdominal CAT scans, bone marrow aspirate, protein electrophoresis and prostate specific antigen were normal. A re-evaluation of prostate biopsy showed an intravascular lymphoid infiltration, positive for CD45 and CD20, compatible with the diagnosis of intravascular lymphoma. Chemotherapy was started, but it was not tolerated by the patient and the response was partial. Therefore, treatment with monoclonal antibodies anti CD20 (Rituximab) was started. The tumor had a complete and prolonged (24 months) remission after the treatment

Jorge, Alfaro L; Arturo, Espinoza N; María, Manríquez A; Leonor, Moyano; Néstor, González G; Milton, Larrondo L; Gastón, Figueroa M.

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Linfoma B intravascular: comprometimento bilateral da suprarrenal em paciente adulta jovem Intravascular large B cell lymphoma: impairment of bilateral adrenal in young woman  

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Full Text Available O linfoma B intravascular de grandes células (IVLBCL é uma doença rara caracterizada pela proliferação neoplásica de células linfoides no interior de capilares. Relatamos um caso de IVLBCL em paciente jovem do sexo feminino com comprometimento bilateral da glândula suprarrenal. O exame imuno-histoquímico confirmou o IVLBCL. A afinidade entre órgãos endócrinos e células linfoides é uma hipótese levantada para explicar a correlação verificada entre o IVLBCL e o comprometimento da glândula suprarrenal. Além disso, a associação entre o IVLBCL e a sintomatologia descrita parece refletir um padrão que poderá auxiliar em um diagnóstico mais eficaz.The Intravascular Large B-cell Lymphoma (IVLBCL is a rare disease characterized by neoplastic proliferation of lymphoid cells within capillaries. We report a case of IVLBCL in a young female patient with bilateral involvement of the adrenal gland. Immunohistochemical examination confirmed IVLBCL. The relationship between endocrine organs and lymphoid cells is a hypothesis to explain the correlation observed between IVLBCL and the involvement of the adrenal gland. Moreover, the association between IVLBCL and the described symptomatology seems to reflect a pattern that may assist in a more effective diagnosis.

Marília Sena de Felipe

2010-02-01

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High grade primary adrenal intravascular large B-cell lymphoma manifesting as Addison disease Linfoma intravascular de alto grado de células B grandes y origen suprarrenal que se manifiesta en forma de enfermedad de Addison  

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Full Text Available We report a rare case of a 68 aged male who presented with adrenal failure and was diagnosed of high grade large B-cell lymphoma primarily arising in the adrenal glands. The patient was administrated with additional chemotherapy but he passed away 7 months later due to infection in the lungs. Intravascular lymphoma should be suspected in patients with bilateral adrenal masses who present with rapidly progressive adrenal insufficiency.Publicamos el caso poco frecuente de un varón de 68 años de edad que debutó con insuficiencia adrenal y fue diagnosticado de linfoma de alto grado de células B grandes ubicado principalmente en las glándulas suprarrenales. Al paciente le administraron quimioterapia adicional, pero falleció 7 meses después de infección pulmonar. El linfoma intravascular debe sospecharse en los pacientes con masas suprarrenales bilaterales que presenten insuficiencia adrenal rápidamente progresiva.

J. Venizelos

2007-08-01

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Linfoma intravascular do pulmão: A propósito de um caso clínico com boa resposta à terapêutica / Intravascular pulmonary lymphoma with good response to treatment. A case report  

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Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese O linfoma intravascular é uma forma muito rara de linfoma não Hodgkin de células grandes B. Caracteriza-se pela proliferação celular tumoral de linfócitos limitada aos pequenos vasos, particularmente nos capilares. Apresentamos o caso de uma doente de 54 anos, não fumadora, que foi admitida no nosso [...] hospital para investigação de um quadro com quatro meses de evolução de febre, sudorese nocturna, emagrecimento não quantificado e dispneia progressiva. Ao exame objectivo apresentava-se febril, taquicárdica e polipneica. Analiticamente, destacava-se anemia, leucocitose e LDH elevada. Gasometria arterial - FiO2 1 l/m: PaO2-63,6 mm Hg. A telerradiografia de tórax revelava infiltado intersticial difuso. Foram excluídas todas as causas de febre de origem indeterminada. O diagnóstico foi realizado por biópsia pulmonar cirúrgica e foi prescrita terapêutica citostática combinada e rituximab com boa resposta clínica. Relatamos o caso pela dificuldade diagnóstica e pela boa resposta à terapêutica. Abstract in english Intravascular lymphoma is a very rare form of large B cell non-Hodgkin’s lymphoma, characterised by the presence of lymphoma cells in the lumina of small vessels only, particulary in the capillaries. We report a 54 year-old female non-smoker, admitted to hospital for further examination of a four mo [...] nth long clinical condition involving high fever, night sweats, unqualified weight loss and progressive dyspnea. Patient’s temperature was 38.5 ºC, pulse 100/min and respiratory 22 cycles/min. Patient’s haemoglobin was 9.4g/dL, she had leukocytosis, elevated LDH and arterial blood gas analysis with moderate hypoxaemia (FiO2 1l/m: PaO2-63.6 mm Hg). Chest X-ray revealed diffuse interstitial changes. All the possible causes of unknown origin fever were excluded. Diagnosis was made through lung biopsy and treatment with combined chemotherapy and rituximab was prescribed leading to a 48 hours clinical remission. We present this case to show how difficult this diagnosis can be and how a good response to therapy is possible.

M, Felizardo; A C, Mendes; A, Fernandes; P, Campos; V, Magalhães; I, Correia; A, Pignatelli; C, Ferreira; R, Sotto-Mayor; A Bugalho de, Almeida.

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Primary lymphoma of the liver treated by extended hepatectomy and chemotherapy: a case report Linfoma primário do fígado tratado por hepatectomia ampliada e quimioterapia: relato de caso  

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Full Text Available Primary lymphoma of the liver is an extremely rare entity. A case of anaplastic large B-cell (both CD-20 and lambda positive non-Hodgkin's lymphoma that was confined to the liver in a 33-year-old man is reported. The patient was treated with an extended right hepatectomy and combination chemotherapy: cyclophosphamide, adriamycin, vincristine, and prednisone. The patient was disease free 24 months after the procedure.O linfoma primário do fígado é uma entidade extremamente rara. Os autores relatam um caso de linfoma não-Hodgkin de células B grandes anaplásicas (positivo para CD-20 e Lambda em um paciente do sexo masculino de 33 anos. O tumor estava localizado no lobo hepático direito e foi tratado por hepatectomia direita ampliada e quimioterapia pós-operatória com ciclofosfamida, adriamicina, vincristina e prednisone. Vinte quatro meses de seguimento o paciente encontra-se sem recidiva tumoral.

Eleazar Chaib

2002-09-01

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Linfoma no Hodgkin secundario a inmunosupresión por transplate renal tratado con quimioterapia  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish OBJETIVO: Los síndromes linfoproliferativos posterior a trasplante renal incluyen un grupo de enfermedades linfoides que por definición se presentan después del mismo en un órgano sólido o en la médula ósea y están en relación con la terapia inmunosupresora administrada. La probabilidad de desarroll [...] ar una neoplasia maligna en un receptor de trasplante renal seguido a lo largo de 17 años, es de un 14 % para cánceres no cutáneos, de un 47 % en los carcinomas de piel y un 55 % para cualquier tipo de cáncer. MÉTODO: En este trabajo se describe un caso poco común de un paciente de 40 años con insuficiencia renal crónica secundario a hipertensión arterial en hemodiálisis, quien se le realizó trasplante renal de cadáver en el 2007, presentando alteración de función renal con masa palpable en fosa ilíaca derecha, en tratamiento con inmunosupresores. RESULTADOS: El examen histopatológico de la biopsia reportó: desorden linfoproliferativo posterior a trasplante con inmunohistoquímica positivo para CD20, CD79 en células linfoides B y CD45 en células linfoides T. Estudios de extensión metástasis en mediastino concluyéndose como: linfoma no Hodgkin inmunofenotipo B CD20+ estadio IV extra nodal renal con metástasis en mediastino superior mayo/2009 IPI score alto riesgo secundario a trasplante renal. Recibió tratamiento con R-CHOP obteniéndose respuesta oncológica completa, demostrado por CT-PET, actualmente libre de enfermedad, en controles nefrológicos. CONCLUSIÓN: Se debe vigilar cualquier alteración clínica, ya que un rechazo de trasplante se puede confundir con una patología oncológica. Abstract in english OBJECTIVE: The posterior transplant lymph syndrome proliferative disorders include a group of renal lymphoid diseases by definition are present after a solid organ transplant or in bone marrow and are related to immunosuppressive therapy administered. The likelihood of developing a malignancy renal [...] transplant recipient followed over the 17 years is 14 % for the non-skin cancers, 47 % in the carcinomas of the skin and 55 % for any type of cancer. METHOD: In this work we describes a rare case of a 40 year old patient with chronic renal failure secondary to arterial hypertension in hemodialysis, who underwent cadaveric renal transplant in 2007, the patient presented impaired renal function with palpable mass in right iliac fosse, in treatment with immune suppressants. RESULTS: The histopathology examination of the biopsy reported, posterior transplant with lymphoproliferative disorder with immunohistochemistry positive for CD20, CD79 on B lymphoid cells and CD45 on T lymphoid cells, the extension studies concluding that the mediastinal metastases were: Non-Hodgkin’s lymphoma immunophenotyping B extranodal CD20 + stage IV renal with metastases in the superior mediastinum IPI score May/2009 classified how secondary to high risk renal transplantation. The patient was treated with R-CHOP we obtained a oncology complete response, as demonstrated by CT-PET, and currently free of disease, in nephrology controls. CONCLUSION: It should monitor any clinical manifestation in the treatment of this kind of patients and served as a rejection of transplant can be confused with metastatic brain tumor.

Ámbar, Guzmán; Hugo, Ruíz; Oneida, Parra; Carmen, Umbría; Angelo, Garofalo; Luisa, González; Karen, Kubicek.

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Primary lymphoma of the liver treated by extended hepatectomy and chemotherapy: a case report / Linfoma primário do fígado tratado por hepatectomia ampliada e quimioterapia: relato de caso  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese O linfoma primário do fígado é uma entidade extremamente rara. Os autores relatam um caso de linfoma não-Hodgkin de células B grandes anaplásicas (positivo para CD-20 e Lambda) em um paciente do sexo masculino de 33 anos. O tumor estava localizado no lobo hepático direito e foi tratado por hepatecto [...] mia direita ampliada e quimioterapia pós-operatória com ciclofosfamida, adriamicina, vincristina e prednisone. Vinte quatro meses de seguimento o paciente encontra-se sem recidiva tumoral. Abstract in english Primary lymphoma of the liver is an extremely rare entity. A case of anaplastic large B-cell (both CD-20 and lambda positive) non-Hodgkin's lymphoma that was confined to the liver in a 33-year-old man is reported. The patient was treated with an extended right hepatectomy and combination chemotherap [...] y: cyclophosphamide, adriamycin, vincristine, and prednisone. The patient was disease free 24 months after the procedure.

Eleazar, Chaib; Katia Ramos Moreira, Leite; Willian Abrão, Saad; Joaquim, Gama-Rodrigues.

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Linfoma Gástrico Primario  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Introducción: El Linfoma Gástrico Primario es una entidad infrecuente dentro de las neoplasias que afectan el estómago. La histología del Linfoma Gástrico Primario es variada y adquiere connotación especial el Linfoma a células B de la zona marginal extranodal, por su potencial remisión con la antib [...] ioticoterapia. Objetivos: Apreciar las características clínicas de los pacientes con Linfoma Gástrico Primario, los hallazgos endoscópicos más relevantes, identificar los factores que influencian la supervivencia y evaluar los efectos de la terapia. Material y métodos: El presente estudio es de tipo observacional, analítico y de corte transversal, se realizó en 169 pacientes con diagnóstico histológico de Linfoma Gástrico que fueron atendidos en el Instituto Especializado de Enfermedades Neoplásicas, Lima-Perú, desde Enero de 1995 a Diciembre del 2000. Para el estadiaje se utilizó el sistema Ann Arbor modificado por Musshoff y la histología de acuerdo a la clasificación REAL-WHO. El análisis estadístico incluyó el t de student y el chi cuadrado. La supervivencia fue consignada con las curvas de Kaplan Meier y los factores pronóstico con el test de regresión de Cox. Resultados: La muestra es representativa de pacientes de la Costa Peruana. La edad promedio es 55 años, con discreta predominancia del sexo femenino (54.4%). Los signos y síntomas son inespecíficos. El estadio clínico I-II corresponde al 75% de los pacientes. El patrón endoscópico de lesiones ulceradas múltiples es característico del Linfoma Gástrico. El 71% de los pacientes con Linfoma a células B de la zona marginal extranodal tuvieron remisión completa de la enfermedad con antibióticoterapia (5/7). El tipo histológico del Linfoma Gástrico en los 169 pacientes fue el siguiente: Linfoma a células B grande difuso 137 pacientes, Linfoma a células B de la zona marginal extra nodal 16 pacientes, Linfoma a células T periférico 6 pacientes, Linfoma a células grandes T anaplásico 3 pacientes, Linfoma no determinado 3 pacientes, Linfoma a células del manto 2 pacientes, Linfoma a células T del adulto 1 paciente y Linfoma folicular 1 paciente. La sobrevida global a 36 meses fue de 61.34%, la supervivencia de acuerdo al tipo histológico fue del 92.31% para Los Linfomas a células B de la zona marginal extranodal, del 62.21% para los Linfomas a células B grande difuso y del 29.63% para los Linfomas a células T. La sobrevida a 36 meses en pacientes con estadio clínico I-II que fueron tratados con quimioterapia fue del 82.16%, con cirugía fue del 71.89% y con cirugía más quimioterapia fue del 70.39%, mostrando los 3 grupos resultados semejantes (p: 0.6530). Los grupos catalogados de acuerdo al índice internacional, mostraron una clara diferencia entre ellos (p: 0.0000). El análisis univariado reveló que el Zubrod (p: 0.0000), el DHL (p: 0.0073), la remisión de la enfermedad (p: 0.0000), el estadio (p: 0.0000), el tratamiento (p: 0.0000), y la localización (p: 0.0000), tuvieron significancia estadística. El análisis multivariado mostró que en el modelo de regresión de Cox, la remisión (OR: 13.342, p: 0.0000), y la localización (OR: 2.375, p: 0.041), se encuentran dentro de la ecuación de dicha función. Conclusiones: Las lesiones ulceradas múltiples son características del Linfoma Gástrico. Se demuestra remisión de enfermedad en el Linfoma a células B de la zona marginal extranodal con antibioticoterapia (5/7). La quimioterapia en pacientes con EC I-II, alcanza resultados de supervivencia semejantes a la cirugía y a la combinación de ambas. Se confirma la validez del índice internacional y se demuestra en el análisis multivariado que la remisión y la localización de la enfermedad tienen significancia estadística. Abstract in english Introduction: Primary Gastric Lymphoma is an uncommon malignancy among gastric malignancies. Histology of the Primary Gastric Lymphoma is varied and the extranodal marginal zone B-cells lympho

Fernando, Barreda B; Regina, Gómez P; Dolly, Quispe L; Juvenal, Sánchez L; Juan, Combe G; Luis, Casanova M; Juan, Celis Z.

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LINFOMA PRIMARIO DE LA MAMA  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se presenta un caso clínico de Linfoma primario de la mama, patología de muy baja ocurrencia (0,1% de los cánceres de mama), en una mujer de 71 años, diagnosticado y tratado en la Unidad de Patología Mamaria del Servicio de Obstetricia y Ginecología del Hospital Clínico San Borja Arriarán en enero d [...] el 2002 Abstract in english A case report of Primary Lymphoma of the Breast, a very unusual breast pathology, that occur in approximately 0.1% of all breast cancer, is presented because of an outstanding clinical case, in a 71 years old woman, diagnosed and managed at the Breast Pathology Unit of the Gynecology Service of "San [...] Borja Arriarán Hospital" in January of 2002

Letzkus B., Jaime; Peralta M., Octavio; Ivanova, Galina; Gamboa G., Jorge; Belmar S., Alejandro; del Castillo S., Cesar; Campos M., Mónica; Peñaloza, Paulina; Cornejo C., Valeria; Vinés V., Eugenio.

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Estudo prospectivo e randomizado de pacientes tratados com e sem stents revestidos com carbeto de silício amorfo para a prevenção da reestenose coronariana. Avaliação ultra-sonográfica / Randomized intravascular ultrasound comparison between endoprostheses with and without amorphous silicon-carbide  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: A reestenose intra-stent é a maior limitação das intervenções coronárias percutâneas. O carbeto de silício amorfo (SiC-a), substância antitrombótica e antiinflamatória capaz de reduzir a deposição de fibrina, plaquetas e leucócitos sobre o stent, apresenta potencial de prevenir a hiperplas [...] ia neo-intimal e a reestenose. MÉTODOS: Estudo prospectivo, randomizado e tipo rótulo aberto comparando pacientes com doença coronariana tratados com e sem stents revestidos com o SiC-a, utilizando a angiografia quantitativa e o ultra-som intracoronário. Foram incluídos 100 pacientes (50 em cada grupo) a fim de mensurar o volume de hiperplasia neo-intimal intra-stent/extremidades. Como os stents comparados apresentavam extensões diferentes, o volume de hiperplasia foi analisado em valores absolutos (por paciente) e relativos (por milímetro de extensão do stent). Avaliaram-se ainda os eventos cardíacos maiores e os resultados da angiografia quantitativa. RESULTADOS: Os grupos apresentaram características de base semelhantes. Todos os pacientes foram tratados com sucesso. No 6° mês de evolução foram reestudados 94% dos casos dos dois grupos, obtendo-se ultra-som em 92%. O volume de hiperplasia neo-intimal absoluto foi significativamente maior nos tratados com os stents revestidos (51.2 DP 18.8 mm³ vs 41.9 DP 16.4 mm³; p=0.014), porém o relativo foi semelhante (2.9 DP 1.0 mm³/mm stent vs 2.5 DP 0.9 mm³/mm stent; p=0.108). A obstrução volumétrica da luz também foi similar (36.4 DP 11.1% vs 37.9 DP 10.9%; p=0.505). O diâmetro mínimo da luz (1.9 DP 0.7 mm vs 1.8 DO 0.6 mm; p=0.552), a reestenose (19.1% vs 17%; p>0.999) e a revascularização do vaso-alvo (16% vs 14%; p>0.999) não diferiram. CONCLUSÃO: Os stents revestidos apresentaram resultados clínicos, angiográficos e ultra-sonográficos similares aos controles. Abstract in english OBJECTIVE: In-stent restenosis remains a major limitation following coronary stent implantation. Amorphous silicon-carbide (a-SiC) coating has been shown to improve stent biocompatibility, therefore, reducing local inflammation and thrombus generation. Due to the latter, a-SiC coating might have an [...] impact on the prevention of neointimal hyperplasia (NIH) and restenosis. METHODS: This prospective, randomized, open-label trial compared a-SiC-coated (group A) versus uncoated (group B) stent implantation in de novo lesions. We included 100 patients (50 patients in each group) and the primary end-point was in-stent volume of NIH measured by intravascular ultrasound. RESULTS: All patients underwent successful stent deployment. Although absolute NIH volume was greater in A (51.2 mm³ SD 18.8 mm³ versus 41.9 mm³ SD 16.4 mm³; P = 0.014), relative (divided per mm of stent length) NIH volume was similar (2.9 mm³/mm stent SD 1.0 mm³/mm stent versus 2.5 mm³/mm stent SD 0.9 mm³/mm stent; P = 0.108). Late loss, restenosis, and major adverse cardiac events (MACE) were similar. CONCLUSION: A-SiC-coated stents did not reduce either NIH or MACE at long-term follow-up.

Luiz Fernando Leite, Tanajura; J. Eduardo M. R., Sousa; Amanda G. M. R., Sousa; Alexandre, Abizaid; João Eduardo T., Paula; Mariano, Albertal; Fausto, Feres; Luiz Alberto P., Mattos; Rodolfo, Staico; Ibraim M.F., Pinto.

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Estudo prospectivo e randomizado de pacientes tratados com e sem stents revestidos com carbeto de silício amorfo para a prevenção da reestenose coronariana. Avaliação ultra-sonográfica Randomized intravascular ultrasound comparison between endoprostheses with and without amorphous silicon-carbide  

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Full Text Available OBJETIVO: A reestenose intra-stent é a maior limitação das intervenções coronárias percutâneas. O carbeto de silício amorfo (SiC-a, substância antitrombótica e antiinflamatória capaz de reduzir a deposição de fibrina, plaquetas e leucócitos sobre o stent, apresenta potencial de prevenir a hiperplasia neo-intimal e a reestenose. MÉTODOS: Estudo prospectivo, randomizado e tipo rótulo aberto comparando pacientes com doença coronariana tratados com e sem stents revestidos com o SiC-a, utilizando a angiografia quantitativa e o ultra-som intracoronário. Foram incluídos 100 pacientes (50 em cada grupo a fim de mensurar o volume de hiperplasia neo-intimal intra-stent/extremidades. Como os stents comparados apresentavam extensões diferentes, o volume de hiperplasia foi analisado em valores absolutos (por paciente e relativos (por milímetro de extensão do stent. Avaliaram-se ainda os eventos cardíacos maiores e os resultados da angiografia quantitativa. RESULTADOS: Os grupos apresentaram características de base semelhantes. Todos os pacientes foram tratados com sucesso. No 6° mês de evolução foram reestudados 94% dos casos dos dois grupos, obtendo-se ultra-som em 92%. O volume de hiperplasia neo-intimal absoluto foi significativamente maior nos tratados com os stents revestidos (51.2 DP 18.8 mm³ vs 41.9 DP 16.4 mm³; p=0.014, porém o relativo foi semelhante (2.9 DP 1.0 mm³/mm stent vs 2.5 DP 0.9 mm³/mm stent; p=0.108. A obstrução volumétrica da luz também foi similar (36.4 DP 11.1% vs 37.9 DP 10.9%; p=0.505. O diâmetro mínimo da luz (1.9 DP 0.7 mm vs 1.8 DO 0.6 mm; p=0.552, a reestenose (19.1% vs 17%; p>0.999 e a revascularização do vaso-alvo (16% vs 14%; p>0.999 não diferiram. CONCLUSÃO: Os stents revestidos apresentaram resultados clínicos, angiográficos e ultra-sonográficos similares aos controles.OBJECTIVE: In-stent restenosis remains a major limitation following coronary stent implantation. Amorphous silicon-carbide (a-SiC coating has been shown to improve stent biocompatibility, therefore, reducing local inflammation and thrombus generation. Due to the latter, a-SiC coating might have an impact on the prevention of neointimal hyperplasia (NIH and restenosis. METHODS: This prospective, randomized, open-label trial compared a-SiC-coated (group A versus uncoated (group B stent implantation in de novo lesions. We included 100 patients (50 patients in each group and the primary end-point was in-stent volume of NIH measured by intravascular ultrasound. RESULTS: All patients underwent successful stent deployment. Although absolute NIH volume was greater in A (51.2 mm³ SD 18.8 mm³ versus 41.9 mm³ SD 16.4 mm³; P = 0.014, relative (divided per mm of stent length NIH volume was similar (2.9 mm³/mm stent SD 1.0 mm³/mm stent versus 2.5 mm³/mm stent SD 0.9 mm³/mm stent; P = 0.108. Late loss, restenosis, and major adverse cardiac events (MACE were similar. CONCLUSION: A-SiC-coated stents did not reduce either NIH or MACE at long-term follow-up.

Luiz Fernando Leite Tanajura

2004-12-01

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Linfoma renal primario / Primary renal lymphoma  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish OBJETIVO: Presentar un caso de linfoma renal primario. MATERIAL Y MÉTODOS: Estudiamos el caso clínico de un paciente en el que se descubrió una masa renal, con el diagnóstico anatomopatológico de linfoma renal primario. RESULTADOS: Se trata de un paciente de 78 años de edad que acudió a nuestra cons [...] ulta por dolor en fosa renal derecha. Al realizar varias pruebas complementarias se llegó al diagnóstico de masa renal derecha, cuyo estudio anatomopatológico tras punción-biopsia reveló un linfoma difuso de células B, siendo tratado con ciclos de quimioterapia sistémica según la pauta CHOP. CONCLUSIONES: El linfoma renal primario es una entidad rara y cuestionada por muchos autores. En la práctica clínica se presenta de modo similar al resto de tumores renales, por lo que su diagnóstico debe ser histológico. El tratamiento de elección es la quimioterapia sistémica con la combinación CHOP. Abstract in english OBJECTIVE: To describe a case of primary renal lymphoma. MATERIAL AND METHODS: We presents a patient with a right renal mass which histological analysis revealed a non-Hodgkin Lymphoma. RESULTS: A 78-year-old male patient with right flank pain mass was referred to our Service. He was diagnosed of re [...] nal mass by imaging studies. Inmunohistochemical investigations revealed a B-cell-type lymphoma. He received combination chemotherapy with CHOP. CONCLUSIONS: Primary renal lymphoma is a rare disease whose existence has been questioned, because the kidney does not normally contain lymphoid tissue. Its clinical presentation is like any other renal tumor and its definitive diagnosis is by histology. Elective treatment is chemotherapy (CHOP).

Torrecilla García-Ripoll, J.R.; Pascual Samaniego, M.; Martín Blanco, S.; Rivera Ferro, J.; Peral Martínez, J.I.; Fernández del Busto, E..

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Linfomas orbitarios: Presentación de nueve casos Orbital lymphomas: Presentation of nine cases  

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Full Text Available Objetivo: Describir nueve casos de linfomas orbitarios. Métodos: Revisión de historias clínicas de nueve pacientes diagnosticados de linfoma orbitario y consulta de la bibliografía relacionada con esta patología. Resultados: Se presenta una serie compuesta por cinco mujeres y cuatro varones con linfoma en la región orbitaria. En nuestros casos, la mayoría de los pacientes presentaron linfoma extraorbitario concurrente en el momento en el que el proceso orbitario fue detectado por primera vez (siete de los nueve pacientes. Tres de los pacientes presentaron linfoma MALT, dos linfomas foliculares, dos linfomas no Hodgkin de células B grandes, un linfoma de células B de bajo grado y un linfoma de células del manto. Ocho pacientes se mantienen vivos y uno ha fallecido a consecuencia de su linfoma en el momento de escribir este artículo. Conclusiones: Se ha observado un incremento de la incidencia de los linfomas no Hodgkin orbitarios durante las últimas tres décadas. El tipo más común en la región orbitaria es el linfoma MALT. La forma de presentación clínica que encontramos en nuestra serie es similar a la que se presenta en otros estudios. Dado que los linfomas son los tumores malignos más frecuentes en la órbita, habitualmente tienen también localización extraorbitaria, y pueden ser tratados con éxito en muchos casos, es importante que el oftalmólogo tenga presente esta patología.Purpose: To report nine cases of orbital lymphomas. Methods: We reviewed the clinical records of nine patients diagnosed with orbital lymphoma and performed a literature search related to this condition. Results: We present a series of five women and four males with orbital lymphoma involving the orbital region. In our cases, most patients presented concurrent extraorbital lymphoma when the orbital disease was first noticed (seven out of nine patients. We found three MALT lymphomas, two follicular lymphomas, two non-Hodgkin large B cell lymphomas, one low grade B cell lymphoma, and one mantle cell lymphoma. Eight patients were alive and one had died as a consequence of his lymphoma at the time this report was written. Conclusions: An increase in the incidence of non-Hodgkin orbital lymphomas has been observed over the last three decades. The most common type in the orbital region is the MALT lymphoma. The clinical features observed in our series are similar to those reported in the literature. Since lymphomas are the most frequent malignant tumours in the orbit, usually with extraorbital involvement, and can be successfully treated in many cases, it is important for the ophthalmologist to be aware of this condition.

C. Rey-Porca

2008-02-01

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Linfomas orbitarios: Presentación de nueve casos / Orbital lymphomas: Presentation of nine cases  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Describir nueve casos de linfomas orbitarios. Métodos: Revisión de historias clínicas de nueve pacientes diagnosticados de linfoma orbitario y consulta de la bibliografía relacionada con esta patología. Resultados: Se presenta una serie compuesta por cinco mujeres y cuatro varones con linf [...] oma en la región orbitaria. En nuestros casos, la mayoría de los pacientes presentaron linfoma extraorbitario concurrente en el momento en el que el proceso orbitario fue detectado por primera vez (siete de los nueve pacientes). Tres de los pacientes presentaron linfoma MALT, dos linfomas foliculares, dos linfomas no Hodgkin de células B grandes, un linfoma de células B de bajo grado y un linfoma de células del manto. Ocho pacientes se mantienen vivos y uno ha fallecido a consecuencia de su linfoma en el momento de escribir este artículo. Conclusiones: Se ha observado un incremento de la incidencia de los linfomas no Hodgkin orbitarios durante las últimas tres décadas. El tipo más común en la región orbitaria es el linfoma MALT. La forma de presentación clínica que encontramos en nuestra serie es similar a la que se presenta en otros estudios. Dado que los linfomas son los tumores malignos más frecuentes en la órbita, habitualmente tienen también localización extraorbitaria, y pueden ser tratados con éxito en muchos casos, es importante que el oftalmólogo tenga presente esta patología. Abstract in english Purpose: To report nine cases of orbital lymphomas. Methods: We reviewed the clinical records of nine patients diagnosed with orbital lymphoma and performed a literature search related to this condition. Results: We present a series of five women and four males with orbital lymphoma involving the or [...] bital region. In our cases, most patients presented concurrent extraorbital lymphoma when the orbital disease was first noticed (seven out of nine patients). We found three MALT lymphomas, two follicular lymphomas, two non-Hodgkin large B cell lymphomas, one low grade B cell lymphoma, and one mantle cell lymphoma. Eight patients were alive and one had died as a consequence of his lymphoma at the time this report was written. Conclusions: An increase in the incidence of non-Hodgkin orbital lymphomas has been observed over the last three decades. The most common type in the orbital region is the MALT lymphoma. The clinical features observed in our series are similar to those reported in the literature. Since lymphomas are the most frequent malignant tumours in the orbit, usually with extraorbital involvement, and can be successfully treated in many cases, it is important for the ophthalmologist to be aware of this condition.

Rey-Porca, C.; Pérez-Encinas, M.; González, F..

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Linfoma de Burkitt Burkitt lymphoma  

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Full Text Available El linfoma de Burkitt es un tipo de linfoma no Hodgkin, no frecuente en Cuba, pues es endémico de África Central. Diagnosticar uno en nuestro país siempre es significativo, por lo que conocerlo es importante.The Burkitt lymphoma is a type of non-Hodgkin lymphoma infrequent in Cuba since it is endemic of Central Africa. The diagnosis of one in our country always is significant, thus it is important to know it.

Fernando Sierra Arego

2012-03-01

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Linfoma de Burkitt / Burkitt lymphoma  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El linfoma de Burkitt es un tipo de linfoma no Hodgkin, no frecuente en Cuba, pues es endémico de África Central. Diagnosticar uno en nuestro país siempre es significativo, por lo que conocerlo es importante. [...] Abstract in english The Burkitt lymphoma is a type of non-Hodgkin lymphoma infrequent in Cuba since it is endemic of Central Africa. The diagnosis of one in our country always is significant, thus it is important to know it. [...

Fernando, Sierra Arego; Carlos Michel, López Rodríguez.

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Intravascular ultrasound chirp imaging :  

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We demonstrate the feasibility of intravascular ultrasound (IVUS) chirp imaging as well as chirp reversal ultrasound contrast imaging at intravascular ultrasound frequency. Chirp excitations were emitted with a 34?MHz single crystal intravascular transducer and compared to conventional Gaussian-shaped pulses of equal acoustic pressure. The signal to noise ratio of the chirp images was increased by up to 9?dB relative to the conventional images. Imaging of contrast microbubbles was impleme...

Maresca, D.; Jansen, K.; Renaud, G.; Soest, G.; Li, X.; Zhou, Q.; Jong, N.; Shung, K. K.; Steen, A. F. W.

2012-01-01

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Intravascular ultrasound chirp imaging  

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We demonstrate the feasibility of intravascular ultrasound (IVUS) chirp imaging as well as chirp reversal ultrasound contrast imaging at intravascular ultrasound frequency. Chirp excitations were emitted with a 34 MHz single crystal intravascular transducer and compared to conventional Gaussian-shaped pulses of equal acoustic pressure. The signal to noise ratio of the chirp images was increased by up to 9 dB relative to the conventional images. Imaging of contrast microbubbles was implemented by chirp reversal, achieving a contrast to tissue ratio of 12 dB. The method shows potential for intravascular imaging of structures in and beyond coronary atherosclerotic plaques including vasa vasorum.

Maresca, D.; Jansen, K.; Renaud, G.; van Soest, G.; Li, X.; Zhou, Q.; de Jong, N.; Shung, K. K.; van der Steen, A. F. W.

2012-01-01

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Linfoma primario de pulmón: Serie de casos / Primary pulmonary lymphoma: A case serie  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Los linfomas primarios de pulmón (LPP) son infrecuentes. Sus manifestaciones clínicas y las imágenes son inespecíficas. El retraso diagnóstico puede ser considerable. Objetivo: Analizar los LPP durante el período 2003-2013 en nuestra institución. Sobre 1892 linfomas, 4 fueron LPP (0,21%): 1) linfoma [...] no Hodgkin (n = 2); 2) linfoma Hodgkin (n= 1); 3) linfoma intravascular pulmonar (n = 1). Las manifestaciones clínicas y radiológicas fueron inespecíficas (masa pulmonar y derrame pleural, consolidación con broncograma aéreo y cavitación o bien ausencia de lesiones). Los métodos diagnósticos fueron: 1) punción guiada bajo TAC; 2) videotoracoscopía (VATS) y 3) VATS orientada por PET (tomografia por emisión de positrones) y 4) toracotomía. El tiempo entre la consulta inicial hasta el diagnóstico fue de 45 a 90 días. Este reporte confirma la baja incidencia de LPP, y sus manifestaciones clínicas y radiologías poco específicas. Esto puede contribuir a las demoras en el diagnóstico. El PETpuede mejorar el rendimiento diagnóstico, en especial en ausencia de compromiso pulmonar radiológico evidente. Abstract in english Primary Pulmonary Lymphomas (LPP) are infrequent and their clinical manifestations and images are usually nonspecific. Diagnostic delay may be important. The objective of this study was to analyze the LLP in our institution. Between 2003 and 2013, over 1,892 lymphomas were analyzed in our institutio [...] n. Only 4 of them (0.21% incidence) were detected as LPP: Non Hodgkin's Lymphoma (n = 2), Hodgkin's Lymphoma (n = 1), and Intravascular Pulmonary Lymphoma (n = 1). Clinical manifestations of the 4 cases presented were unspecific: 1) pulmonary mass and pleural effusion; 2) consolidation with air bronchogram and cavitations; 3) normal images and 4) pulmonary mass. Given these clinical settings, 4 diagnostic methods were used: 1) Computed Tomography-Guided Puncture, 2) Video-Assisted Thoracoscopic Surgery (VATS); 3) VATS guided by positron emission tomography (PET) and 4) thoracotomy. Hence, diagnosis was successfully made between 45 to 90 days from the initial consultation. This report confirms the low incidence of LPP, and its unspecific clinical and radiographic manifestations that may cause delay in diagnosis. PET can contribute to improve diagnostic performance, especially in patients without apparent lung involvement.

JULIO C, VILLARROEL S; MÁXIMO, ROMANCZUK; ESTEBAN J, WAINSTEIN; MARCOS, LAS HERAS; EDUARDO L, DE VITO; GRACIELA, SVETLIZA; JUAN A, PRECERUTTI.

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Linfoma de Hodgkin con afectación ósea: comunicación de un caso y revisión de la literatura  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Existen pocas comunicaciones en la literatura acerca de la afectación ósea primaria por linfoma de Hodgkin. El linfoma de Hodgkin representa menos del 0'15% de los tumores malignos primarios del hueso, aunque por radiología es frecuente detectar lesiones óseas en pacientes con enfermedad de Hodgkin. [...] Comunicamos el caso de un paciente inicialmente diagnosticado de linfoma de Hodgkin en fémur izquierdo, tratado con un régimen combinado de quimioradioterapia secuencial, que permanece libre de recaída a cuatro años después, aprovechando para revisar la literatura respecto a su diagnóstico y tratamiento. Abstract in english There are few literature reports about bone primary Hodgkin's lymphoma. Hodgkin's lymphoma represents less than 0.15 % of the primary malignant bone tumors, although radiology studies frequently detect bone lesions in patients with Hodgkin's disease. We report the case of a patient that was initiall [...] y diagnosed of bone Hodgkin's lymphoma with left femur involvement. The patient was treated by a combined regime of sequential chemo-radiotherapy in our Oncology Unit. He remains relapse-free three years after diagnosis. Taking advantage of our report we reviewed the literature looking for diagnostic and treatment strategies for the process.

Márquez Medina, D.; Márquez Lobo, B.; Talavera Hernández, M. C.; Blancas López-Barajas, I.; Sáez Medina, I.; García Puche, J. L..

 
 
 
 
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Linfoma de Burkitt oral: relato de caso Oral Burkitt's lymphoma: case report  

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Full Text Available O linfoma de Burkitt é um raro e agressivo tipo de linfoma não-Hodgkin pobremente diferenciado. O presente relato trata de uma criança do sexo masculino, com sete anos de idade, que foi examinada na Clínica de Odontopediatria do Departamento de Odontologia da UFRN, exibindo uma massa tumoral na região de pré-molares mandibulares com mobilidade dentária. O exame radiográfico revelou uma área radiolúcida difusa e o diagnóstico histopatológico foi de linfoma de Burkitt. O paciente foi tratado por poliquimioterapia e obteve completa remissão da patologia.Burkitt's lymphoma is a poorly differentiated rare and aggressive type of non-Hodgkin's lymphoma. This article reports the case of a male child aged seven years, who was examined at the Odontopediatric Clinic of the UFRN Dentistry Department. The patient presented a tumor in the premolar region of the mandible; teeth were mobile in this region. Radiology revealed a diffuse radioluscent area which was diagnosed histopathologically as Burkitt's lymphoma. The patient was treated with polychemotherapy; complete remission of the disease was attained.

Roseana de Almeida Freitas

2008-06-01

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Intravascular Papillary Endothelial Hyperplasia.  

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Papillary endothelial hyperplasia is a peculiar benign intravascular process that bears a remarkable resemblance to a hemangiosarcoma. In 44 cases of this lesion studied from the files of the Armed Forces Institute of Pathology, the process manifested as ...

K. P. Clearkin F. M. Enzinger

1975-01-01

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Linfoma nasal de células T asesinas naturales  

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Full Text Available El linfoma nasal de células T asesinas naturales, también conocido como granuloma letal de la línea media, es una entidad poco frecuente. Se trata de un linfoma extraganglionar de comportamiento agresivo que, usualmente, se origina en la cavidad nasal, prevalente en países orientales y en hombres en la tercera década de la vida. Su asociación con infección por el virus de Epstein-Barr actualmente está bien documentada. Su tratamiento es aún controvertido; la tendencia actual está a favor de la radioterapia. A continuación se presenta un caso de linfoma nasal de células T asesinas naturales y la revisión de la literatura, con el fin de proveer un mayor entendimiento de la enfermedad.

MARu00CDA CLAUDIA CHAVARRIAGA

2011-01-01

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Intravascular ultrasound imaging  

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This book will give vascular surgeons, cardiologists, radiologists, and technologists a complete working knowledge of intravascular ultrasound imaging and the crucial role of this new technology in endovascular diagnosis and therapy. The book reviews the essential principles of vascular pathology and ultrasound imaging and then provides state-of-the-art information on intraluminal ultrasound imaging devices and techniques, including practical guidelines for using catheters, optimizing image quality, and avoiding artifacts. Image interpretation and computerized image reconstruction are also discussed in detail. The first section explains the diagnostic, therapeutic, and experimental applications of intravascular ultrasound, particularly as a adjunct to angioplasty and other current interventional procedures.

Cavaye, D.M.; White, R.A. (UCLA School of Medicine in Los Angeles, CA (United States))

1992-01-01

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Linfoma MALT en diferentes localizaciones MALT lymphoma in different locations  

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Full Text Available Se describen 3 casos de pacientes con linfoma MALT, diagnosticados, tratados y seguidos en la consulta de hematología del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, a la cual fueron remitidos por gastroenterólogos, otorrinolaringólogos y maxilofaciales de la mencionada institución. Uno de los afectados presentaba una masa tumoral gástrica y en nasofaringe, aparecida en diferentes momentos; otro un tumor linfoide en el paladar duro, que recurrió en ganglios infradiafragmáticos; y un tercero un nódulo linfoide en la glándula salival parótida unilateral, con recidiva en ganglios regionales después de haber sido extirpado. Todos experimentaron una buena respuesta clínica al inicio del tratamiento convencional, pero en 2 de ellos se confirmaron reapariciones no locales del proceso morboso.Three cases of patients with MALT lymphoma are described, who were diagnosed, treated and followed up at the hematology department of "Saturnino Lora" Teaching Provincial Hospital in Santiago de Cuba, to which they were referred by gastroenterologists, otolaryngologists and maxillofacial specialists of that institution. One of those patients presented with a nasopharyngeal and gastric mass, which appeared at different times; another patient had lymphoid tumor of the hard palate, which recurred in infradiaphragmatic lymph nodes; and a third one had a lymphoid node in the unilateral salivary parotid gland with recurrence in regional nodes after having been removed. All experienced a good clinical response at the beginning of conventional treatment, but in 2 of them non-local recurrences of the disease process were confirmed.

Ana Dolores Izquierdo Calzado

2012-03-01

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Primary Non-Hodgkins lymphoma of the parotid gland / Linfomas malignos primários nas glandulas salivares  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Linfomas primários das glândulas salivares são relativamente raros. Sua apresentação clínica não écaracterística e, frequentemente, a doença passa despercebida, resultando em atrasos no diagnóstico e tratamento. OBJETIVO: Enfatizar a importância do diagnóstico e tratamento combinado. Apresentamos um [...] a casuística de oito pacientes com linfoma maligno da parótida, que foram diagnosticados somente após a cirurgia e tratados com radio e quimioterapia. MÉTODOS: Estudo retrospectivo de pacientes com linfoma maligno primário da glândula parótida, tratados com radioterapia e ressecção cirúrgica parcial diagnóstica. RESULTADOS: Após a conclusão do tratamento, atingimos uma taxa de controle loco-regional de 87,5%. A toxicidade foi classificada de acordo com os Critérios Comuns de Toxicidade e afetou seis pacientes (75%). Seis pacientes ainda estão vivos, sem evidência de doença na mais recente consulta de acompanhamento. CONCLUSÃO: Nosso estudo confirma que o Linfoma primário Não-Hodgkin em estágios iniciais da glândula parótida é uma doença com excelente prognóstico e boa taxa de controle local, com mínima morbidade. Abstract in english Primary malignant lymphomas in the salivary glands are relatively rare. Clinical presentation is not characteristic and the disease is often overlooked resulting in diagnosis and treatment delays. AIM: To stress the importance of the diagnostic process and combined management, we present a series of [...] eight patients with malignant lymphoma of the parotid who were diagnosed only after surgery and managed with radiation and chemotherapy. METHODS: Retrospective series of patients with primary malignant lymphoma of the parotid gland managed with radiotherapy and diagnostic surgical partial resection. RESULTS: After treatment completion we achieved a loco-regional control rate of 87.5%. Toxicity was charted according to the Common Toxicity Criteria and it was seen in six patients (75%). Six patients are still alive without evidence of recurrent disease in their last follow-up. CONCLUSION: Our study confirms that primary early stage Non-Hodgkin Lymphoma of the parotid gland is a disease with an excellent prognosis and a good local control rate, with minimal morbidity.

Francesco, Dispenza; Giuseppe, Cicero; Gianluca, Mortellaro; Donatella, Marchese; Gautham, Kulamarva; Carlo, Dispenza.

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Linfoma não Hodgkin simulando hanseníase virchowiana  

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Os autores relatam caso de linfoma não Hodgkin em paciente do sexo feminino, de 28 anos, ressaltando o diagnóstico diferencial com formas multibacilares de hanseníase. Além de achados clínicos passíveis de confusão, a histologia mostrava, de modo não usual, infiltrado inflamatório mononuclear perineural e perianexial.

2003-01-01

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Rinoscleroma e linfoma não-Hodgkin nasal  

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Full Text Available Introdução: O rinoscleroma é uma doença nasal granulomatosa rara, causada pela bactéria klebsiella rhinoscleromatis. O nariz representa a região primária de ocorrência. O linfoma não-Hodgkin nasal é uma rara neoplasia maligna, podendo ser do tipo T ou B. O rinoscleroma e o linfoma nasal não-Hodgkin apresentam como principal sintoma a obstrução nasal, e fazem parte do diagnóstico diferencial das granulomatoses nasais. Objetivo: Relatar a associação de rinoscleroma e linfoma não-Hodgkin nasal em um mesmo paciente, destacando a importância do diagnóstico diferencial das granulomatoses nasais. Relato do Caso: Paciente do sexo feminino, 49 anos, atendida com obstrução nasal progressiva há um mês. A rinoscopia evidenciava lesão aspecto papilomatoso em meato médio esquerdo. A imunohistoquímica confirmou rinoscleroma. A paciente foi corretamente tratada com remissão total da lesão. Dez meses após retornou com mesmos sintomas, mas histologia confirmou linfoma não-Hodgkin. Comentários Finais: Ambas as patologias podem causar sintomas nasais graves e complicações. O diagnóstico precoce possibilita a instituição do tratamento adequado e favorece o prognóstico. O estudo imunohistoquímico foi fundamental para a diferenciação diagnóstica.

Oliveira, Henrique Fernandes de

2009-03-01

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Thermal intravascular photoacoustic imaging  

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Intravascular photoacoustics (IVPA)—a minimally invasive imaging technique with contrast related to optical absorption properties of tissue, can be used to visualize atherosclerotic plaques. However, the amplitude of photoacoustic signals is also related to a temperature dependent, tissue specific parameter—the Grüneisen parameter. Therefore, photoacoustic signals measured at different temperatures may reveal information about tissue composition. In this study, thermal IVPA (tIVPA) imagi...

Wang, Bo; Emelianov, Stanislav

2011-01-01

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Intravascular lesions of the hand  

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Full Text Available Abstract Introduction Intravascular lesions of the hand comprise reactive and neoplastic entities. The clinical diagnosis of such lesions is often difficult, and usually requires pathologic examination. We present the largest series to date of intravascular lesions affecting the hand. Methods A retrospective review of intravascular (arterial and venous lesions involving the hand was conducted. Data regarding clinicopathologic findings were analyzed. Results We identified 10 patients with intravascular lesions of their hands including thromboemboli (n = 3, reactive intravascular conditions such as papillary endothelial hyperplasia or Masson's tumor (n = 2 and fasciitis (n = 1, as well as vascular neoplasms including pyogenic granuloma (n = 2 and angioleiomyoma (n = 2. Conclusion Blood vessel injury and/or venous thrombosis may predispose to several intravascular lesions of the hand. Recognition of reactive entities from neoplastic conditions is important.

Duke Wayne H

2008-05-01

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Linfoma não-Hodgkin de órbita: relato de caso Non-Hodgkin orbital lymphoma: case report  

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Full Text Available O objetivo é relatar manifestação incomum de linfoma não-Hodgkin de órbita. Paciente masculino, de 75 anos, se apresentou com queixa de lacrimejamento crônico bilateral. Havia feito dacriocistorrinostomia endonasal à direita e à esquerda por duas vezes, sem sucesso. Ao exame, massas de consistência fibroelástica, em topografia das "bolsas" de gordura das pálpebras inferiores e proptose axial. O paciente negava outros sintomas ou sinais sistêmicos. Hemograma sem alteração, hormônios tireoidianos normais. A tomografia computadorizada mostrava infiltrado difuso na órbita e proptose axial. Biópsia de gordura orbitária e de medula óssea diagnosticaram linfoma não-Hodgkin. O paciente foi tratado com quimioterapia, sendo em seguida submetido à cirurgia da via lacrimal bilateral, com resolução do quadro. A doença sistêmica que exigia diagnóstico e tratamento adequados para que se tivesse bom prognóstico estava mascarada pelo quadro de epífora bilateral.The purpose is to report an unusual case of orbital non-Hodgkin lymphoma. A 75-year-old man presented with bilateral chronic epiphora complaint and inferior eyelid tumors, axial proptosis, without previous systemic manifestation. The patient was submitted to bilateral endonasal dacryocystorhinostomy twice and the epiphora complaint persisted. The inferior eyelid and bone marrow biopsy revealed non-Hodgkin lymphoma. The patient was treated with systemic chemotherapy and dacryocystorhinostomy with good resolution. The precise diagnosis and the treatment were very important to reach a good resolution of the bilateral epiphora complaint.

Cristiane do Prado Silva

2008-04-01

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Linfoma não-Hodgkin de órbita: relato de caso / Non-Hodgkin orbital lymphoma: case report  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O objetivo é relatar manifestação incomum de linfoma não-Hodgkin de órbita. Paciente masculino, de 75 anos, se apresentou com queixa de lacrimejamento crônico bilateral. Havia feito dacriocistorrinostomia endonasal à direita e à esquerda por duas vezes, sem sucesso. Ao exame, massas de consistência [...] fibroelástica, em topografia das "bolsas" de gordura das pálpebras inferiores e proptose axial. O paciente negava outros sintomas ou sinais sistêmicos. Hemograma sem alteração, hormônios tireoidianos normais. A tomografia computadorizada mostrava infiltrado difuso na órbita e proptose axial. Biópsia de gordura orbitária e de medula óssea diagnosticaram linfoma não-Hodgkin. O paciente foi tratado com quimioterapia, sendo em seguida submetido à cirurgia da via lacrimal bilateral, com resolução do quadro. A doença sistêmica que exigia diagnóstico e tratamento adequados para que se tivesse bom prognóstico estava mascarada pelo quadro de epífora bilateral. Abstract in english The purpose is to report an unusual case of orbital non-Hodgkin lymphoma. A 75-year-old man presented with bilateral chronic epiphora complaint and inferior eyelid tumors, axial proptosis, without previous systemic manifestation. The patient was submitted to bilateral endonasal dacryocystorhinostomy [...] twice and the epiphora complaint persisted. The inferior eyelid and bone marrow biopsy revealed non-Hodgkin lymphoma. The patient was treated with systemic chemotherapy and dacryocystorhinostomy with good resolution. The precise diagnosis and the treatment were very important to reach a good resolution of the bilateral epiphora complaint.

Cristiane do Prado, Silva; Maria Aparecida, Domingues; Silvana Artioli, Schellini; Ligia, Niero.

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Linfoma no Hodgkin fulminante presentándose con acidosis láctica e insuficiencia hepática aguda: reporte de caso y revisión de la literatura  

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Full Text Available La falla hepática causada por neoplasias malignas es rara. Puede ser secundaria a cáncer hepatocelular, metástasis hepáticas, neoplasias secundarias o como complicación de agentes quimioterapéuticos. Las neoplasias hematológicas, como la leucemia, linfoma no Hodgkin y linfoma Hodgkin generalmente no causan falla hepática y más raramente aún producen falla hepática aguda fulminante. Caso clínico: se presenta un hombre de 43 años de edad con diarrea, náuseas y dolor abdominal leve de dos semanas de evolución. Fue tratado con antibióticos orales sin mejoría. Ingresó con falla hepática al departamento de urgencias en donde se lo encontró ictérico, agitado, taquicárdico e hipotenso. Tenía equimosis alrededor de los ojos y tórax, sangrado activo en sitios de venopunción y hematuria macroscópica. El abdomen estaba doloroso con hepatomegalia. Los estudios de laboratorio tenían hallazgos que correspondían a falla hepatorrenal aguda, serología para hepatitis viral negativa, anticuerpos antinucleares negativos y el panel de hierro normal. El ultrasonido abdominal mostró hepatoesplenomegalia. El paciente desarrolló hipoglucemia refractaria y mayor aumento de ácido láctico sérico. Falleció a los cinco días de su admisión. Conclusiones: la falla hepática aguda como presentación inicial de linfoma es rara. Esto puede retrasar el diagnóstico, contribuyendo al mal pronóstico de esta entidad. Establecer el diagnóstico de malignidad como causa de falla hepática aguda es difícil y requiere un alto índice de sospecha. Dado el mal pronóstico asociado con el diagnóstico tardío y los potenciales beneficios de la quimioterapia, se debe considerar al linfoma como causa de falla hepática aguda sin una etiología evidente y asociado a acidosis láctica y hepatomegalia.

Guillermo Flores Padilla

2009-01-01

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Linfomatosis intravascular cerebral como causa de demencia rápidamente progresiva: Reporte de un caso / Cerebral intravascular lymphomatosis as cause of subacute dementia: Report of a case  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La linfomatosis intravascular cerebral es un tipo de Linfoma no Hodgkin generalmente de células B, de presentación infrecuente, curso clínico progresivo y fatal. El daño vascular es producto de oclusión de vasos de pequeño calibre por infiltración tumoral, con resultado de múltiples infartos. Las ma [...] nifestaciones neurológicas suelen ser la forma de presentación clínica inicial, caracterizadas por un amplio espectro que incluye encefalopatía subaguda, deterioro cognitivo, delirio, afasia, hemiparesia, trastornos visuales, paraplejia, parestesias y compromiso de pares craneanos. Los estudios de RNM evidencian alteraciones indistinguibles de las vasculitis del SNC. La linfomatosis intravascular debe considerarse en el diagnóstico diferencial de las demencias rápidamente progresivas y en los cuadros de multi infarto cerebral de pequeño vaso de etiología inusual y recurrente. Se presenta el caso de un paciente con demencia rápidamente progresiva, con manifestaciones neurológicas de deterioro cognitivo y enfermedad sistémica. El compromiso del SNC se expresó como encefalopatía subaguda con confusión, agitación, y crisis convulsivas, trastornos motores con reflejo cutáneo plantar extensor bilateral y compromiso cerebeloso, de curso clínico sintomático progresivo, con baja de peso y fiebre fluctuante. El paciente fue sometido a tratamiento con metilprednisolona a pesar del cual falleció. El estudio necrópsico demostró alteraciones por Linfoma no Hodgkin difuso de células B, variante intra vascular, con compromiso del cerebro, cerebelo, glándulas suprarrenales, páncreas, miocardio, tiroides, pulmón riñón e hígado. Abstract in english Cerebral Intravascular Lymphomatosis is a type of non Hodgkin Lymphoma, generally composed with B cells, its ocurrence is infrequent, clinically progressive and has a fatal course. Vascular damage is related with tumoral infiltration and small caliber occlusion, with results in multi infarcts. Neuro [...] logical symptoms and signs are frequently the first clinical manifestation, which include sub acute encephalopathy, cognitive impairment, delirium, aphasia, hemipharesis, visual disturbances, paraplegia, paresthesia and cranial nerves involvement. MRI shows images of vasculitis from CNS. Cerebral Intravascular Lymphomatosis must be considered in differential diagnosis of rapid and subacute dementias, and clinical cases with small vessel recurrent multi infarct of unusual etiology. We present the clinical case of a patient with rapid progressive dementia and systemic disease manifestation. The CNS involvement was characterized as a subacute encephalopathy, with confusion and agitation, seizures, motor disturbances, bilateral plantar extensor reflexes and cerebellar signs. The clinical symptomatic course was progressive, with weight loss and fluctuant fever. The patient had a fatal course after he was treated with Methylprednisolone. Postmortem pathologic examination revealed a diffuse non Hodgkin lymphoma of B cells, intravascular variant, with brain compromise, cerebellum, suprarenal glands, pancreas, myocardium, thyroid gland, lung kidney and the lever.

Paula, Jiménez P; Oscar, Jiménez L; Pía, García F.

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Transfusión intrauterina intravascular  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Objetivo: Evaluar los resultados de 90 transfusiones intrauterinas intravasculares realizadas en 45 fetos afectados por aloinmunización Rh. Método: Descripción del procedimiento de transfusiones intrauterinas intravasculares y presentación de la evaluación y seguimiento prospectivo de 90 transfusion [...] es llevadas a cabo entre el período 1995- 2002. Ambiente: Unidad de Alto Riesgo del Servicio de Prenatal de la Maternidad “Concepción Palacios”. Caracas. Resultados: La edad promedio de las pacientes fue 25,8 años; se realizaron en promedio 2 transfusiones por paciente, con un mínimo de 1 y un máximo de 4; la mayoría de las pacientes tenían antecedentes de importancia como mortinato anterior e historia de enfermedad hemolítica; la principal indicación para realizar la el procedimiento fue la lectura de densidad óptica seguida por el hidrops fetal; la edad promedio para realizar la primera transfusión fue de 25,6 semanas con un mínimo de 20 semanas; los valores de hemoglobina fetal previa a la primera oscilaron entre 2 y 11,3 g/dL ascendiendo posterior a la transfusión a valores entre 5 y 15,3 g/dL; la sobrevida total fue de 69 % y al analizar sólo los fetos sin hidrops la sobrevida ascendió a 84,37 %. Conclusiones: La prevención con el uso de inmunoglobulina anti Rh D es definitivamente el mejor protocolo para evitar la anemia fetal por aloinmunización Rh, cuando se produce la enfermedad hemolítica intrauterina el mejor tratamiento es la reposición de sangre a través del cordón umbilical. En nuestro trabajo confirmamos que se debe adquirir una amplia experiencia en el manejo de las transfusiones intrauterinas para de esta forma prolongar la vida intrauterina y así alcanzar mayor madurez y probabilidad de sobrevida neonatal con menores riesgos y complicaciones. Abstract in english Objective: To present the results of 90 intrauterine intravascular transfusions performed in 45 Rh isoinmunized fetuses. Method: Description of the intrauterine intravascular transfusion´s procedure and presentation of evaluation and prospective floow up of 90 transfusions practiced from 1995 to 200 [...] 2. Setting: High Risk Unit of Prenatal Service at Maternidad Concepción Palacios. Caracas. Results: The mean age of patients was 25.8 years; the number of transfusions ranged from one to tour (the mean was two); most patients had important records of fetal death and hemolytic disease; transfusion was mainly prescribed after optical density values followed by fetal hydrops. Gestational age for the first procedure was 25.6 weeks with a minimum of 20 weeks; fetal haemoglobin values prior to the first transfusion ranged between 2-11.3 g/dL increasing to 5-15.3 g/dL post transfusion. Total survival was 69 % and increased to 84.37 % in the nonhydropic group. Conclusion: Prevention using antiRhD inmunoglobulin is definitively the best protocol when avoiding fetal anaemia due to Rh isoimmunization. When intrauterine hemolytic disease occurs, blood transfusion through umbilical cord seems to be the best option. In our experience, we confirmed that the accumulation of experience in intrauterine intravascular transfusion is needed in order to extend intrauterine life and so achieve a higher neonatal outcome along with less risk and complications.

Freddy, González Arias; Iván, Paravisini; Jazmín, Morales; Nelly, Vásquez de Martínez.

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Linfoma não Hodgkin gástrico / Gastric non-Hodgkin Lymphoma  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os linfomas extralinfonodais representam aproximadamente 1/3 de todos os linfomas não Hodgkin (LNH) e, embora possam ter início em qualquer tecido, mais frequentemente acometem o trato gastrointestinal, sendo o estômago o órgão responsável pela grande maioria dos casos. Os linfomas primários gástric [...] os são comumente LNH, sendo representados em mais de 95% dos casos pelo linfoma difuso de grandes células B e pelo linfoma MALT (mucosa associated lymphoid tissue). De evolução indolente, o linfoma MALT destaca-se por ser um modelo de câncer secundário à estimulação antigênica crônica exercida por uma bactéria denominada Helicobacter pylori (HP). No outro polo, situa-se o linfoma difuso de células B (LDGCB), que, de patogênese duvidosa, pode tratar-se de uma transformação de LNH MALT ou ainda se caracterizar por um linfoma "de novo". Neste estudo, revisamos a literatura, enfatizando aspectos importantes à prática clínica destes linfomas. Abstract in english Extranodal lymphomas account for about 30% of all non-Hodgkin lymphomas (NHL), and although they can originate in any tissue, the gastrointestinal tract is the most commonly affected structure with the stomach being the most common subtype. Diffuse Large B cell lymphoma (DLBCL) and MALT (mucosa asso [...] ciated lymphoid tissue) lymphoma account for more than 95% of the cases of gastric lymphoma. The indolent development of MALT lymphoma stands out as it is a type of cancer subject to chronic antigen stimulation by the Helicobacter pylori bacteria. Conversely, diffuse large B cell lymphomas, whose pathogenesis is uncertain, can be a transformation from MALT NHL or perhaps a new type of lymphoma. In this study we carried out a review of the literature, stressing the key aspects of these lymphomas in the clinical practice.

Costa, Renata O.; Hallack Neto, Abrahão E.; Chamone, Dalton A. F.; Aldred, Vera Lúcia; Pracchia, Luis F.; Pereira, Juliana.

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Linfoma angiocéntrico centrofacial / Centrofacial angiocentric lymphoma  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El linfoma angiocéntrico centrofacial es una neoplasia linfoide rara, con un diagnóstico a menudo difícil, debido al cuadro clínico inespecífico y a que muchas veces son necesarias varias biopsias para llegar a un diagnóstico correcto. Se trata de un linfoma no Hodgkin(LNH) agresivo, de localización [...] preferente en el tracto respiratorio superior (sobre todo en cavidad nasal), y con un pronóstico ominoso, ya que la supervivencia media es de 12-18 meses aproximadamente(1). Predomina en orientales y sudamericanos, entre los 50-60 años de edad, y con ligera preferencia por el sexo masculino (2:1). Se presenta el caso de una paciente ecuatoriana que acude a nuestro servicio con edema hemifacial, rinorrea achocolatada y obstrucción respiratoria nasal de 1 mes de evolución, sin respuesta al tratamiento antibiótico y antiinflamatorio, que tras realizar varias pruebas diagnósticas se evidenció histológicamente la presencia de un linfoma T extranodal de tipo nasal (también llamado linfoma de células T angiocéntrico). Abstract in english The centrofacial angiocentric lymphoma is a rare lymphoid neoplasm, with an often-difficult diagnosis due to the non-specific clinical picture. On many occasions it is necessary to perform various biopsies to reach the correct diagnosis. This lymphoma is an aggressive Non-Hodgkin?s (NHL) type, which [...] is normally found in the upper respiratory tract (predominantly in the nasal cavity), and has an ominous prognosis, as the average survival rate is between 12 and 18 months (1). It is predominantly found in subjects of oriental and South American extraction, who are between the ages of 50 and 60 years and with a slight tendency towards males (2:1). This is the case study of a female Ecuadorian patient who was referred to our department with a hemifacial edema, chocolate-like rhinorrhea and nasal respiratory obstruction, which had been treated with antibiotics and anti-inflammatories for a month without success. After performing a number of diagnostic tests, it was found histologically that the patient had an extranodal T-cell lymphoma of the nasal type (also known as T-cell angiocentric lymphoma).Key words: Centrofacial angiocentric lymphoma, T-cell nasal lymphoma, lethal midline granuloma.

Peral Cagigal, Beatriz; Galdeano Arenas, María; Crespo Pinilla, Juan Ignacio; García Cantera, José Miguel; Sánchez Cuéllar, Luis Antonio; Verrier Hernández, Alberto.

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Complicaciones neurológicas en pacientes con linfomas  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio descriptivo prospectivo en 270 pacientes con diagnóstico de linfoma ingresados en el Servicio de Hematología del Hospital Clinicoquirúrgico "Hermanos Ameijeiras" de Ciudad de La Habana, Cuba, en el período comprendido del 1ro de marzo de 1996 al 31 de diciembre de 1998, para co [...] nocer las complicaciones neurológicas. Se detectaron 26 pacientes con complicaciones neurológicas. De 188 enfermos con linfomas no-Hodgkin, el 12,2 % presentó manifestaciones neurológicas. En estos pacientes, la infiltración leptomeníngea fue la complicación neurológica más frecuente. En los 82 pacientes con enfermedad de Hodgkin, solamente 3,6 % tuvieron alteraciones neurológicas y la infección por Herpes zoster fue la más común. Se observó el mayor porcentaje de pacientes con síntomas y signos atribuibles a compresión de la médula espinal y a la alteración de pares craneales, la cefalea como el síntoma más común y el déficit motor, el signo más frecuente. Se comprobó que los pacientes con linfoma no Hodgkin de alto grado de malignidad presentaron el mayor porcentaje de complicaciones neurológicas (28,7 %) y el tiempo promedio entre el diagnóstico del linfoma y el diagnóstico de la complicación neurológica fue menor en estos enfermos (5,5 meses). El tiempo de supervivencia después del diagnóstico de las manifestaciones neurológicas en la mayoría de los pacientes fue inferior a un año. De los 14 pacientes fallecidos, la complicación neurológica fue la principal causa directa de la muerte Abstract in english A prospective and descriptive study was carried out in 270 patients diagnosed of lymphoma, admitted in Hematology Service of "Hermanos Ameijeiras" Clinical Surgical Hospital in Havana City, Cuba, from March 1, 1996 to December 31, 1998, to assess neurologic complications. 26 patients presenting with [...] neurologic complications were detected. From 188 sick persons with non-Hodgkin's lymphoma, 12,2 % had neurologic manifestations. In these patients, leptomeninges infiltration was the more frequent neurologic complication. In 82 patients with Hodgkin's disease, only 3,6 % had neurologic alteration and Herpes zoster infection was the commonest one. We found higher percent of patients with syndromes attributable to spinal cord compression and to craneal pars disturbance, headache was commonest and motor deficit the more frequent one. It was confirmed that patients carriers of high grade malinancy non-Hodgkin' s lymphoma, had the great percentage of neurologic complications (28,7 %), and average time between diagnosis of lymphoma and that of neurologic complications was shorter in these patients was (5,5 months). Survival after diagnosis of neurologic manifestations in most patients was under l year. In 14 patients deceaced, neurologic complication was main direct cause of death

Nelson, Gómez Viera; Marisol, Monteagudo Torres; Raúl, de Castro Arenas; Dania, Ruiz García.

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Complicaciones neurológicas en pacientes con linfomas  

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Full Text Available Se realizó un estudio descriptivo prospectivo en 270 pacientes con diagnóstico de linfoma ingresados en el Servicio de Hematología del Hospital Clinicoquirúrgico "Hermanos Ameijeiras" de Ciudad de La Habana, Cuba, en el período comprendido del 1ro de marzo de 1996 al 31 de diciembre de 1998, para conocer las complicaciones neurológicas. Se detectaron 26 pacientes con complicaciones neurológicas. De 188 enfermos con linfomas no-Hodgkin, el 12,2 % presentó manifestaciones neurológicas. En estos pacientes, la infiltración leptomeníngea fue la complicación neurológica más frecuente. En los 82 pacientes con enfermedad de Hodgkin, solamente 3,6 % tuvieron alteraciones neurológicas y la infección por Herpes zoster fue la más común. Se observó el mayor porcentaje de pacientes con síntomas y signos atribuibles a compresión de la médula espinal y a la alteración de pares craneales, la cefalea como el síntoma más común y el déficit motor, el signo más frecuente. Se comprobó que los pacientes con linfoma no Hodgkin de alto grado de malignidad presentaron el mayor porcentaje de complicaciones neurológicas (28,7 % y el tiempo promedio entre el diagnóstico del linfoma y el diagnóstico de la complicación neurológica fue menor en estos enfermos (5,5 meses. El tiempo de supervivencia después del diagnóstico de las manifestaciones neurológicas en la mayoría de los pacientes fue inferior a un año. De los 14 pacientes fallecidos, la complicación neurológica fue la principal causa directa de la muerteA prospective and descriptive study was carried out in 270 patients diagnosed of lymphoma, admitted in Hematology Service of "Hermanos Ameijeiras" Clinical Surgical Hospital in Havana City, Cuba, from March 1, 1996 to December 31, 1998, to assess neurologic complications. 26 patients presenting with neurologic complications were detected. From 188 sick persons with non-Hodgkin's lymphoma, 12,2 % had neurologic manifestations. In these patients, leptomeninges infiltration was the more frequent neurologic complication. In 82 patients with Hodgkin's disease, only 3,6 % had neurologic alteration and Herpes zoster infection was the commonest one. We found higher percent of patients with syndromes attributable to spinal cord compression and to craneal pars disturbance, headache was commonest and motor deficit the more frequent one. It was confirmed that patients carriers of high grade malinancy non-Hodgkin' s lymphoma, had the great percentage of neurologic complications (28,7 %, and average time between diagnosis of lymphoma and that of neurologic complications was shorter in these patients was (5,5 months. Survival after diagnosis of neurologic manifestations in most patients was under l year. In 14 patients deceaced, neurologic complication was main direct cause of death

Nelson Gómez Viera

2000-06-01

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Linfoma no Hodgkin secundario a inmunosupresión por transplate renal tratado con quimioterapia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJETIVO: Los síndromes linfoproliferativos posterior a trasplante renal incluyen un grupo de enfermedades linfoides que por definición se presentan después del mismo en un órgano sólido o en la médula ósea y están en relación con la terapia inmunosupresora administrada. La probabilidad de desarrollar una neoplasia maligna en un receptor de trasplante renal seguido a lo largo de 17 años, es de un 14 % para cánceres no cutáneos, de un 47 % en los carcinomas de piel y un 55 % para c...

2011-01-01

 
 
 
 
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Manifestaciones pulmonares en pacientes con linfomas  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio descriptivo en 88 pacientes con linfomas (25 con enfermedad de Hodgkin y 63 con linfoma no Hodgkin) atendidos en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras" desde abril de 1997 hasta diciembre de 1998, para identificar las manifestaciones pulmonares. Se estudiaron los s [...] íntomas y signos del aparato respiratorio y los resultados de la radiografía del tórax en todos los pacientes. En 79 de ellos se realizaron pruebas funcionales respiratorias. Predominaron los pacientes asintomáticos (69/88; 78,4 %) (p Abstract in english A descriptive study was conducted in 88 patients with lymphomas (25 Hodgkin?s disease and 63 non-Hodgkin?s lymphoma) seen at "Hermanos Ameijeiras" Clinical and Surgical Hospital from April 1997 to December 1998. Its objective was to identify the pulmonary manifestations. Symptoms and signs of the re [...] spiratory system and chest Rx results were analyzed in all the patients. Seventy-nine of them underwent respiratory function testing. Asymptomatic patients prevailed (69/88 for 78,4 %) (p

de la Campa, Jesús Diego; Carnot Uría, José; Muñío Perurena, Jorge; de Castro Arenas, Raúl; Pérez Román, Guillermo; Suárez González, Lisbett.

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Tejido linfoide y linfomas gástricos Lymphoid tissue and gastric lymphomas  

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Full Text Available En este artículo hemos realizado una amplia revisión de los linfomas primarios gástricos, su clasificación y aspectos clínico-patológicos más importantes, haciendo énfasis especial en los linfomas MALT o asociados a las mucosas y su relación con la infección por Helicobacter pylori.In this review we describe various aspects of the primary gastric lymphomas, the classification, and the most important clinico-pathological aspects, with emphasis in mucosa associated lymphoma (MALT and the Helicobacter pylori infection.

Rocío del Pilar López P

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Linfoma Nasossinusal de Células T Natural Killer: Relato de Caso  

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Full Text Available Introdução: O linfoma nasal primário é um tumor extranodal raro e representa 0,44% de todos os linfomas extranodais nessa localização. O linfoma nasal primário deriva da linhagem T em torno de 75% dos casos. Objetivo: Descrever um caso de Linfoma nasossinusal de células T Natural Killer, atendido no Hospital das Clínicas da Universidade Federal de Goiás. Relato do Caso: Paciente de 48 anos, sexo feminino, apresentando tumefação difusa na hemiface esquerda, de consistência firme-elástica e dolorosa a compressão digital. Tomografia dos seios da face identificou um velamento maxilar total à esquerda e de algumas células etmoidais posteriores. Com a hipótese diagnóstica de uma afecção tumoral, optou-se por remoção cirúrgica via transmaxilar, sendo encaminhado o material para biopsia. O exame histopatológico diagnosticou um tumor altamente necrótico padrão angiocêntrico, população linfoide polimórfica e atípica (Linfoma T/NK, diante do diagnóstico a paciente foi submetida à quimioterapia com regressão total do edema facial. Comentários Finais: O otorrinolaringologista deve estar atento para a existência dos linfomas entre as doenças nasossinusais, pois o diagnóstico precoce melhora a sobrevida na medida em que previne metástases, crescimento e destruição local.

Castro, Victor Labres da Silva

2011-01-01

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SEPSIS Y COAGULACIÓN INTRAVASCULAR DISEMINADA  

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Full Text Available La coagulación intravascular diseminada se presenta en el contexto de numerosas situaciones clínicas de las cuales la sepsis es la más común, particularmente la de origen bacteriana. Se analizaron las principales características del factor tisular y su participación en el inicio de la coagulación durante la endotoxemia. Se revisó el papel fisiopatológico y terapéutico del sistema de la proteína C en la modulación de la coagulación y de la respuesta inflamatoria durante la coagulación intravascular diseminada por sepsis, y finalmente se examinó en detalle el papel de las citocinas y de la fibrinólisis en la aparición y en la evolución del cuadro de coagulación intravascular diseminada, así como las posibles dianas terapéuticas dentro de los mecanismos que se estudiaron, actualmente no existen pautas de tratamiento estandarizados, a parte de la lucha contra la enfermedad de base.

Carlos Miguel Sarduy Ramos

2004-01-01

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QUIMIOTERAPIA COMBINADA NEOADYUVANTE SEGUIDA DE RADIOTERAPIA EXTERNA EN EL TRATAMIENTO DE DOS CASOS DE LINFOMA PRIMARIO DEL CUELLO UTERINO  

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Full Text Available Los linfomas primarios del cuello uterino son poco frecuentes. Dado que no hay esquemas de manejo definido, presentamos 2 nuevos casos tratados y controlados desde 1999 a la fecha en la Fundación Arturo López Pérez. El tratamiento consistió en quimioterapia combinada neoadyuvante seguida de radioterapia externa. Se verificó respuesta clínica y radiológica completa en ambos casos. Conclusión: Se puede lograr respuesta completa de estas neoplasias linfoides con esta modalidad de tratamientoBackground: Primary extranodal lymphomas of the genital tract are rare. Cases: As there is no current consensus in its management, we present two further cases and their treatment with neoadyuvant chemotherapy, followed by radiation therapy. A radical hysterectomy with bilateral pelvic lymphadenectomy was performed after primary treatment in one case. Clinical response was complete in both cases and pathological response was documented in one. Conclusions: Complete response of these lymphoid neoplasms can be achieved by neoadyuvant chemotherapy followed by external irradiation

Marco Bravo S.

2005-01-01

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Intravascular adenomyomatosis: expanding the morphologic spectrum of intravascular leiomyomatosis.  

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Intravascular leiomyomatosis (IVL) is characterized by the presence of smooth muscle in venous and lymphatic spaces within the myometrium. Although the intravascular component usually consists solely of typical smooth muscle or variants of smooth muscle differentiation, we report 5 cases in which the intravascular component also included endometrioid glandular and stromal elements. We propose the term "intravenous adenomyomatosis" to describe this unusual variant of IVL. The mean age of the patients in this series was 50.2 years, slightly older than that of patients with conventional IVL. In addition to intravenous adenomyomatosis, both adenomyosis and leiomyomas were identified in all of our cases, supporting the hypothesis that the intravascular smooth muscle component in IVL is derived from associated myometrial pathology rather than from vessel walls. In our series, intravenous adenomyomatosis had a similar benign clinical behavior to most cases of IVL with no metastatic or recurrent disease identified at follow-up in 4 cases for which follow-up information was available. The main differential diagnoses are adenomyosis with vascular involvement, low-grade endometrial stromal sarcoma (ESS), including ESS with smooth muscle and glandular differentiation, and adenosarcoma with lymphovascular invasion. The possibility of intravenous adenomyomatosis should be borne in mind when considering these diagnoses, particularly ESS and adenosarcoma, which have different implications for patient management and prognosis. PMID:24076777

Hirschowitz, Lynn; Mayall, Frederick G; Ganesan, Raji; McCluggage, W Glenn

2013-09-01

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Primary testicular non-Hodgkin's lymphoma: a review article / Linfoma primário do testículo: um artigo de revisão  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese O linfoma primário do testículo (LPT) foi descrito como uma entidade clínica pela primeira vez em 1866. É uma doença rara e corresponde a 1% de todos os linfomas não-Hodgkin, 2% de todos os linfomas extranodais e 5% de todos as neoplasias testiculares. É o tumor testicular mais comum em homens entre [...] 60 e 80 anos de idade. LPT é único em sua elevada incidência de envolvimento bilateral (8-38%), sendo o tumor testicular bilateral mais comum. Tem uma predileção por disseminação para regiões extranodais não-contíguas, especialmente para o sistema nervoso central (SNC). Estágios avançados da doença são usualmente tratados com quimioterapia à base de doxorubicina. Para os estágios mais precoces, as opiniões são divergentes quanto à quimioterapia associada à orquiectomia. A alta prevalência de disseminação, especialmente para o SNC, sugere o uso de quimioterapia intratecal como profilaxia. Estudos prospectivos multicêntricos incluindo um grande número de pacientes poderiam resolver a questão com relação ao manejo deste subtipo de linfoma não-Hodgkin. Abstract in english Primary testicular non-Hodgkin's lymphoma was first described as a clinical entity in 1866. It is a rare disease and accounts for 1% of all non-Hodgkin's lymphoma, 2% of all extranodal lymphomas and 5% of all testicular neoplasms. It is the most common testicular tumor in males between sixty and eig [...] hty years of age. Testicular non-Hodgkin's lymphoma is unique in its high incidence of bilateral involvement (8-38%), and it is also the most common bilateral testicular tumor. Testicular non-Hodgkin's lymphoma has a predilection for spreading to non-contiguous extranodal sites, especially the central nervous system. Advanced-stage disease is usually managed with doxorubicin-based chemotherapy. For early-stage disease, opinion is divided regarding systemic chemotherapy following orchidectomy. The high incidence of spreading, especially to the central nervous system, leads to advocacy of the use of central nervous system prophylaxis with intrathecal chemotherapy. Prospective multicenter trials incorporating a large number of patients may lead to better guidelines for optimal management of this subtype of non-Hodgkin's lymphoma.

Bhatia, Komal; Vaid, Ashok Kumar; Gupta, Sachin; Doval, Dinesh Chandra; Talwar, Vineet.

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Linfoma no Hodgkin de células T: una nueva visión  

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Full Text Available Los linfomas no Hodgkin de células T, son enfermedades malignas poco comunes. La clasificación actual WHO/EORTC, reconoce 10 entidades clínico patológicas diferentes, estas entidades tiene una única característica y requieren individualizar el diagnóstico y el tratamiento de los mismos. En años recientes se han hecho grandes progresos en el conocimiento de la patogenia de estas enfermedades. La traslocación cromosomal especifica, y las infecciones virales son asociadas actualmente a ciertos linfomas. En esta revisión se describen la presentación clínico patológica, y además se discuten los estudios moleculares en diagnóstico de de los linfomas de células T, debido a la rareza de estas entidades y la escasez de investigaciones a gran escala acerca de las mismas su tratamiento aun es un reto, basado en bases anecdóticas, requiriéndose aun estudios mas extensos acerca de las bases biológicas de estas enfermedades para poder obtener terapias mas satisfactorias.

Alfredo Arredondo Bruce

2009-01-01

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ENFERMEDAD RENAL POLIQUISTICA ASOCIADA A LINFOMA EXTRANODAL EN UN CANINO  

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Full Text Available Objetivo: Presentar el caso de un paciente canino, con enfermedad renal poliquística, asociada alinfoma extranodal. Materiales y métodos: Se estudió el caso de un paciente canino de raza SiberianHusky de 7 años de edad, al que se le encontraron múltiples nódulos renales bilaterales, condiagnóstico histopatológico de linfoma extranodal. Resultados: Se expone el caso clínico de unpaciente canino de raza Siberian Husky, que es presentado a consulta dermatológica por exhibirlesiones alopécicas multifocales. Una vez realizado el examen físico sistemático se evidenció demanera incidental nefromegalia. Los exámenes paraclínicos e histopatológicos aplicadosdemostraron la presencia de enfermedad renal poliquística asociada a linfoma extranodal, comoconsecuencia se presento falla renal crónica. Conclusiones: El linfoma extranodal renal es unaentidad patológica de rara presentación, clínicamente cursa con signos muy similares a otrasalteraciones tumorales, su diagnóstico suele ser histopatológico.

Diego Echeverry B

2006-12-01

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Manifestaciones pulmonares en pacientes con linfomas  

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Full Text Available Se realizó un estudio descriptivo en 88 pacientes con linfomas (25 con enfermedad de Hodgkin y 63 con linfoma no Hodgkin atendidos en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras" desde abril de 1997 hasta diciembre de 1998, para identificar las manifestaciones pulmonares. Se estudiaron los síntomas y signos del aparato respiratorio y los resultados de la radiografía del tórax en todos los pacientes. En 79 de ellos se realizaron pruebas funcionales respiratorias. Predominaron los pacientes asintomáticos (69/88; 78,4 % (p A descriptive study was conducted in 88 patients with lymphomas (25 Hodgkin’s disease and 63 non-Hodgkin’s lymphoma seen at "Hermanos Ameijeiras" Clinical and Surgical Hospital from April 1997 to December 1998. Its objective was to identify the pulmonary manifestations. Symptoms and signs of the respiratory system and chest Rx results were analyzed in all the patients. Seventy-nine of them underwent respiratory function testing. Asymptomatic patients prevailed (69/88 for 78,4 % (p < 0,01; the most frequent respiratory symptom was cough (6/25 for 24 % in Hodgkin’s disease and 10/63 for 15,8 % in non-Hodgkin’s lymphomas. A high number of patients did not present alterations when they were applied a respiratory physical exam (73/88 for 82,9 % (p < 0,01; the reduction of vesicular breath sounds was the most frequent disturbance (15/88 for 17 %. It was observed that chest radiology was normal in more than half of the cases (53/88 for 60.2% (p = 0,025 and mediastinal adenopathies were the most frequent disorders (30/88 for 34 %. Alterations in X-rays were mostly found in Hodgkin’s disease (18/25 for 72 % that non-Hodgkin´s lymphoma (17/63, 27 %. The respiratory function tests were normal in 74.7 % of the cases (59/79 (p < 0,01 whereas slight restrictive ventilatory disorder was more detected (9/79 for 11,4 %. Data revealed that in the group of studied patients, the frequency of pulmonary manifestations is similar to the one reported by other authors and that there are neither pathognomonic respiratory symptoms nor signs for each type of lymphoma.

Jesús Diego de la Campa

2002-04-01

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Linfoma T-NK extranasal y extranodal en hipofaringe: un tipo de linfoma poco frecuente en nuestro medio  

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Full Text Available Varón de 81 años que presenta una lesión en la hipofaringe de crecimiento rápido. Se le diagnostica de linfoma T de tipo “Natural Killer” (NK, un tipo de linfoma raro en esta localización. Con el estudio inmunhistoquímico pudo caracterizarse este linfoma. Fallece en el transcurso del primer ciclo de tratamiento quimioterápico. Se le realiza estudio necrópsico para evaluar la rápida evolución del tumor, su extensión y la causa de la muerte. La autopsia sigue mostrándose una herramienta básica y fundamental para el estudio de ciertas entidades raras en su frecuencia o localización. En este caso además, debido a su rápida evolución, la autopsia fue fundamental para demostrar la persistencia de enfermedad y su extensión a otros órganos no identificados en vida, como la médula ósea, con implicaciones en el estadiaje de la enfermedad.

M. Mayorga Fernández

2006-01-01

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Hiperplasia papilar endotelial intravascular Intravascular papillary endothelial hyperplasia  

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Full Text Available La hiperplasia endotelial papilar intravascular (PEH, también conocida como hemangioendotelioma vegetante intravascular o pseudoangiosarcoma de Masson, es una lesión vascular benigna inusual, no neoplásica, que consiste en una rara proliferación endotelial reactiva, comúnmente localizada en la piel y en los tejidos subcutáneos. Es importante remarcar los aspectos que distinguen esta entidad de otras lesiones neoplásicas para evitar tratamientos inapropiados: se diferencia del angiosarcoma por su circunscripción, la localización en un vaso, su asociación con trombosis y su arquitectura papilar sin atipia citológica significativa o áreas de crecimiento sólido. El tratamiento consiste en la completa resección de la lesión incluyendo amplios márgenes para evitar la recurrencia.The intravascular papillary endothelial hyperplasia (PEH, also known as hémangioendothéliome végétant intra-vasculaire or Masson's pseudoangiosarcoma, is an unusual benign, non-neoplastic, vascular lesion, with rare non-neoplasic reactive endothelial proliferation most commonly located in the skin or subcutaneous tissues. It is important to remark the features that can distinguish this entity from other neoplasms to avoid inappropriate treatment. Pathological characteristics that distinguish PEH from angiosarcoma could be reduced to circumscription of the lesion, location in a vessel or association with thrombus and papillary architecture without significant cytologic atypia or areas of solid growth. Treatment consists of complete resection of the tumor, including wide enough margins to avoid recurrence.

R. Fernández García-Guilarte

2009-06-01

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Hiperplasia papilar endotelial intravascular / Intravascular papillary endothelial hyperplasia  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La hiperplasia endotelial papilar intravascular (PEH), también conocida como hemangioendotelioma vegetante intravascular o pseudoangiosarcoma de Masson, es una lesión vascular benigna inusual, no neoplásica, que consiste en una rara proliferación endotelial reactiva, comúnmente localizada en la piel [...] y en los tejidos subcutáneos. Es importante remarcar los aspectos que distinguen esta entidad de otras lesiones neoplásicas para evitar tratamientos inapropiados: se diferencia del angiosarcoma por su circunscripción, la localización en un vaso, su asociación con trombosis y su arquitectura papilar sin atipia citológica significativa o áreas de crecimiento sólido. El tratamiento consiste en la completa resección de la lesión incluyendo amplios márgenes para evitar la recurrencia. Abstract in english The intravascular papillary endothelial hyperplasia (PEH), also known as hémangioendothéliome végétant intra-vasculaire or Masson's pseudoangiosarcoma, is an unusual benign, non-neoplastic, vascular lesion, with rare non-neoplasic reactive endothelial proliferation most commonly located in the skin [...] or subcutaneous tissues. It is important to remark the features that can distinguish this entity from other neoplasms to avoid inappropriate treatment. Pathological characteristics that distinguish PEH from angiosarcoma could be reduced to circumscription of the lesion, location in a vessel or association with thrombus and papillary architecture without significant cytologic atypia or areas of solid growth. Treatment consists of complete resection of the tumor, including wide enough margins to avoid recurrence.

Fernández García-Guilarte, R.; Enríquez de Salamanca Celada, J.; Comenero, I..

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Incidencia de linfoma gastrointestinal en el hospital militar Dr. Carlos Arvelo en el lapso 2003-2008 un período de 5 años  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Los Linfomas No Hodgkin del tracto gastrointestinal son los linfomas extranodales más comunes, representando entre el 30 y 70% de esta última patología constituyendo un grupo heterogéneo de tumores con diferentes características clínicas y patológicas. El estómago está lesionado de manera predominan [...] te siendo los linfomas tipo MALT los tumores de bajo grado más frecuentes en el sistema gastrointestinal, contando con 40% de todos los linfomas gástricos primarios, manteniéndose localizados por períodos prolongados sin tratamiento. Objetivos: evaluar la epidemiología de los linfomas gastrointestinales en nuestro centro. Pacientes y métodos: Análisis retrospectivo de las historias de pacientes con diagnóstico de Linfoma Gastrointestinal. Resultados: Se presentan datos clínicos e histopatológicos de 20 pacientes con diagnóstico de Linfoma Gastrointestinal tratados en el Hospital Militar "Dr. Carlos Arvelo", Caracas, Venezuela, desde 2003 a 2008. 15 hombres, 5 mujeres, con edades comprendidas entre 23 y 64 años. De ellos, 14 (70 %) se presentaron con enfermedad limitada (estadio I-II) mientras que 6 (30%) tuvieron lesión de varios órganos (hígado, páncreas, bazo, duodeno) o más de un órgano gastrointestinal, siendo clasificado como estadio IV. 11 pacientes tuvieron linfoma gástrico, 2 de páncreas, 1 hepático esplénico y de columna lumbar, 1 intestino delgado, 1 en bazo, 4 de colon, y en 5 pacientes se observaron multiples localizaciones en el sistema gastrointestinal. Dolor abdominal, hemorragia digestiva, pérdida de peso fueron los síntomas más frecuentes de presentación. El estómago fue el órgano mas frecuentemente lesionado. Abstract in english Non-Hodgkin´s lymphomas (NHL) of the gastrointestinal (GI) tract are the most common extra nodal lymphomas. They represent between 30% to 70% of all extra nodal lymphomas and constitute a heterogeneous group of tumors with different clinical and pathological features. The stomach is predominantly in [...] volved. MALT type lymphomas are the most frequent low grade non-Hodgkin´s lymphomas encountered in the GI tract. They account for 40% of all primary gastric lymphomas and remain, in the majority of cases, localized for a prolonged period of time without therapy. Aim: To evaluate the epidemiology of gastrointestinal lymphomas in our Hospital. Patients and Methods: Retrospective analysis of patientÊs recorders performed at the Hospital Militar "Dr. Carlos Arvelo", Caracas, that had the diagnosis of gastrointestinal lymphoma. Results Clinical and histopathologjcal data from 20 patients presenting with GI-NHL treated from 2003 until 2008, were reviewed. 15 men, 5 women with an age range between 23 and 64 years old. Of these, 14 (70%) presented with limited disease (stage I and II), while 6 patients were found to have disease involvement of other abdominal organs (i.e., liver, pancreas, spleen, duodenum) or more than one gastrointestinal site and were therefore classified as stage IV. 11 patients presented with lymphoma in the stomach, 2 pancreatic, 1 in liver, spleen and lumbar vertebrae, 1 in the small intestine and 4 in the large bowel, while in 5 cases multiple localizations of the gastrointestinal tract were documented. Abdominal pain, gastrointestinal bleeding, weighs loose were the main presenting symptom.

Pernalete, Beatriz; La Cruz, María Alejandra; Rodríguez, Livia; Benítez, Sylvia; Pérez, Oscar; Bonardo, Rosanna; Camaray, Noheltriz; Guzman, Francisco; Villarreal, Lorena; Lara, Jacinto.

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Primary lymphoma of the colon Linfoma primario de colon  

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Full Text Available Background: primary colorectal lymphoma is a very rare disease, representing less than 0.5 % of all primary colorectal neoplasms. The gastrointestinal tract is the most frequently involved site of all extranodal lymphomas, the most common type of that is non-Hodgkin's lymphoma. Early diagnosis is often difficult because of unspecific symptoms. Therapeutic approaches have classically included radical resection, chemotherapy and radiotherapy. Materials and methods: we present our experience in the management of primary colorectal lymphomas over a 17-year period (1994-20011. Results: in this period 7 cases of primary colorectal lymphoma were diagnosed in our institution. Abdominal pain and change in bowel habit were the most frequent symptoms. Five patients underwent emergency surgery because of bleeding or bowel obstruction. All primary intestinal lymphomas studied were of the B-cell phenotype. Patients were followed up for a median of 59 months (range 1-180. Three of them are alive with no evidence of recurrence. Conclusion: combination treatment with chemotherapy and surgery can obtain good remission rate. Surgery can resolve complications such bleeding or intestinal perforation that are implicated in lymphoma mortality.Introducción: el linfoma primario de colon y recto es una patología poco prevalente, representa tan solo el 0,5 % de todas las neoplasias primarias de colon y recto. El tracto gastrointestinal es el lugar donde asientan la gran mayoría de los linfomas extranodales, siendo el más frecuente el tipo linfoma no-Hodking. El diagnóstico precoz es siempre difícil debido a que la sintomatología es muy poco específica. Los algoritmos terapéuticos han incluido clásicamente la resección radical, el tratamiento con quimioterapia y con radioterapia. Materiales y métodos: presentamos nuestra experiencia en el manejo de los linfomas primarios de colon en un periodo de 17 años (1994-2011. Resultados: en dicho periodo en nuestro centro fueron diagnosticaron 7 casos de linfoma primario de colon. El dolor abdominal y los cambios en el ritmo deposicional fueron los síntomas más frecuentes. Cinco pacientes requirieron tratamiento quirúrgico urgente debido a hemorragia digestiva u obstrucción intestinal. El estudio anatomopatológico reveló que todos los linfomas tenían el fenotipo de tipo B. Los pacientes tuvieron un seguimiento medio de 59 meses (rango 1-180. Tres de ellos siguen vivos sin evidencia de recidiva. Conclusión: el tratamiento combinado con quimioterapia y cirugía puede obtener buenos resultados de remisión. La cirugía puede resolver complicaciones como la hemorragia o la perforación intestinal, ambas directamente relacionadas con la mortalidad por linfoma.

Marta Pascual

2013-02-01

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Estudio histológico e inmunofenotípico de linfoma canino en el centro de México  

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Full Text Available El inmunofenotipo constituye un factor importante en el pronóstico del linfoma canino. Se ha demostrado que perros con linfoma de células B presentan tiempos de sobrevivencia más largos que los perros con linfoma de células T. Los antígenos CD3 y CD79a son los marcadores más utilizados en inmunohistoquímica para la determinación del fenotipo celular T y B, respectivamente, en muestras fijadas en formalina y conservadas en bloques de parafi na. En este estudio se describen las características morfológicas e inmunofenotípicas de 31 casos de linfoma en México, de casos del archivo del Departamento de Patología de la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Nacional Autónoma de México. Para la clasificación histológica se utilizó el sistema del National Cancer Institute-Working Formulation (NCI-WF. Catorce casos (45.16% correspondieron a células B, 15 (48.39% a células T, y dos (6.45% fueron de origen indeterminado. Histopatológicamente, el linfoma difuso de células grandes fue el tipo más común, representó 38.71% de los casos; le siguieron los siguientes linfomas: linfocítico, inmunoblástico y linfoblástico. Los linfomas de grado intermedio a alto representaron 77.42% de los casos. En este estudio se encontró mayor prevalencia de linfoma de células T. Los resultados en este trabajo pudieran indicar una diferencia en la prevalencia en el inmunofenotipo del linfoma canino en México, en relación con otras zonas geográficas.

Gilberto Chávez Gris

2009-01-01

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Intravascular ultrasound and photoacoustic imaging.  

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There is a need for an imaging technique that can reliably identify and characterize the vulnerability of atherosclerotic plaques. Catheter-based intravascular ultrasound (IVUS) is one of the imaging tools of the clinical evaluation of atherosclerosis. However, histopathological information obtained with IVUS imaging is limited. We present and discuss the applicability of a combined intravascular photoacoustic (IVPA) and intravascular ultrasound (IVUS) imaging approach to assess both vessel structure and tissue composition thus identifying rupture-prone atherosclerotic plaques. Photoacoustic (or optoacoustic and, generally, thermoacoustic) imaging relies on the absorption of electromagnetic energy, such as light, and the subsequent emission of an acoustic wave. Therefore, the amplitude and temporal characteristics of the photoacoustic signal is primarily determined by optical absorption properties of different types of tissues and can be used to differentiate the lipid, fibrous and fibro-cellular components of an inflammatory lesion. Simultaneous IVUS and IVPA imaging studies were conducted using 40 MHz clinical IVUS imaging catheter interfaced with a pulsed laser system. The performance of the IVPA/IVUS imaging was assessed using phantoms with point targets and vessel-mimicking phantoms. To detect the lipids in the plaque, ex-vivo IVPA imaging studies of a normal and an atherosclerotic rabbit aorta were performed at a 532 nm wavelength. To assess plaque composition, multi-wavelength (680-950 nm) spectroscopic IVPA imaging studies were carried out. Finally, molecular and cellular IVPA imaging was demonstrated using plasmonic nanoparticles. Overall, our studies suggest that plaque detection and characterization can be improved using the combined IVPA/IVUS imaging. PMID:19162578

Emelianov, Stanislav; Wang, Bo; Su, Jimmy; Karpiouk, Andrei; Yantsen, Evgeniya; Sokolov, Konstantin; Amirian, James; Smalling, Richard; Sethuraman, Shriram

2008-01-01

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COMPROMISO MUSCULAR POR LINFOMA NO HODGKIN: CASO CLÍNICO Y REVISIÓN DEL TEMA MUSCLE INFILTRATION BY NON-HODGKIN LYMPHOMA: A CASE AND BIBLIOGRAPHIC REVIEW  

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Full Text Available Se presenta un caso clínico de paciente con linfoma no Hodgkin tratado; en control tomográfico habitual se le solicitó PET-CT para complementar su estudio, que demuestra un foco metabólicamente activo en el espesor de músculo aductor izquierdo sin traducción tomográfica evidente. La lesión fue estudiada con ultrasonografia de partes blandas y biopsia dirigida, que resultó positiva para infiltración secundaria por linfoma. Este caso demuestra la utilidad de las técnicas complementarias en el manejo de estos pacientes, en especial la utilidad del PET-CT en el estudio de sitios inhabituales de diseminación. En este examen existe la posibilidad de identificar con precisión la localización de las lesiones mediante la TC complementaria, lo que permite efectuar posteriormente el estudio dirigido.A case report of a patient with treated Non-Hodgkin Lymphoma is presented. In his usual tomographic control patient was requested a PET-CT scan to supplement prior study that showed a metabo-lically active focus on the left adductor muscle without evident tomographic correlation. Lesion underwent both a soft tissue ultrasound study and a directed biopsy, the latter being positive for secondary infiltration by lymphoma. This case has demonstrated the usefulness of applying complementary techniques in the management of these lesions, mainly of PET-CT scans in the study of unusual sites of spread. This combined medical imaging technique allows accurate lesion localization, which in turn permits performance of a subsequent directed study.

Pablo Avaria P

2010-01-01

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Asociación de linfomas malignos con herpes virus I y II  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivos: Conocer la prevalencia de la seropositividad para herpes virus I y II en pacientes con linfomas non Hodgkin y su asociación con el linaje celular (B ó T). Pacientes y métodos: Se tomó una muestra de 60 pacientes en el Hospital Almenara de agosto de 1999 a diciembre del 2000 todos ellos pa [...] cientes con diagnostico establecido de linfoma non Hodgkin nuevos o en primera recaída, el análisis se realizó mediante bioestadística descriptiva. Resultados: La mediana de la edad fue de 59 años, 2/3 fueron varones, 65% pacientes nuevos y el linfoma primario fue extraganglionar en un 58% de los casos. El 80% de los linfomas fueron a células B y mas del 90% en estadios avanzados (III y IV), ningún caso fue positivo para IgM herpes I o II y 25% tuvieron serología positiva IgG para herpes I o II (2/3 positivos para IgG I) de los cuales el 93% fueron a células B. Conclusiones: La prevalencia de seropositividad para herpes virus I y II en pacientes con linfoma non Hodgkin es del 25%, mayormente asociado a células B, además de tener un porcentaje considerable de linfomas a células T (25%) y linfomas extranodales (58%); para evaluar la posibilidad de asociación entre este virus y los linfomas requerimos de un estudio caso-control. Abstract in english Objectives: To know the prevalence of seropositivity for herpes virus I and II in patients with malignant non Hodgkin lymphoma (NHL), and the association with the cell lineage (B or T). Patients and Methods: We considered 60 new or in first recurrence patients with NHL at the Hospital Nacional Guill [...] ermo Almenara from August 1999 to December 2000. We analyzed the data by descriptive biostatistics in Epi-Info program. Results: Median age was 59 years, two thirds were men, 65% were new patients and the primary site was extranodular in 58% of the cases. 80% were NHL to B cells, and more than 90% in advance stage (III and IV), none of them were positive for IgM herpes virus I or II and 25% were positive for IgG I or II (2/3 positive for IgG I) and more than 90% of them were for B cell. Conclusion: The prevalence of seropositivity for herpes I or II in patients with NHL was 25%, usually associated to B cells, on the other hand we have an elevated percentage of T cell NHL (25%) as well as extranodular NHL (58%). We need more studies specially a case-control study to define the association of herpes virus I or II with NHL.

Alarcon-Rozas, Ashley Efraín; Salas Sánchez, Fernando; Villacres Vela, Karina; Guevara Guevara, Julio.

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Linfoma de Hodgkin: aspectos atuais Hodgkin lymphoma: current issues  

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Full Text Available A par dos extraordinários avanços obtidos no tratamento do linfoma de Hodgkin, diversos desafios persistem na compreensão da biologia da doença, e na determinação de alternativas que maximizem a eficácia terapêutica e minimizem as toxicidades imediatas e tardias. O objetivo deste artigo é apresentar informações recentes que têm relevância imediata para aqueles que cuidam de pacientes com linfoma de Hodgkin (LH.Knowing the extraordinary advances obtained in the treatment of Hodgkin's lymphoma, several challenges persist related to the biology of the disease and to the determination of alternatives that maximize the therapeutic efficacy and minimize immediate and long-term toxicity. The aim of this article is to present recent information that has immediate relevance for those who care for patients with Hodgkin's lymphoma.

Nelson Spector

2009-08-01

 
 
 
 
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Linfoma de Burkitt en un portador de granulomatosis de Wegener  

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Full Text Available Se reporta el caso de un paciente costarricense portador de granulomatosis de Wegener, en tratamiento con ciclofosfamida y prednisona, quien desarrolla un linfoma de Burkitt que lo lleva a la muerte. Se menciona la posible relación entre estas dos patologías.This is a report of a costarrican male with Wegener' s granulomatosis undergoing treatment with prednisone and cyclophosphamide, he developed a fatal Burkitt' s lymphoma. The possible relationship between these two disorders is addressed.

Kryssia Rodríguez-Castro

2005-10-01

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Actualidad clínica-biológica de los linfomas T cutáneos  

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Full Text Available Los linfomas cutáneos resultan modelos útiles para el estudio de los mecanismos patogénicos de las enfermedades linfoproliferativas dado que para el diagnóstico y el seguimiento, las muestras de tejido se obtienen a través de métodos no invasivos. Aunque los linfomas T cutáneos se desarrollan a partir de los linfocitos T residentes en la piel, otras células y diversos factores asociados al tejido linfoide participan en la linfomagénesis. La aparición de estos linfomas en la piel no excluye la presencia de células malignas en la circulación y su desarrollo en otros órganos. Actualmente, la posibilidad de detectar las lesiones en estadios tempranos y la precisión de alteraciones en el receptor de células T permite ampliar el estudio de esta enfermedad.The cutaneous lymphomas are useful models for studying the etiopathogenic mechanisms of the lymphoproliferative diseases, since the samples of tissue are obtained through non invasive methods for the diagnosis and follow-up. Although the cutaneous T-cell lymphomas are developed from the T lymphocytes existing in the skin, other cells and diverse factors associated with the lymphoid tissues take part in the lymphomagenesis. The appearance of these lymphomas in the skin does not exclude the presence of malignant cells in the circulation and their development in other organs. Nowadays, the possibility of detecting the injuries in early stages and the accuracy of alterations in the T-cell receptor allows to extend the study of this disease.

María E. Faxas García

2003-03-01

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Linfoma MALT do pulmão: Uma forma rara de linfoma / Pulmonary MALT lymphoma: A rare form of lymphoma  

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Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese Os autores apresentam um caso de linfoma MALT do pulmão numa doente assintomática mas com imagens radiológicas exuberantes, cujo diagnóstico só foi possível por biópsia pulmonar cirúrgica obtida por toracoscopia assistida por vídeo, após a ineficácia da biópsia pulmonar transbrônquica e da punção as [...] pirativa transtorácica. Descrevem os aspectos clínicos e radiológicos daquela forma de linfoma, salientando a possibilidade de expressão assintomática prolongada e discutem problemas de diagnóstico, prognóstico e terapêutica. Abstract in english The authors report a case of pulmonary MALT lymphoma in an asymptomatic patient with a chest radiograph showing bilateral infiltrates. The diagnosis was made by surgical lung biopsy performed by videoassisted thoracoscopy. The transbronchial lung and the transthoracic core-needle biopsies were non-d [...] iagnostic. The clinical and radiological features of the pulmonary MALT lymphoma are described and relevant diagnostic, prognostic and treatment factors are discussed.

João Meneses, Santos; Raed, Zakout; Carlos, Ferreira; Maria João, Palhano; Rui MM, Victorino.

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Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization  

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The presence of pneumocephalus without a history of intracranial or intrathecal procedures is a significant radiographic finding. Although pneumocephalus means a violation of the dural barrier or the presence of infection, intravascular pneumocephalus is different from intraparenchymal pneumocephalus and its benign nature must be known in the presence of intravenous catheterization. Herein, we present a case of iatrogenic intravascular pneumocephalus with CT findings. To our knowledge, there are only a few reported cases of iatrogenic intravascular pneumocephalus in the literature. Careful intravenous catheterization and diagnosis of the condition on imaging helps to prevent unnecessary treatment procedures. (orig.)

Yildiz, Altan; Oezer, Caner; Egilmez, Hulusi; Duce, Meltem Nass; Apaydin, Demir F.; Yalcinoglu, Orhan [Department of Radiology, Faculty of Medicine, Mersin University (Turkey)

2002-03-01

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Síndrome de vena cava superior: Una emergencia oncológica en niños con linfoma. Revisión de 5 casos Superior Vena Cava Syndrome: an oncologic emergency in children with lymphoma  

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Full Text Available Introducción: Un niño con cáncer puede presentar durante su enfermedad una emergencia, ya sea como manifestación inicial, en la fase de diagnóstico, durante la evolución o en el periodo terminal. Objetivo: Presentar nuestra experiencia en el manejo del síndrome de Vena Cava Superior en niños con linfoma. Pacientes y Método: Revisión retrospectiva de 44 fichas clínicas de menores de 15 años con linfoma tratados entre enero de 1989 y diciembre de 1999 en la Unidad de Hematología/Oncología Infantil del Hospital Clínico Regional de Valdivia. Resultados: 5 casos presentaron síndrome de Vena Cava Superior: Linfoma de Hodgkin 2. Linfoma no Hodgkin 3. El síndrome de Vena Cava Superior fue la manifestación inicial en 4. En la emergencia todos los pacientes recibieron corticoides y radioterapia. Tres pacientes se encuentran vivos y en remisión completa. Conclusiones: El síndrome de Vena Cava Superior, es poco frecuente en niños con patología tumoral, sin embargo, por constituir una emergencia médica requiere tratamiento inmediato, necesitándose claras pautas de manejoIntroduction: A child with cancer may have an oncologic emergency during one of the following situations: A Primary manifestation of the disease. B Diagnostic phase. C During clinical evolution of the disease. D Terminal stage. Objective: To review our experience in the management of patients with lymphoma presenting with Superior Vena Cava Syndrome (SVCS. Method: Retrospective analysis of clinical data of 44 patients younger than 15 years-old affected with lymphoma and treated at the Hemathology/Oncology Unit of the Clinical Hospital from Valdivia, between 1989 and 1999. Results: 5 patients presented SVCS; 2 of them had Hodgkin lymphoma and 3 had no-Hodgkin lymphoma. The SVCS was the first clinical manifestation in 4 of them. During the emergency, all patients were treated with steroids and radiotherapy, observing 3 of them still alive and free of disease. Conclusions: The SVCS is a rare complication in pediatric tumoral disease. It constitutes an oncologic emergency that we ought to know in terms of diagnosis and treatment

Miriam Davis G.

2005-10-01

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Intravascular metastatic melanoma: a difficult diagnosis.  

Science.gov (United States)

Melanoma is a common cancer with the potential for widespread metastasis; however intravascular metastasis is extremely rare. We report an unusual case of a patient with metastatic melanoma in whom (18) F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) demonstrated an intravascular melanoma metastasis in the superior vena cava (SVC), successfully treated with external beam radiotherapy. To our knowledge, this is the first reported case where FDG PET-CT was used to make this diagnosis. PMID:23425235

Ghattas, Samer; Howle, Julie; Wang, Wei; Kefford, Richard; Gruenewald, Simon

2013-05-01

67

Apresentação cutânea inicial de linfomas na infância / Initial cutaneous manifestation of lymphomas in children  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os linfomas cutâneos compreendem um grupo heterogêneo de desordens linfoproliferativas que envolvem a pele e são classificados como um subgrupo dos linfomas não Hodgkin. No período de 1981 a 2007, 100 casos de linfomas em crianças foram admitidos no Serviço de Hematologia, do Hospital das Clínicas d [...] a Universidade Federal de Minas Gerais, sendo que nove apresentaram manifestação cutânea inicial. Três pacientes foram classificados como linfoma cutâneo primário e seis como sistêmicos. Sete pacientes apresentaram linfoma de células T, um, linfoma linfoblástico B e um, imunofenótipo indefinido. Nenhum óbito ocorreu nos pacientes com linfoma cutâneo primário Abstract in english Cutaneous lymphomas comprise a heterogeneous group of lymphoproliferative disorders with skin involvement and are classified as a subgroup of non-Hodgkin lymphomas. From 1981 to 2007, 100 children with non-Hodgkin lymphomas were admitted to the Hematology Unit of the Federal University of Minas Gera [...] is Teaching Hospital. In nine of these children, the skin was involved at the onset of the disease. Three patients were classified as having primary cutaneous lymphoma, while in six the disease was systemic with cutaneous involvement. In seven patients, the immunophenotype was T-cell, in one it was B-cell, and in the remaining case the immunophenotype was indefinable. No deaths occurred in any of the children with primary cutaneous lymphoma

Maria Christina Lopes Araujo de, Oliveira; Luciana Baptista, Pereira; Priscila Cezarino, Rodrigues; Keyla Cunha, Sampaio; Benigna Maria de, Oliveira; Marcos Borato, Viana.

68

Linfoma cutáneo de células B grande de las piernas: presentación de un caso  

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Full Text Available Introducción: los linfomas cutáneos primarios de células B se definen como una proliferación neoplásica de células B que se originan en la piel. El linfoma de células B grande de las piernas, es un linfoma agresivo con un predominio de células B grande que se presenta en las extremidades inferiores. Existen múltiples clasificaciones con diferentes nomenclaturas; debido a la accesibilidad de la piel resulta relativamente sencillo tomar una biopsia, con lo que se obtienen muestras de lesiones precoces y más difíciles de diagnosticar. Objetivo: reportar un paciente con linfoma cutáneo de células B grande de la pierna. Caso Clínico: paciente masculino de 72 años, blanco, con presencia de múltiples tumores en las piernas, de varios meses de evolución, y se le diagnostica como un linfoma cutáneo de células B grande de las piernas. Conclusiones: el linfoma cutáneo de células B grande de la pierna es una enfermedad poco frecuente, que representan un subtipo clínico e histológico diferente de linfomas extranodales, no doloroso, de evolución buena, y buen pronóstico, cuya clasificación y origen celular es controvertido. El principal criterio de diagnóstico es la clínica y la histopatología. El tratamiento conservador se instala para esta enfermedad, se obtienen buenos resultados con la poliquimioterapia, además de otras alternativas como la terapia con anticuerpos monoclonales.

Idalmis Campollo Rodru00EDguez

2011-01-01

69

Apresentação cutânea inicial de linfomas na infância Initial cutaneous manifestation of lymphomas in children  

Directory of Open Access Journals (Sweden)

Full Text Available Os linfomas cutâneos compreendem um grupo heterogêneo de desordens linfoproliferativas que envolvem a pele e são classificados como um subgrupo dos linfomas não Hodgkin. No período de 1981 a 2007, 100 casos de linfomas em crianças foram admitidos no Serviço de Hematologia, do Hospital das Clínicas da Universidade Federal de Minas Gerais, sendo que nove apresentaram manifestação cutânea inicial. Três pacientes foram classificados como linfoma cutâneo primário e seis como sistêmicos. Sete pacientes apresentaram linfoma de células T, um, linfoma linfoblástico B e um, imunofenótipo indefinido. Nenhum óbito ocorreu nos pacientes com linfoma cutâneo primárioCutaneous lymphomas comprise a heterogeneous group of lymphoproliferative disorders with skin involvement and are classified as a subgroup of non-Hodgkin lymphomas. From 1981 to 2007, 100 children with non-Hodgkin lymphomas were admitted to the Hematology Unit of the Federal University of Minas Gerais Teaching Hospital. In nine of these children, the skin was involved at the onset of the disease. Three patients were classified as having primary cutaneous lymphoma, while in six the disease was systemic with cutaneous involvement. In seven patients, the immunophenotype was T-cell, in one it was B-cell, and in the remaining case the immunophenotype was indefinable. No deaths occurred in any of the children with primary cutaneous lymphoma

Maria Christina Lopes Araujo de Oliveira

2011-08-01

70

Leucemia / linfoma T del adulto: Primer caso en Cuba  

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Full Text Available Se presentó el caso de una paciente con diagnóstico de linfoma no Hodgkin de histología agresiva, en el año 1990, que por los hallazgos clínicos y resultados de los exámenes complementarios realizados se sospechó la posibilidad de una leucemia / linfoma tipo T del adulto (LLTA relacionada con la infección por el virus linfotrópico de células T humanas tipo I (conocido como HTLV-I, lo cual fue confirmado por los resultados de los estudios virológicos. Se observó comportamiento evolutivo y respuesta terapéutica tórpidos. Falleció en los primeros 4 meses de efectuado el diagnóstico, lo que corroboró lo publicado en la literatura médica sobre este tema. Este es el primer caso diagnosticado en Cuba de una leucemia / linfoma tipo T del adulto (LLTA relacionada con la infección por el virus linfotrópico de células T humanas tipo I (HTLV-IThe case of a female patient with diagnosis of non Hodgkin lymphoma of aggressive histology in 1990 was presented .According to the clinical findings and to the results of the complementary tests made, it was suspected the possibility of adult T-cell leukemia/lymphoma (ATLL related to human T lymphotropic virus type I (HTLV-1 infection, which was confirmed by the results of the virological studies. It was observed a torpid evolutive behavior and therapeutic response. The patient died during the first 4 months of the diagnosis, which corroborated what is published in medical literature on this topic.This is the first case diagnosed in Cuba of an adult T-cell leukemia/lymphoma associated with HTLV-1.

Jorge E. Muñío Perurena

2003-06-01

71

Pain in an osseous lymphoma. A case presentation. Dolor en el linfoma oseo. Presentación de un caso.  

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Full Text Available This is a 79 year-old, white, male patient suffering from osseous lymphoma, a less frequent illness, came to the university Hospital Dr. Gustavo Aldereguía Lima¨ in Cienfuegos city, Cuba complaining of intercostal pain in the left hemithorax. This pain was not relieved with the regular medical treatment, that´s why the anesthesia service doctors gave assistance. Costal osteolysis at level D7, D8 and D9 were shown in a thorax X ray. He was treated with analgesic through peridural via such as morphine, local anesthetic. Betametasone was used as anti-inflammatory having positive results. The use of ethylic alcohol as agents contributed to the patient´s improvement and to get back to his normal life. 

Se presenta el caso de un paciente del hospital provincial clínico quirúrgico universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos, portador de una enfermedad muy poco frecuente (linfoma óseo, de 79 años de edad, masculino, de raza blanca, que refería dolor intercostal en hemitórax izquierdo, el cual no cedía ante el tratamiento médico habitual, por lo que es atendido por anestesiología. En el rayos X de tórax se apreció osteolisis costal a nivel de D7, D8 y D9. En forma frecuente fue tratado con analgésicos por vía peridural: morfina, anestésicos locales y como antiinflamatorio la betametasona con resultados satisfactorios. El uso de agentes como el alcohol etílico, contribuyó a mejorar su cuadro y a que se incorporara a sus labores habituales.

Alexis Guillén Sánchez

2003-05-01

72

Diffuse large B-cell lymphoma of the oral cavity / Linfoma difuso de células B grandes de la cavidad bucal  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: English Abstract in spanish Se reporta un caso de linfoma difuso de células B grandes (DLBL) de la cavidad bucal. Se trata de un paciente masculino, blanco, de 73 años de edad, que se presentó a la División de Estomatología, con una masa nodular difusa en el paladar duro y una lesión nodular en el labio superior, diagnosticada [...] s como DLBL. El paciente fue tratado con ocho ciclos de quimioterapia CHOP (ciclofosfamida, doxorrubicina, vincristina, prednisona), pero se constató recidiva de la enfermedad en ambos sitios primarios, en el paladar duro y en el labio superior a los 22 meses después del término de la terapia. El paciente fue sometido de nuevo a la quimioterapia. Abstract in english The authors report a case of diffuse large B-cell lymphoma (DLBL) of the oral cavity. The patient was a 73-year-old white man who first presented at the Division of Stomatology with a large nodular mass in the hard palate and a nodular lesion in the upper lip, which were diagnosed as DLBL. The patie [...] nt was treated with eight cycles of CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone), but the disease recurred 22 months after the end of the therapy. Both primary sites hard palate and upper lip were involved again and the patient was resubmitted to chemotherapy.

Carlos Bortoluzzi, Marcelo; Dantas Batista, Jonas; Cherubini, Karen; Gonçalves Salum, Fernanda; Figueiredo, Maria Antonia.

73

Lymphogranuloma venereum and non-Hodgkin lymphoma: a case report Linfogranuloma venéreo e linfoma não Hodgkin: um relato de caso  

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Full Text Available Lymphogranuloma venereum (LGV is an uncommon, contagious, sexually transmitted disease (STD. We report a case of a 17-year-old teenager who presented with a 2-month-old ulcerous vegetant lesion in the right inguinal region. The patient was diagnosed with LGV and received erythromycin treatment. Three months after treatment, he presented with a new ulcerous lesion, very similar to the previous one, in the right supraclavicular region. He was diagnosed with a diffuse large B-cell non-Hodgkin lymphoma. Both diseases are rare in Rio de Janeiro City, Brazil, and physicians should not neglect the possibility of STDs in such cases.Linfogranuloma venéreo (LGV é uma doença sexualmente transmissível e de ocorrência pouco frequente. Relatamos um caso de um adolescente com 17 anos de idade que apresentou uma lesão ulcerativa vegetante a cerca de dois meses na região inguinal direita. Foi diagnosticado como LGV e o paciente foi tratado com eritromicina. Três meses após o tratamento o paciente apresentou uma nova lesão ulcerativa, muito semelhante à anterior, na região supraclavicular direita. O diagnóstico desta lesão foi de linfoma difuso de células B do tipo não-Hodgkin. Ambas as patologias não são comuns na Cidade do Rio de Janeiro, Brasil e um médico não deve negligenciar a possibilidade da ocorrência de uma doença sexualmente transmissível (DST.

Mauro Romero Leal Passos

2012-06-01

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É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais? / Differentiating between tuberculosis-related and lymphoma-related lymphocytic pleural effusions by measuring clinical and laboratory variables: Is it possible?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. MÉTODOS: Estudo retrospectivo com 159 pacientes adulto [...] s HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente) tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), entre outubro de 2008 e março de 2010. RESULTADOS: A média de idade e de duração dos sintomas foi menor no grupo tuberculose que no grupo linfoma. Os níveis pleurais de proteínas, albumina, colesterol, amilase e adenosina desaminase (ADA), assim como os níveis séricos de proteínas, albumina e amilase, foram maiores no grupo tuberculose, enquanto os níveis séricos de colesterol e triglicérides foram maiores no grupo linfoma. As contagens de leucócitos e linfócitos no líquido pleural foram maiores no grupo tuberculose. Células malignas estavam ausentes no grupo tuberculose, entretanto, linfócitos atípicos foram observados em 4 desses pacientes. No grupo linfoma, a citologia para células neoplásicas foi positiva, suspeita e negativa em 51,8%, 24,1% e 24,1% dos pacientes, respectivamente. A imunofenotipagem do líquido pleural foi conclusiva na maioria dos pacientes com linfoma. CONCLUSÕES: Nossos resultados demonstram semelhanças clínicas e laboratoriais entre os pacientes com tuberculose ou linfoma. Embora os níveis de proteínas e ADA no líquido pleural tendam a ser mais elevados no grupo tuberculose que no grupo linfoma, mesmo essas variáveis mostraram uma sobreposição. Entretanto, nenhum paciente com tuberculose apresentou níveis de ADA no líquido pleural inferiores ao ponto de corte (40 U/L). Abstract in english OBJECTIVE: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphoma-related lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. METHODS: This was a retrospective study involvin [...] g 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively), treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, in the city of São Paulo, Brazil. RESULTS: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA) in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. CONCLUSIONS: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.

Leila, Antonangelo; Francisco Suso, Vargas; Eduardo Henrique, Genofre; Caroline Maris Neves de, Oliveira; Lisete Ribeiro, Teixeira; Roberta Karla Barbosa de, Sales.

75

É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais? Differentiating between tuberculosis-related and lymphoma-related lymphocytic pleural effusions by measuring clinical and laboratory variables: Is it possible?  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. MÉTODOS: Estudo retrospectivo com 159 pacientes adultos HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP, entre outubro de 2008 e março de 2010. RESULTADOS: A média de idade e de duração dos sintomas foi menor no grupo tuberculose que no grupo linfoma. Os níveis pleurais de proteínas, albumina, colesterol, amilase e adenosina desaminase (ADA, assim como os níveis séricos de proteínas, albumina e amilase, foram maiores no grupo tuberculose, enquanto os níveis séricos de colesterol e triglicérides foram maiores no grupo linfoma. As contagens de leucócitos e linfócitos no líquido pleural foram maiores no grupo tuberculose. Células malignas estavam ausentes no grupo tuberculose, entretanto, linfócitos atípicos foram observados em 4 desses pacientes. No grupo linfoma, a citologia para células neoplásicas foi positiva, suspeita e negativa em 51,8%, 24,1% e 24,1% dos pacientes, respectivamente. A imunofenotipagem do líquido pleural foi conclusiva na maioria dos pacientes com linfoma. CONCLUSÕES: Nossos resultados demonstram semelhanças clínicas e laboratoriais entre os pacientes com tuberculose ou linfoma. Embora os níveis de proteínas e ADA no líquido pleural tendam a ser mais elevados no grupo tuberculose que no grupo linfoma, mesmo essas variáveis mostraram uma sobreposição. Entretanto, nenhum paciente com tuberculose apresentou níveis de ADA no líquido pleural inferiores ao ponto de corte (40 U/L.OBJECTIVE: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphoma-related lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. METHODS: This was a retrospective study involving 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively, treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, in the city of São Paulo, Brazil. RESULTS: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. CONCLUSIONS: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.

Leila Antonangelo

2012-04-01

76

Linfoma primário de cavidade pleural em paciente imunocompetente Primary effusion lymphoma in an immunocompetent patient  

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Full Text Available O linfoma primário de cavidade é um tipo raro de linfoma não-Hodgkin que acomete principalmente pacientes imunocomprometidos e, mais raramente, pacientes imunocompetentes. Neste relato de caso são apresentados os achados clínicos e laboratoriais de um paciente imunocompetente com derrame pleural diagnosticado como linfoma primário de cavidade pleural.Primary effusion lymphoma is an unusual non-Hodgkin's lymphoma rarely seen in immunocompetent patients. Herein, we present clinical and biochemical data obtained from an immunocompetent patient diagnosed with primary effusion lymphoma.

Leila Antonangelo

2005-12-01

77

Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular  

Energy Technology Data Exchange (ETDEWEB)

Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

Campos, Laelia Pumilla Botelho

2000-03-01

78

Diagnóstico de Linfoma no Hodgkin con infiltración intra-auricular / No Hodgkin Linfoma diagnosis with intra-atrial infiltration  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Los tumores cardíacos, son entidades raras en la práctica médica, tienen una incidencia del 0,05%, aproximadamente el 75% es benigno y un 25% maligno. De estos el linfoma es infrecuente representando alrededor del 0,25%. Los linfomas no Hodgkin pueden ser extranodales en el 20% de los casos, así mis [...] mo el 80% de los linfomas no Hodgkin son de células B difusos, que es la forma más frecuente de presentación en adultos jóvenes; corresponden a alto grado de malignidad y crecimiento rápido, pueden presentarse con infiltración primaria a diferentes órganos, con afectación cardiaca en 20 a 28% de los casos y suelen localizarse en las cavidades derechas. Los síntomas son inespecíficos, dependientes de la localización y extensión del tumor y la prueba diagnóstica en estos casos es indudablemente la biopsia ya sea del ganglio linfático o del tejido afectado. Se presenta un caso de linfoma no Hodgkin difuso, de células grandes con afectación intra-auricular derecha, en una paciente de 23 años que debutó con disnea progresiva. Se realizó un ecocardiograma transesofágico que detectó una masa tumoral intra-auricular derecha, por lo que se realizó biopsia por cateterismo venoso por vía femoral, que permitió hacer el diagnóstico histopatológico y establecer el tratamiento, con lo cual se encuentra en primera remisión completa a un año del evento Abstract in english Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin [...] lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission

Marco Antonio, Alcocer Gamba; Salvador León, González; Eliodoro, Castro Montes; Luis Martín, Loarca Piña; Leslie Marisol, Lugo Gavidia; Enrique, García Hernández; Ulises, González Galindo; Miguel Isaías, Paredes Serrano.

79

Obese patient has less intravascular volume. Intravascular volume and fat free mass measured by computed tomography  

International Nuclear Information System (INIS)

It has been difficult to estimate a true patient's intravascular volume. Although about 99% of basic metabolic consumption is conducted in the non-fat tissues, the cardiac index itself does not include a fat effect and may predict inappropriate value in obese patients. This study evaluates the efficacy of the method excluding fat effect using computed tomography imaging to estimate the intra-vascular volume. Fat mass was obtained from the images of computed tomography and fat free mass was calculated by reducing the fat mass from the body weight. Intravascular volume was gained with a dilution method by the records of the cardiopulmonary bypass. Correlation between the fat free mass and the intravascular volume was assessed and statistic analysis was performed. There was a significant correlation between the fat free mass and the intra-vascular volume. Using computed tomography to calculate fat free mass, correlates well with the intravascular volume. Considering the result of this study, the Intra-vascular volume of obese patients would be low, thus the indicated Cardiac index value by Swan-Ganz catheter should be underestimated. (author)

2008-11-01

80

Linfoma folicular avanzado eficacia de la quimioterapia IAPVP-16 y resultados del autotrasplante hematopoyético /  

Digital Repository Infrastructure Vision for European Research (DRIVER)

El linfoma es una enfermedad neoplásica originada por transformación maligna de los linfocitos que residen en los ganglios linfáticos y otros tejidos linfoides. El linfoma folicular (LF) es un subtipo histológico. Cuando se presenta en fase avanzada es prácticamente incurable con tratamiento quimio-radioterápico convencional. Muchos de los pacientes responden inicialmente al tratamiento, pero la mayoría, presentan recaídas de la enfermedad, en ese momento el número de respuestas obte...

2005-01-01

 
 
 
 
81

Linfoma Folicular Avanzado. Eficacia de la Quimioterapia IAPVP-16 y Resultados del Autotrasplante Hematopoyético  

Digital Repository Infrastructure Vision for European Research (DRIVER)

El linfoma es una enfermedad neoplásica originada por transformación maligna de los linfocitos que residen en los ganglios linfáticos y otros tejidos linfoides. El linfoma folicular (LF) es un subtipo histológico. Cuando se presenta en fase avanzada es prácticamente incurable con tratamiento quimio-radioterápico convencional. Muchos de los pacientes responden inicialmente al tratamiento, pero la mayoría, presentan recaídas de la enfermedad, en ese momento el número de respuestas obt...

2004-01-01

82

Interventional and intravascular MR angiography  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance imaging (MRI) has a number of characteristics which make it attractive for guidance of intravascular therapeutic procedures, including high soft tissue contrast, imaging in any arbitrary oblique plane, lack of ionizing radiation, and the ability to provide functional information, such as flow velocity and volume per unit time. For MR guidance of vascular interventions to be safe, catheters and guidewires must be visualized relative to the vascular system and surrounding tissues. A number of approaches for making instruments visible in an MR environment are presented, including both passive and active techniques. Passive techniques depend on contrast agents or susceptibility artifacts, whereas active techniques, including MR tracking, MR profiling, and active field inhomogeneity, use some form of electrical coil built into the instrument. The potential for obtaining high-resolution images of the vessel wall using coils built into a catheter is also discussed. These images provide the capability to distinguish and identify various plaque components. The additional capabilities of MRI could potentially open up new applications beyond those currently performed under X-ray fluoroscopic guidance. (orig.) [German] Die magnetresonanztomographische (MRT) Bildgebung wird durch einige Merkmale charakterisiert, die sie fuer die Ueberwachung und Steuerung intravaskulaerer Interventionen besonders attraktiv macht: hervorragender Weichteilkontrast, beliebige Schnittfuehrung im dreidimensionalen Raum, fehlende ionisierende Strahlung, die eine beliebige Wiederholung von Bildakquisitionen erlaubt, sowie die Moeglichkeit, zusaetzlich zu den morphologischen Daten mittels Phasenkontrastmethoden funktionelle Informationen zu sammeln (zum Beispiel Flussgeschwindigkeit oder Flussvolumen pro Zeiteinheit vor und nach einer Intervention). Um die Sicherheit der Durchfuehrung von vaskulaeren Interventionen mittels MRT zu gewaehrleisten, muessen die Gefaesse selbst, aber auch die Katheter und Fuehrungsdraehte in Relation zu den Gefaessen und der Umgebung gut sichtbar sein. Mit kontrastverstaerkten dreidimensionalen Akquisitionen kann das arterielle Gefaesssystem in diagnostischer Qualitaet dargestellt werden. Zur Visualisierung von intravaskulaer gefuehrten Instrumenten in der MRT koennen verschiedene Methoden eingesetzt werden. Diesen Methoden liegt entweder eine passive oder eine aktive Visualisierung zugrunde. Die passiven Techniken basieren auf einer Fuellung oder Beschichtung des Instruments mit Kontrastmitteln oder auf inhaerenten Suszeptibilitaetsartefakten durch das Herstellungsmaterial, welche das Instrument innerhalb des akquirierten Bildes mit einem hohen Kontrast zur Umgebung sichtbar werden lassen. Leider ist die Sichtbarkeit der Instrumente nicht unter allen Umstaenden gewaehrleistet. Deshalb wurden aktive Methoden entwickelt, die den Kontrast auch unter nicht optimalen Bildgebungsbedingungen gewaehrleisten. Saemtliche aktiven Techniken, wie das MR-Tracking, das MR-Profiling oder die Erzeugung einer aktiven Feldinhomogenitaet des Instruments, basieren auf dem Einbau von kleinen Spulen in das Instrument selbst. Derartige Spulen dienen nicht nur zur Ortung und Fuehrung eines Katheters oder Fuehrungsdrahts, sondern haben auf der anderen Seite auch zusaetzlich das Potential, hoch aufloesende Bilder von der Ge-faesswand zu akquirieren. Anhand dieser Bilder ist eine Cha-rakterisierung der verschiedenen Plaquekomponenten moeglich. (orig.)

Ladd, M.E.; Debatin, J.F. [Zentralinstitut fuer Roentgendiagnostik, Universitaetsklinikum Essen (Germany)

2000-06-01

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Linfoma primario del sistema nervioso central en pacientes inmunocompetentes / Primary central nervous system lymphoma in immunocompetent patients  

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Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish El linfoma primario del sistema nervioso central ha sido informado con frecuencia en pacientes que padecen síndromes de inmuno deficiencia. Sin embargo ésta no es una condición necesaria para su presentación, dado que existen informes de la enfermedad en sujetos inmunológicamente competentes. En el [...] presente trabajo se analizaron en forma retrospectiva, los expedientes de 22 pacientes inmunocompetentes con diagnóstico confirmado de linfoma primario encefálico, se revisó la literatura mundial, con el fin de analizar objetivamente las manifestaciones clínicas, comportamiento radiológico, aspecto histopatológico, dificul tades diagnósticas y terapéuticas, así como las consideraciones pro nósticas. El promedio de edad fue de 65 años y con una relación equitativa hombre/mujer. El tiempo de evolución del cuadro clínico fue de 80.4 días y estuvo dominado por cefalea y déficit neurológico focal. En cuatro pacientes se encontraron lesiones múltiples, mientras que en el resto se trataba de lesiones únicas con localización predominante en la región periventricular de los hemisferios cerebrales. Todos los pacientes fueron manejados inicialmente con esteroides y sometidos a toma de biopsia por estereotaxia. La variedad histológica más frecuente fue la de células grandes difusas y la totalidad de los casos reaccionaron positivamente a antígenos de células B en la inmunohistoquímica. Los 22 pacientes fueron tratados con radio terapia y 10 de ellos además con quimioterapia con metotrexato. La supervivencia promedio fue de 11 meses en los pacientes radiados y de 36 meses en los que se agregó quimioterapia. Abstract in english Primary central nervous system lymphoma has been traditionally described in patients with immunodeficiency syndromes; however, there is an increasing number of immunocompetent patients with this type of tumor that have been reported recently. In this paper we have retrospectively analyzed 22 immunoc [...] ompetent patients with a confirmed diagnosis of primary lymphoma of the brain. The mean age in this group was 65 years with a similar male/female ratio. The time of evolution of the clinical course was 80.4 days and it was mainly characterized by headache and focal neurological deficit. In four patients multiple lesions were observed, while the remaining presented single lesions mainly located in the periventricular area of the cerebral hemispheres. All patients were initially administered steroids and a stereotactic biopsy was performed. The majority of tumors were histologically classified as diffuse large cells and all of them showed a positive reaction to B cells antigens on immunohistochemistry. All patients were treated with radiotherapy and in 10 of them, chemotherapy with methotrexate was also indicated. The mean survival rate was 11 months among patients treated with radiotherapy alone and increased to 36 months when chemotherapy was added.

Gerardo, Guinto-Balanzar; Ignacio, Félix-Espinoza; Salvador, De Anda Ponce-de -León; Norma C, Aréchiga-Ramos; Víctor, Arteaga-Larios; Kalman, Kovacs.

84

Argyrophilic Fibers of Intravascular Threadlike Structures in Rat  

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Full Text Available Objective : We took intravascular threadlike structures from rat aortas to investigate their histological characteristics consistent with the intravascular Bonghan duct. Methods : Gomori’s silver impregnation method, in addition to routine hematoxylin and eosin staining, was applied to demonstrate the characteristic feature of the intravascular threadlike structures. Results : These two staining methods clearly showed that the intravascular threadlike structures had unique features of argyrophilic reticular fibers and heavily stained oval or rod-shaped nuclei in them. Conclusion : The results are strong evidences for identifying threadlike structure as the intravascular Bonghan duct.

Byung-Cheon Lee

2008-09-01

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Linfomas asociados a infección por VIH en pacientes del Hospital Clínico San Borja Arriarán / Fundación Arriarán2001-2008 / Lymphomas associated with HIV infection in patients at the Hospital San Borja Arriarán /Fundación Arriarán 2001-2008, Santiago, Chile  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Introducción: Los linfomas de Hodgkin (LH) y no Hodgkin (LNH) se asocian con alta frecuencia al síndrome de inmunodeficiencia humana en adultos. Objetivo: Sistematizar los aspectos clínicos e histológicos de los linfoma que afectan a pacientes con SIDA, su tratamiento y resultados globales en nuestr [...] a institución. Pacientes y Métodos: Análisis retrospectivo de pacientes con linfoma asociado a VIH entre enero de 2001 y diciembre de 2008 en el complejo hospitalario San Borja Arriarán. Resultados: Se obtuvo información de 30 pacientes con LNH y 7 LH, con una mediana de 40 años. Los tipos histológicos predominantes fueron linfoma de Burkitt (47 %), linfoma difuso de células grandes de estirpe B (37 %) y LNH de estirpe T (10%). No se diagnosticaron LNH del SNC ni linfoma de cavidades. Casi la totalidad de los pacientes (86,7%) con LNH se trataron con esquema CHOP, 57% de quienes recibieron tratamiento presentaron progresión o recaída desde remisión completa, ofreciéndoles una quimioterapia de rescate a cuatro pacientes. El 73% de los pacientes que recibieron CHOP lograron completar entre cinco y seis ciclos de quimioterapia. El uso de quimioterapia CHOP para el subgrupo de pacientes con linfoma de Burkitt alcanzó bajos porcentajes de remisión completa y mayoritariamente progresó la enfermedad, siendo esta quimioterapia, inefectiva para mejorar la sobrevida, especialmente en los pacientes de riesgo alto. Se encontraron diferencias estadísticamente significativas en sobrevida según el IPIae (índice internacional pronóstico ajustado por edad) al ingreso. Conclusión: El LNH en los pacientes con VIH tratados con los protocolos de quimioterapia PANDA persiste en nuestro medio como una enfermedad de muy mal pronóstico comparado con los resultados en la literatura internacional. La incorporación de nuevos fármacos de demostrada utilidad como rituximab y esquemas específicos de quimioterapia podrían mejorar estos resultados. El establecimiento de grupos pronósticos establecidos por IPIae puede orientar el trabajo clínico para el uso de quimioterapia ajustada a su riesgo específico y optimizado según tipo histológico. Abstract in english Introduction: Hodgkin lymphomas (HL) and non Hodgkin lymphomas (NHL) are frequently associated to acquired immunodeficiency syndrome in adults. Objective: To systematize the clinical features and histological characteristics of lymphomas in AIDS patients, its treatment and outcomes in our institutio [...] n. Patients and Methods: Retrospective analysis of patients with HIV-associated lymphoma between January 2001 and December 2008 at the San Borja Arriarán Hospital complex. Results: Information was obtained from 30 patients with NHL and 7 with HL, with a median of 40 years. The majority of tumors were Burkitt lymphoma (47%), diffuse large cell lymphoma B-cell (37%) and NHL of T lineage (10%). There was no CNS or cavities lymphoma. Almost all patients (86.7%) with NHL were treated with CHOP chemotherapy, 57% of those receiving treatment had progression or relapse from complete remission. A rescue chemotherapy was indicated in 4 patients. 73% of patients receiving CHOP, complete 5 to 6 cycles of chemotherapy. The use of CHOP chemotherapy for the subgroup of patients with Burkitt lymphoma achieved low rates of complete remission and frequent relapse and disease progression, showing that CHOP was ineffective in improving survival, especially in high risk patients. We found statistically significant differences in survival according to IPIae (International prognostic Index age-adjusted). Conclusion: Non-Hodgkin lymphoma in HIV patients treated with chemotherapy protocols PAlNDA persists in our environment as a disease with a poor prognosis compared with findings in the international literature. The incorporation of new drugs of proven utility as rituximab and specific schemes chemotherapy could improve these results. The establishment of prognostic groups established by IPIae can guide clinical

Álvaro, Pizarro; Hernán, García; Ana, Riquelme; Javiera, Carmona; Claudia, Cortés.

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Linfoma metastásico cardíaco / Metastatic Cardiac Lymphoma / Metastatic Cardiac Lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Los tumores cardíacos secundarios o metastásicos son unas 20-40 veces más comunes que los primitivos benignos y malignos. Las neoplasias que con más frecuencia producen metástasis en el corazón son los carcinomas pulmonares, los de mama, los melanomas malignos y, en una proporción menor, las leucosi [...] s y los linfomas. En esta presentación se describe el caso de una paciente femenina, de 36 años, con síntomas cardiovasculares de arritmia y síncope y evidencia ecocardiográfica de tumor cardíaco de crecimiento acelerado. Debido al agravamiento de las manifestaciones clínicas, se inició tratamiento con esteroides sistémicos, con el que experimentó mejoría clínica en las primeras 72 horas. Esto llevó a enfocar el diagnóstico en una causa secundaria de invasión cardíaca. Los hallazgos histopatológicos de una biopsia gástrica evidenciaron la presencia de un linfoma no Hogdkin. Se inició el tratamiento citostático específico; la paciente se encuentra en remisión y con regresión total de sus síntomas cardiovasculares. En nuestra paciente llama la atención la forma de presentación de los síntomas, que estuvieron limitados a la esfera cardiovascular pese a la localización en el sistema digestivo del tumor primario. Abstract in english Secondary or metastatic cardiac tumors are 20 to 40 times more common than primary benign or malignant neoplasms. Lung and breast carcinoma, malignant melanoma, and, to a lesser degree, leukemia and lymphoma, often metastasize to the heart. We describe the case of a 36-year old female patient with a [...] rrhythmia and echocardiographic evidence of a rapidly growing heart tumor. Treatment with systemic corticosteroids was initiated due to symptoms aggravation and the patient improved within 72 hours. A metastatic tumor was then suspected. A gastric biopsy confirmed the presence of a non-Hodgkin lymphoma. Specific cytostatic treatment was started; the patient remains in remission with complete regression of cardiovascular symptoms. Interestingly, our patient presented only cardiovascular symptoms despite the primary tumor was located in the digestive system.

Hechavarría Pouymiró, Sheila; Marrero Mederos, Roberto; Valiente Mustelier, Juan; Cabrera, Francisco.

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Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice  

Science.gov (United States)

Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with complementary imaging modalities.

Maresca, David; Adams, Samantha; Maresca, Bruno; van der Steen, Antonius F. W.

2014-01-01

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Linfoma renal: espectro de imagens na tomografia computadorizada Renal lymphoma: spectrum of computed tomography findings  

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Full Text Available O acometimento renal no linfoma é raro, uma vez que o rim não possui tecido linfóide. O envolvimento secundário é mais freqüente, ocorrendo em até um terço das autópsias dos portadores de linfoma. Alguns autores acreditam que esta seja a única forma de acometimento renal, questionando a existência do linfoma primário. O linfoma renal representaria metástases hematogênicas ou invasão direta do tumor ocorrendo no espaço perirrenal. A partir destes tipos de envolvimento decorrem as formas de apresentação do linfoma renal: múltiplos nódulos, massa solitária, invasão renal por doença retroperitoneal contígua, doença perirrenal e infiltração difusa. Neste trabalho são discutidas e apresentadas imagens destas diferentes formas de acometimento.Isolated renal lymphoma is rare due to the absence of lymphoid tissue in kidneys. Secondary involvement occurs more frequently and is reported in up to 1/3 of the autopsies of patients who died from lymphoma. Some authors believe this is actually the only existing form of renal lymphoma. The involvement of the kidney by lymphoma would occur through hematogenic metastasis or direct tumor invasion of the perirenal space. These different types of involvement determine the several forms of renal lymphoma presentation: multiple nodules, solitary mass, renal invasion from contiguous retroperitoneal disease, perirenal disease and diffuse infiltration. In this study the imaging findings features of the different forms of involvement are presented and discussed.

Carol Pontes de Miranda Maranhão

2005-04-01

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Techniques for Intravascular Foreign Body Retrieval  

International Nuclear Information System (INIS)

As endovascular therapies increase in frequency, the incidence of lost or embolized foreign bodies is increasing. The presence of an intravascular foreign body (IFB) is well recognized to have the potential to cause serious complications. IFB can embolize and impact critical sites such as the heart, with subsequent significant morbidity or mortality. Intravascular foreign bodies most commonly result from embolized central line fragments, but they can originate from many sources, both iatrogenic and noniatrogenic. The percutaneous approach in removing an IFB is widely perceived as the best way to retrieve endovascular foreign bodies. This minimally invasive approach has a high success rate with a low associated morbidity, and it avoids the complications related to open surgical approaches. We examined the characteristics, causes, and incidence of endovascular embolizations and reviewed the various described techniques that have been used to facilitate subsequent explantation of such materials

2013-08-01

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Temporary intravascular shunts for peripheral vascular trauma.  

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Full Text Available Polyvinylchloride (PVC disposable endotracheal suction catheters were successfully used as temporary intravascular shunts in 5 patients of popliteal artery trauma. These simple shunts should be used routinely in such conditions to immediately re-establish blood supply to the ischaemic limb particularly in patients of polytrauma where systemic anticoagulation is contraindicated. This avoids the inherent delay prior to vascular repair and reduces the incidence of irreversible ischemia.

Husain A

1992-04-01

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Intravascular haemolysis in the recreational runner.  

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Intravascular haemolysis has been found to result from prolonged endurance competition, rigorous military training and participation in impact sports. Haematological research involving the recreational runner is sparse. Recreational runners frequently vary their training to avoid monotony and improve endurance capacity. This study investigated the haematological effects of a typical day of increased distance training in 15 male recreational runners (62.4(3.1) ml kg-1 min-1 treadmill VO2max; 4...

1991-01-01

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Contrast enhanced intravascular ultrasound chirp imaging  

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Intravascular ultrasound (IVUS) imaging in combination with a microbubble ultrasound contrast agent (UCA) has the potential to image microvascular networks within the coronary artery wall, also referred to as vasa vasorum (VV). We report the relative performance of three chirp-based UCA detection methods at IVUS frequencies (30 to 60 MHz) for VV imaging: pulse inversion, subharmonic emission and chirp reversal. The contrast to tissue ratio, the contrast to noise ratio and the artifacts of eac...

Maresca, David; Renaud, Guillaume; Jong, Nico; Steen, Ton

2012-01-01

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Intravascular volume after aneurysmal subarachnoid hemorrhage  

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Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in patients who have survived the first hours after the hemorrhage. Hypotension and hypovolemia have been associated with an increased risk for DCI after SAH. The aim of the research presented in this thesi...

Hoff, R. G.

2009-01-01

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Percutaneous Retrieval of Chronic Intravascular Foreign Bodies  

International Nuclear Information System (INIS)

To evaluate the feasibility of intravascular retrieval of chronic foreign bodies, we retrospectively reviewed an 8 year experience (1993-2001) of percutaneous retrieval of chronically retained intravascular foreign bodies (n = 6). In 6 of 6 cases (4 catheter fragments, 2 guidewires), 5-90 days elapsed before retrieval via the femoral or internal jugular vein. Under fluoroscopy, we determined the foreign body's course, position and size. A guidewire was advanced through a multipurpose catheter to the foreign body. The multipurpose catheter was replaced with a gooseneck snare catheter and the snare advanced to grasp and remove the foreign body. Percutaneous retrieval was successful in all 6 cases. One patient experienced mild hemoptysis, which resolved within 24 hr of observation. No patient experienced long-term sequelae. Given the potential life-threatening complications from intravascular foreign bodies and the low complication rate from percutaneous retrieval, we recommend extraction of the foreign body even if it is asymptomatic in the chronic setting (> 24 hr)

2003-09-01

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Diagnosis and treatment of disseminated intravascular coagulation.  

Science.gov (United States)

Disseminated intravascular coagulation (DIC) is a condition in which systemic activation of coagulation without a specific localization occurs, resulting in extensive formation of intravascular fibrin, particularly in small and midsize vessels. Disseminated intravascular coagulation may lead to several altered coagulation parameters, including a low platelet count, abnormal global clotting assays, low levels of physiological anticoagulant proteases, or increased fibrin degradation products. Also, more complex assays for activation of coagulation factors or pathways may indicate involvement of these molecules in DIC. None of these tests alone, however, can accurately ascertain or rebuff a diagnosis of DIC. Nonetheless, a combination of readily available routine assays may be instrumental in establishing a diagnosis of DIC and can also be useful to point to a subset of patients with DIC that may need definite, often costly, interventions in the hemostatic system. Current insights on relevant etiological pathways that may contribute to the occurrence of DIC have led to innovative therapeutic and adjunctive approaches to patient with DIC. Management options directed at the amelioration of hemostatic activation may tentatively be indicated and were found to be advantageous in experimental and clinical investigations. These treatments encompass elimination of tissue factor-mediated thrombin generation or restitution of normal anticoagulant function. PMID:24750668

Levi, M

2014-06-01

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21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.  

Science.gov (United States)

...Subcutaneous, implanted, intravascular infusion port and catheter. 880.5965 Section...Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification...subcutaneous, implanted, intravascular infusion port and catheter is a device...

2009-04-01

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76 FR 77834 - Scientific Information Request on Intravascular Diagnostic and Imaging Medical Devices  

Science.gov (United States)

...Effectiveness Review of Intravascular Diagnostic Procedures and Imaging Techniques...evidence for intravascular diagnostic procedures and imaging techniques...are supplementing the usual manual and electronic database searches...that report on intravascular diagnostic and imaging medical...

2011-12-14

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Linfoma do sistema nervoso central: ensaio iconográfico Central nervous system lymphoma: iconographic essay  

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Full Text Available Ilustramos este ensaio iconográfico de linfoma do sistema nervoso central com imagens de ressonância magnética obtidas em nosso serviço nos últimos 13 anos e discutimos algumas das principais características radiológicas deste tipo de linfoma, primário e secundário. O linfoma sistema nervoso central é um tumor relativamente infrequente, mas alguns achados na ressonância magnética podem sugerir este diagnóstico.The authors illustrate the present pictorial essay about central nervous system lymphoma with magnetic resonance images obtained in their institution over the past 13 years. Some of the main radiological findings in primary and secondary presentations of this type of lymphoma are discussed. Central nervous system lymphoma is a relatively uncommon tumor, but magnetic resonance imaging findings may suggest the diagnosis.

Fabiano Reis

2013-04-01

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Linfoma primário de cólon: relato de caso Primary colorectal lymphoma: case report  

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Full Text Available O linfoma colorretal primário é uma doença rara (0.2 a 0.6% de todas as neoplasias colônicas, apresentando pior prognóstico quando comparado com o linfoma gástrico primário ou com o adenocarcinoma do cólon. É uma doença com sintomatologia inespecífica, o que dificulta o diagnóstico precoce. O objetivo deste relato é mostrar um caso de linfoma primário do cólon, revisar critérios diagnósticos e tratamento.The primary colorectal lymphoma is a rare disease (0.2 to 0.6% of all colonic neoplasias, that has a worse prognosis than primary gastric lymphoma or colon adenocarcinoma. The poor signals makes the early diagnosis difficult. The objectives of this report is to describe a case of primary colon lymphoma, revise diagnosis criteria and treatment.

Rafael Luís Luporini

2010-09-01

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Características imaginológicas del linfoma primario de recto: reporte de un caso y revisión de la literatura  

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Full Text Available El linfoma primario de recto es un tumor intestinal, poco frecuente, que está constituido, principalmente, por el tipo no Hodgkin extraganglionar y corresponde de 0,2% a 0,6% de todos los tumores de colon y recto. Se presenta el caso de una mujer de 79 años que consultó por una masa en recto de varios meses de evolución y rectorragia crónica. Se le tomó una biopsia, cuyo reporte histopatológico fue indicativo de linfoma no Hodgkin. El linfoma no Hodgkin de recto es un tumor raro, con pobre pronóstico, cuyo pilar de tratamiento es la cirugía. A continuación, se presenta el caso y una breve revisión de las características clínicas e imaginológicas de esta neoplasia poco frecuente.

LIDA MILENA APONTE

2010-01-01

 
 
 
 
101

Reuso do efluente tratado na indústria curtidora  

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Full Text Available Com o objetivo de avaliar a possibilidade de reúso do efluente líquido tratado de uma indústria curtidora, foi realizada esta pesquisa. O procedimento experimental comparou a produção de couros confeccionados com água potável, extraída de poçosartesianos, com couros produzidos a partir do efluente líquido final tratado. Para alcançar este objetivo, foram realizados testes físicose químicos através de análises em laboratório (análises químicas e de resistências físicas e avaliações organolépticas executadas porprofissionais do setor de couro (quanto a cor, firmeza de flor, enchimento e toque. A avaliação analítica e a das característicasorganolépticas não indicam diferenças representativas quando comparadas aos padrões de referência da ABNT de couros produzidos,permitindo, assim, concluir que o reúso de efluente tratado não altera a aparência dos artigos de couro.Abstract This research was carried out to evaluate the possibility of reuse of a tannery treated effluent. The experimental procedure compared the production of leather made by the use of drinking water, extracted from artesian wells, to leather produced by the use of the final treated liquid effluent. In order to achieve this goal, physic-chemical tests were carried out in laboratory (chemical and physical resistance analysis and leather industry professionals performed organoleptic evaluations (for color, grain firmness, filling and touch. The analytical evaluation and the organoleptic properties evaluation do not indicate a statistically significant difference when compared to ABNT reference standards of produced leathers, what allows the researchers to conclude that the reuse of treated effluent does not change the appearance of leather goods.

Karl Heinz Luersen

2012-01-01

102

Aneurismas saculares: avaliação experimental de procedimento terapeutico por via intravascular Saccular aneurysms: experimental evaluation of the efficacy of an intra-vascular therapeutic procedure  

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Full Text Available Visando à avaliar a possibilidade de ocluir aneurismas saculares através da injeção intra-vascular por cateterismo super-seletivo de um adesivo tecidual, os autores injetaram Bucrylat (isobutil-2-cianoacrilato no interior de quatorze aneurismas produzidos artificialmente em artérias carótidas de cães. Estudos angiográficos realizados imediatamente antes e depois da injeção e 1 mês após o tratamento revelaram uma oclusão progressiva e persistente dos aneurismas. Os exemplares examinados histologicamente 1 mês após a injeção demonstraram a presença de uma faixa fibrosa endotelializada cruzando o colo do aneurisma, o que parece indicar o caráter permanente da oclusão dos aneurismas tratados. Em nosso estudo, a reação tecidual ao adesivo foi discreta e restrita à íntima das artérias. A aplicação clínica deste método dependerá dos avanços nas técnicas de cateterização intracraniana super-seletiva, que irão permitir um cateterismo preciso e seguro da câmara aneurismática.Studies were performed on adult mongrel dogs to evaluate the possibility of occluding saccular aneurysms with an intravascular injection of the tissue adhesive Bucrylat (isobutyl-2-cyanoacrylate. Fourteen surgically constructed carotid aneurysms were occluded by the injection of Bucrylat through a fluoroscopically positioned intra-arterial catheter. Angiography performed immediately before and after injection and up to 1 month following treatment revealed progressive and persistent occlusion of the aneurysms. The specimens examined histologically 1 month after the injection showed an endothelialized fibrous tissue bridge crossing the neck of the aneurysm what appear to indicate a permanent occlusion of the structures treated. A similar approach to treat intracranial aneurysms will depend on advances in the field of selective intracranial catheterization that will permit safe and accurate catheterization of the aneurysm sac.

Mario G. Siqueira

1980-03-01

103

Aneurismas saculares: avaliação experimental de procedimento terapeutico por via intravascular / Saccular aneurysms: experimental evaluation of the efficacy of an intra-vascular therapeutic procedure  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Visando à avaliar a possibilidade de ocluir aneurismas saculares através da injeção intra-vascular por cateterismo super-seletivo de um adesivo tecidual, os autores injetaram Bucrylat (isobutil-2-cianoacrilato) no interior de quatorze aneurismas produzidos artificialmente em artérias carótidas de cã [...] es. Estudos angiográficos realizados imediatamente antes e depois da injeção e 1 mês após o tratamento revelaram uma oclusão progressiva e persistente dos aneurismas. Os exemplares examinados histologicamente 1 mês após a injeção demonstraram a presença de uma faixa fibrosa endotelializada cruzando o colo do aneurisma, o que parece indicar o caráter permanente da oclusão dos aneurismas tratados. Em nosso estudo, a reação tecidual ao adesivo foi discreta e restrita à íntima das artérias. A aplicação clínica deste método dependerá dos avanços nas técnicas de cateterização intracraniana super-seletiva, que irão permitir um cateterismo preciso e seguro da câmara aneurismática. Abstract in english Studies were performed on adult mongrel dogs to evaluate the possibility of occluding saccular aneurysms with an intravascular injection of the tissue adhesive Bucrylat (isobutyl-2-cyanoacrylate). Fourteen surgically constructed carotid aneurysms were occluded by the injection of Bucrylat through a [...] fluoroscopically positioned intra-arterial catheter. Angiography performed immediately before and after injection and up to 1 month following treatment revealed progressive and persistent occlusion of the aneurysms. The specimens examined histologically 1 month after the injection showed an endothelialized fibrous tissue bridge crossing the neck of the aneurysm what appear to indicate a permanent occlusion of the structures treated. A similar approach to treat intracranial aneurysms will depend on advances in the field of selective intracranial catheterization that will permit safe and accurate catheterization of the aneurysm sac.

Siqueira, Mario G.; Vieira, Ivoney A.; Cilião, Elizeu A.; Guerra, Dora M. G..

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Linfoma primario del sistema nervioso central de la fosa posterior en un paciente joven  

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Full Text Available El linfoma primario del sistema nervioso central es una neoplasia rara que se encuentra con relativa frecuencia en pacientes con inmunosupresión. Se presenta el caso de una mujer de 38 años sin antecedentes relevantes, a quien se le resecó un tumor del ángulo ponto-cerebeloso izquierdo, cuya anatomopatología reportó un linfoma B de célula grande muy maligno. Se hicieron estudios en busca de inmunosupresión, los que fueron negativos. La paciente no se encontraba en el rango de edad de presentación de este tipo de tumor y sólo estudios moleculares genéticos podrían dar alguna explicación a este caso.

TATIANA ROLDu00C1N

2011-01-01

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Recidiva tardia de linfoma da zona marginal Late relapse of marginal zone lymphoma  

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Full Text Available O linfoma de zona marginal é um linfoma de baixo grau com curso clínico indolente e potencial de recidiva.1,2 Apresentamos um caso de recidiva tardia após 25 anos de aparente remissão completa, levantando a possibilidade de recidiva de doença preexistente ou desenvolvimento de novo clone neoplásico.Marginal zone lymphoma is a low grade lymphoma with an indolent course and chance to relapse. We present a case of a patient who suffered relapse after 25 years of apparently complete remission of a low-grade non-Hodgkin lymphoma.

Talita M. B.S. Rocha

2009-01-01

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Linfoma mediastinal en una lactante Mediastinal lymphoma in an infant  

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Full Text Available Se presenta el caso clínico de una lactante de 17 meses, remitida al Hospital Infantil Sur de Santiago de Cuba, en fase terminal, desde el Hospital Pediátrico de Palma Soriano, donde había permanecido ingresada durante 14 días por neumonía grave. Inicialmente se planteó la posibilidad de un proceso séptico de origen tuberculoso o tumoral. En todo momento, la niña evolucionó desfavorablemente hasta fallecer. Los hallazgos anatomopatológicos confirmaron la presencia de un linfoma linfoblástico agudo del mediastino, con infiltración linfomatosa del saco pericardio, ambas pleuras, parénquima pulmonar, ganglios aorticoabdominales y ambos riñones.The clinical case of a 17-months infant is reported, who was referred to the Southern Children Hospital of Santiago de Cuba, in terminal period, from Palma Soriano Children Hospital, where she was hospitalized during 14 days due to severe pneumonia. Initially it was raised the possibility of a tumor or tuberculous septic process. All the time she made a poor progress until death. Pathological findings confirmed the presence of acute lymphoblastic lymphoma of the mediastinum with lymphomatous infiltration of the pericardial sac, pleurae, lung parenchyma, aorticoabdominal lymph nodes and kidneys.

Delfín Chaveco Bautista

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MALT-linfoma de cérvix: reporte de caso  

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Full Text Available Los linfomas MALT de cérvix son de muy rara presentación. Se reporta el caso de una paciente de 38 años con neoplasia linfoproliferativa detectada incidentalmente en los cortes de rutina, durante el estudio anátomo-patológico de espécimen de resección producto de histerectomía total, motivada por hallazgos ecográficos compatibles con miomatosis en cuerpo uterino. La etiología de esta neoplasia está asociada a procesos infecciosos o autoinmunes, se ha descrito alta radiosensibilidad y quimiosensibilidad a la biotera-pia contra anticuerpos CD20.The MALT-lymphomas of cervix are of very rare presentation. This is the case of a 38 years old patient in which this linfoproliferative disorder was detected incidentally in the routine cuts, during the anatomo-pathological study of a resection specimen product of total hysterectomy motivated by ecographic findings that were compatible with myomatosis of the uterine corpus. The etiology of these tumors is associated with infectious or autoimmune processes, and high radiosensitivity and chemosensitivity to biotherapy against antibodies CD20 (rituximab has been described.

Inés Benedetti P

2012-01-01

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Disseminated Intravascular Coagulation and Death Due to Snake Bites  

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Full Text Available Disseminated intravascular coagulation is a serious and life threatening systemic complication of snake bites that can cause death if the treatment is delayed. Herein we present a 57-year-old female patient with no prior systemic disease who died because of disseminated intravascular coagulation that developed in 6 hours due to a snake bite.

Yavuz Orak

2012-04-01

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Recurrent Disseminated Intravascular Coagulation Caused by Intermittent Dosing of Rifampin  

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Daily rifampin therapy is associated with minimal adverse effects, but administration on an intermittent or interrupted basis has been associated with severe immunoallergic reactions such as hemolytic anemia, acute renal failure, and disseminated intravascular coagulation. We describe a patient with Mycobacterium leprae infection who experienced recurrent episodes of disseminated intravascular coagulation after intermittent exposures to rifampin, and review eight previously reported cases of ...

Havey, Thomas C.; Cserti-gazdewich, Christine; Sholzberg, Michelle; Keystone, Jay S.; Gold, Wayne L.

2012-01-01

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Intravascular imaging with a storage phosphor detector  

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The aim of this study is to develop and test an intravascular positron imaging system based on a storage phosphor detector for imaging and detecting vulnerable plaques of human coronary arteries. The radiotracer F18-FDG accumulates in vulnerable plaques with inflammation of the overlying cap. The vulnerable plaques can, therefore, be imaged by recording positrons emitted from F18-FDG with a detector inserted into the artery. A prototype intravascular detector was constructed based on storage phosphor. The detector uses a flexible storage phosphor tube with 55 mm length, 2 mm diameter and 0.28 mm wall thickness. The intravascular detector is guided into the vessel using x-ray fluoroscopy and the accumulated x-ray signal must be erased prior to positron imaging. For this purpose, a light diffuser, 0.9 mm in diameter and 55 mm in length, was inserted into the detector tube. The light diffuser was connected to a laser source through a 2 m long optical fiber. The diffuser redirected the 0.38 W laser light to the inner surface of the phosphor detector to erase it. A heart phantom with 300 cm3 volume and three coronary arteries with 3.2 mm diameter and with several plaques was constructed. FDG solution with 0.5 µCi cm-3 activity concentration was filled in the heart and coronary arteries. The detector was inserted in a coronary artery and the signal from the plaques and surrounding background activity was recorded for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm-2 were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 360° circumference. Spatial resolution was 0.6-1.2 mm FWHM with a readout pixel resolution of 80 µm. The detector is flexible, reusable and easy to handle; it provides virtually real-time imaging. An intravascular imaging detector based on storage phosphor has shown a potential for imaging human coronary artery plaques. The detector provides the sensitivity, spatial resolution, flexibility and short imaging times necessary for clinical applications. Future research will decrease the detector diameter from 2 mm to 1 mm, and will apply the design to in vivo animal experiments.

Shikhaliev, Polad M.; Petrek, Peter; Matthews, Kenneth L., II; Fritz, Shannon G.; Bujenovic, L. Steven; Xu, Tong

2010-05-01

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Intravascular Ultrasound Image Segmentation Using Morphological Snakes  

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Full Text Available From the first use of the technics of intravascular ultrasound (IVUS as an imaging technique for the coronary artery system at the 70th century until now , the segmentation of the arterial wall boundaries still an important problem . Much research has been done to give better segmentation result for better diagnostics , evaluation and therapy planning. In this paper we present a new segmentation technics based on Morphological Snakes which developed by Luis Álvarez used for the first time for IVUS segmentation. It is a simple , fast and stable approach of snakes evolution algorithm. Results are presented and discussed in order to demonstrate the effectiveness of this approach in IVUS segmentation.

Hamdi Mohamed Ali

2012-06-01

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Linfoma tonsilar em crianças com assimetria tonsilar / Tonsillar lymphoma in children with unilateral tonsillar enlargement / Linfoma tonsilar en niños con asimetría tonsilar  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Demonstrar a importância do exame físico com ênfase nas alterações das tonsilas palatinas (TP) e na anamnese direcionada para a identificação precoce de pacientes com linfoma de TP. DESCRIÇÃO DO CASO: Caso 1 - Menina de cinco anos com voz abafada, observada pela mãe, e "sensação de algo es [...] tranho na garganta" há duas semanas. Foi atendida em outro serviço no início do quadro, sendo medicada com amoxicilina, sem melhora. Apresentava aumento importante da TP direita com superfície lisa e ausência de criptas. Após cirurgia, foi confirmado o diagnóstico de linfoma não Hodgkin (LNH). Na investigação também foi identificado acometimento dos linfonodos mesentéricos pelo linfoma. Caso 2 - Menina de 11 anos procurou o pronto-socorro para investigar nódulo em TP esquerda, indolor, de crescimento progressivo há um ano, sem outras queixas. Já havia passado por consultas médicas anteriores, não tendo sido valorizada a queixa da paciente. A TP esquerda encontrava-se aumentada, ultrapassando a linha média e com nódulo no polo superior. Também foi diagnosticado LNH após exame anatomopatológico. COMENTÁRIOS: Um exame minucioso da cavidade oral e do pescoço é essencial para identificar alterações suspeitas de linfoma tonsilar. Pacientes com assimetria tonsilar e outros achados sugestivos de malignidade devem ser submetidos à tonsilectomia. Abstract in spanish OBJETIVO: Demostrar la importancia de un examen físico con énfasis en las alteraciones de las tonsilas palatinas (TP) y en la anamnesis dirigida a la identificación temprana de pacientes con linfoma de TP. DESCRIPCIÓN DEL CASO: Caso 1 - Niña de cinco años, con voz velada, observada por la madre, y « [...] sensación de algo extraño en la garganta» hace dos semanas. Fue atendida en otro servicio en el inicio del cuadro, siendo medicada con amoxicilina, sin mejora. Presentaba aumento importante de la TP derecha con superficie lisa y ausencia de criptas. Después de la cirugía, se confirmó el diagnóstico de linfoma no Hodgkin (LNH). En la investigación también se identificó acometimiento de los nodos linfáticos mesentéricos por el linfoma. Caso 2 - Muchacha de 11 años buscó al servicio de urgencia para investigar nódulo en TP izquierda, indolora, de crecimiento progresivo hace un año, sin otras quejas. Ya había pasado por consultas médicas anteriores, no habiendo sido valorizada la queja de la paciente. La TP izquierda se encontraba aumentada, sobrepasando la línea media y con nódulo en el polo superior de esa. También se diagnosticó LNH después de examen anatomopatológico. COMENTARIOS: Un examen minucioso de la cavidad oral y del cuello es esencial para identificar alteraciones sospechosas de linfoma tonsilar. Pacientes con asimetría tonsilar y otros hallazgos sugestivos de malignidad deben ser sometidos a tonsilectomía. Abstract in english OBJECTIVE: To demonstrate the importance of a medical examination with emphasis on changes of the palatine tonsils (PT) and proper anamnesis to early identify patients with tonsillar lymphoma. CASE DESCRIPTION: Case 1 - 5-year-old girl with a muffled voice noted by her mother and a report of "feelin [...] g a strange sensation in the throat" for two weeks. She was previously treated in another service at the beginning of the symptoms with amoxicillin without improvement. An important increase in the right PT was noted, with smooth surface and absence of crypts. The diagnosis of non-Hodgkin lymphoma (NHL) was confirmed after surgery. On further investigation, positive mesenteric lymph nodes were noted. Case 2 - 11-year-old girl came to the emergency service to investigate a painless nodule in the left palatine tonsil with progressive growth for one year, without other complaints. She had previously undergone other medical consultations, but no importance was given to the patient's complaint. Oroscopy showed that the left PT was increased crossing the midline and with a nodule in the upp

Guimarães, Alexandre Caixeta; Carvalho, Guilherme Machado de; Gusmão, Reinaldo Jordão.

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Role of informed consent for intravascular contrast media  

International Nuclear Information System (INIS)

To evaluate the usefulness of different degrees of informed consent for intravascular contrast media, the authors divided 100 patients into four groups: (1) informed consent with no information on intravascular contrast media, (2) simple written informed consent that detailed common risks, (3) detailed written informed consent that detailed all known risks, and (4) MD informed consent, during which a radiologist discussed all known risks of intravascular contrast media. Physician counseling time for group 4 averaged 11.4 minutes. On a postprocedure test about the common complications and risk factors of intravascular contrast media, the average scores were: group 1, 38.4%; group 2, 68.2%; group 3, 63.2%; and group 4, 69.8%. There was no statistical difference between groups 2-4 on the postprocedure test. If informed consent is to be used prior to intravascular contrast media administration, a simple written consent detailing the common risks and risk factors appears to be the best method

1988-12-02

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Taquicardia ventricular associada com linfoma não-Hodgkin Taquicardia ventricular asociada con linfoma no Hodgkin Ventricular tachycardia associated with non-Hodgkin's lymphoma  

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Full Text Available Linfoma não-Hodgkin sistêmico pode afetar o miocárdio, particularmente em pacientes imunocomprometidos. Quando presentes, sinais e sintomas são geralmente inespecíficos, tornando o diagnóstico de envolvimento cardíaco muito difícil antes da autópsia. Arritmias ventriculares também são pouco usuais nesse cenário. Descrevemos um caso de linfoma não-Hodgkin miocárdico secundário, que se apresentou com taquicardia ventricular monomórfica sustentada e espessamento do septo interventricular basal. Completa remissão das lesões miocárdicas foi observada após o término da quimioterapia de segunda linha, sem recorrências posteriores de arritmias em oito meses.Linfoma no Hodgkin sistémico puede afectar el miocardio, particularmente en pacientes inmunocomprometidos. Cuando están presentes, señales y síntomas son generalmente inespecíficos, volviendo el diagnóstico de compromiso cardíaco muy difícil antes de la autopsia. Arritmias ventriculares también son poco usuales en ese escenario. Describimos un caso de linfoma no Hodgkin miocárdico secundario, que se presentó con taquicardia ventricular monomórfica sustentada y engrosamiento del septo interventricular basal. Completa remisión de las lesiones miocárdicas fue observada después del término de la quimioterapia de segunda línea, sin recurrencias posteriores de arritmias en ocho meses.Systemic non-Hodgkin's lymphoma can affect the myocardium, particularly in immunocompromised patients. When present, symptoms and signs are usually nonspecific, making the diagnosis of cardiac involvement very difficult before an autopsy. Ventricular arrhythmias are also unusual in this setting. We describe a case of secondary myocardial non-Hodgkin's lymphoma presenting with sustained monomorphic ventricular tachycardia and thickening of the basal interventricular septum. Complete remission of myocardial lesions was observed after completion of second-line chemotherapy treatment, without further recurrences of arrhythmias in eight months.

Diego Chemello

2011-12-01

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Taquicardia ventricular associada com linfoma não-Hodgkin / Ventricular tachycardia associated with non-Hodgkin's lymphoma / Taquicardia ventricular asociada con linfoma no Hodgkin  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Linfoma não-Hodgkin sistêmico pode afetar o miocárdio, particularmente em pacientes imunocomprometidos. Quando presentes, sinais e sintomas são geralmente inespecíficos, tornando o diagnóstico de envolvimento cardíaco muito difícil antes da autópsia. Arritmias ventriculares também são pouco usuais n [...] esse cenário. Descrevemos um caso de linfoma não-Hodgkin miocárdico secundário, que se apresentou com taquicardia ventricular monomórfica sustentada e espessamento do septo interventricular basal. Completa remissão das lesões miocárdicas foi observada após o término da quimioterapia de segunda linha, sem recorrências posteriores de arritmias em oito meses. Abstract in spanish Linfoma no Hodgkin sistémico puede afectar el miocardio, particularmente en pacientes inmunocomprometidos. Cuando están presentes, señales y síntomas son generalmente inespecíficos, volviendo el diagnóstico de compromiso cardíaco muy difícil antes de la autopsia. Arritmias ventriculares también son [...] poco usuales en ese escenario. Describimos un caso de linfoma no Hodgkin miocárdico secundario, que se presentó con taquicardia ventricular monomórfica sustentada y engrosamiento del septo interventricular basal. Completa remisión de las lesiones miocárdicas fue observada después del término de la quimioterapia de segunda línea, sin recurrencias posteriores de arritmias en ocho meses. Abstract in english Systemic non-Hodgkin's lymphoma can affect the myocardium, particularly in immunocompromised patients. When present, symptoms and signs are usually nonspecific, making the diagnosis of cardiac involvement very difficult before an autopsy. Ventricular arrhythmias are also unusual in this setting. We [...] describe a case of secondary myocardial non-Hodgkin's lymphoma presenting with sustained monomorphic ventricular tachycardia and thickening of the basal interventricular septum. Complete remission of myocardial lesions was observed after completion of second-line chemotherapy treatment, without further recurrences of arrhythmias in eight months.

Diego, Chemello; Priscila, Raupp-da-Rosa; Guilherme, Teló; Nadine, Clausell.

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Linfoma primario de hueso con afectación multicéntrica / Primary bone lymphoma with multicentric involvement  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de l [...] a lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgkin difuso de células grandes B, inició R-CHOPP (ciclofosfamida, doxorrubicina, vincristina, prednisona y rituximab) con rápida disminución de todas las lesiones sin evidencia de progresión al cabo de los seis ciclos. Abstract in english Primary bone lymphoma is a rare disease, which usually has a different presentation and evolution than lymphomas of other locations. We are presenting a case of primary bone lymphoma of rapid growth, in cranial and sternal locations. In its evolution, once the excision of the primary lesion of the s [...] kull was performed, the patient presented new lesions of rapid growth at the skull and femur level, and progression of pre-sternal lesion. With large B-cell diffuse non-Hodgkin lymphoma pathology, the patient initiated R-CHOPP (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab) with rapid reduction of all lesions without evidence of progression after the six cycles.

Graziadio, Marcelo; Medina, Natalia; Amato, Marcelo; Ardaiz, María del Carmen; Ilutovich, Santiago; Torino, Marcelo.

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Linfoma primario de hueso con afectación multicéntrica Primary bone lymphoma with multicentric involvement  

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Full Text Available El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de la lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgkin difuso de células grandes B, inició R-CHOPP (ciclofosfamida, doxorrubicina, vincristina, prednisona y rituximab con rápida disminución de todas las lesiones sin evidencia de progresión al cabo de los seis ciclos.Primary bone lymphoma is a rare disease, which usually has a different presentation and evolution than lymphomas of other locations. We are presenting a case of primary bone lymphoma of rapid growth, in cranial and sternal locations. In its evolution, once the excision of the primary lesion of the skull was performed, the patient presented new lesions of rapid growth at the skull and femur level, and progression of pre-sternal lesion. With large B-cell diffuse non-Hodgkin lymphoma pathology, the patient initiated R-CHOPP (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab with rapid reduction of all lesions without evidence of progression after the six cycles.

Marcelo Graziadio

2012-10-01

118

T-lymphoblastic lymphoma in adults Linfoma linfoblástico-T em adultos  

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Full Text Available In this short opinion review we discuss recent aspects of T-lymphoma lymphoblastic adults, like the evolution of the knowledge of classification, prognostic factors and the patients management.Nesta breve revisão os autores apresentam diversos aspectos de evolução dos conhecimentos na classificação e no manuseio dos pacientes portadores de linfoma linfoblástico-T em adultos.

Gino Santini

2009-08-01

119

Linfoma gástrico tipo malt presentación de un caso  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Paciente femenina, raza blanca, de 50 años de edad, que acudió a consulta de gastroenterología de la clínica Popular „Simón Bolívar‰ remitida de su área de salud, por presentar dolor abdominal de tipo epigastralgias, de moderada intensidad, de 2 meses de evolución, con sensación de ardor, además de [...] aparecer más recientemente náuseas y vómitos post-prandiales. La endoscopia superior evidenció lesiones nodulares del fondo y ulcerada del cardias, el estudio histopatológico con inmunohistoquímica reveló linfoma no Hodgkin de células B extranodal, del tejido linfoide asociado a mucosa (MALTOMA). Cumplió tratamiento erradicador para el Helicobacter pylori. Las endoscopias evolutivas mostraron evidente mejoría. Catorce meses después, la evaluación histopatológica reportó gastritis crónica atrófica sin atipias, ausencia de infección por Helicobacter pylori. Actualmente está asintomática y tiene seguimiento semestral. Abstract in english Female patient, Caucasian, 50 years old, who turned up for Gastroenterology consult of the „Simon Bolivar‰Popular Clinic, remitted from their health area , because of epigastric abdominal pain of moderate intensity with two months of evolution, with burning sensation, besides nauseas and vomiting. T [...] he upper digestive endoscopy showed a big ulceration in the cardial portion and granulate mucosa in the bottom of stomach. The histological study with inmunohistochemistry revealed a B extranodal cell non Hodgkin lymphoma of mucosa-associated lymphoid tissue (MALT). She completed treatment for eradication of Helicobacter pylori . Fourteen months later, the histopathologic evaluation reported a chronic atrophic gastritis without atypical cells and an absence of infection for Helicobacter pylori. At the moment she is asymptomatic and has a biannual follow-up.

Alfonso, Norlan de la Cruz; Zuleyma Carolina, De Jesús; Caridad, Kindelán Medina.

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Simultaneous occurrence of follicular lymphoma and mixed-cellularity Hodgkin's lymphoma: lymph node and extranodal involvement / Ocorrência simultânea de linfoma folicular e linfoma de Hodgkin celularidade mista: envolvimento nodal e extranodal  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os autores apresentam um caso raro e bem caracterizado de linfoma composto no baço e linfonodos. A ocorrência simultânea de um linfoma de Hodgkin e um linfoma não-Hodgkin foi demonstrada em um homem de 66 anos admitido com anemia, hepatosplenomegalia e múltiplos linfonodos abdominais. O estudo morfo [...] lógico do baço e linfonodo do hilo esplênico mostrou infiltração por duas neoplasias distintas. O fígado estava envolvido por linfoma não-Hodgkin e o linfonodo peripancreático mostrava um linfoma de Hodgkin. As células de Reed-Sternberg (RS) expressaram CD 15 e CD 30, enquanto as células do linfoma não-Hodgkin apresentaram os aspectos imunoistoquímicos clássicos do linfoma folicular. Na literatura médica, este é o quinto caso descrito de envolvimento do baço por linfoma composto. A incidência, aspectos clínicos e imunoistoquímicos desta rara associação são discutidos. Abstract in english An unusual and well-characterised case of composite lymphoma in the spleen and lymph node is presented. The simultaneous occurrence of mixed-cellularity Hodgkin's lymphoma (HL) and follicular non-Hodgkin's lymphoma (NHL) was demonstrated in a 66-year-old man admitted in our Service with anaemia, hep [...] atosplenomegaly and multiple abdominal lymph nodes. The morphological study of the spleen and lymph node of the splenic hilum showed an infiltrate composed of two distinct neoplasias. The liver was involved by NHL infiltrate and the peripancreatic lymph node exhibited HL. The Reed-Sternberg (RS) cells expressed CD 15 and CD 30, whereas the NHL cells presented standard immunohistochemical features of follicular lymphoma. To our knowledge, this is the fifth case report of concurrent spleen involvement by composite lymphoma. The incidence, clinicopathological and immunohistochemical features of this rare association are discussed.

Grangeiro, Maria do Patrocínio F.; Magalhães, Sílvia Maria M.; Ferreira, Francisco Valdeci A.; Rocha Filho, Francisco Dário.

 
 
 
 
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Laparoscopic colectomy for primary colonic lymphoma Tratamiento del linfoma primario de colon mediante colectomía laparoscópica  

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Full Text Available Primary colorectal lymphoma is an infrequent disease of unknown origin and with a growing incidence. Differentiation be-tween primary lymphoma and secondary colorectal involvement is of great therapeutic and prognostic importance. The diagnosis must always be based on histological findings. Different forms of presentation have been described, though all are nonspecific. While full agreement on the best management approach for colorectal lymphoma is lacking, surgical resection is usually the treatment of choice. The role of chemotherapy has not been defined. This study reports on a case of primary lymphoma in the cecum, with clinical manifestations in the form of meteorism and early satiety. The diagnosis was established by colonoscopy and biopsy. The absence of lymph-node involvement, tumor size, existing cardiopulmonary risk factors, and the fact that a full resection of the malignancy proved possible, with tumor-free resection margins, led us to exclude adjuvant chemotherapy. After one year of follow-up the patient remains disease-free.El linfoma primario colorrectal es una enfermedad muy infrecuente, de causa desconocida y con una incidencia en aumento. Diferenciar entre el linfoma primario y la afectación colorrectal secundaria en el linfoma sistémico es de elevada importancia terapéutica y pronóstica. El diagnóstico ha de ser siempre histológico. Se han descrito diferentes formas de presentación, pero todas ellas inespecíficas. No existe un total acuerdo sobre cuál es el mejor tratamiento del linfoma colorrectal. La resección quirúrgica suele ser el procedimiento de elección, sin haberse definido el papel de la quimioterapia. Presentamos un caso de linfoma primario localizado en el ciego, cuyas manifestaciones clínicas fueron meteorismo y saciedad precoz, siendo diagnosticado mediante colonoscopia y biopsia. La resección asistida por laparoscopia fue el tratamiento de elección. La no afectación ganglionar, tamaño tumoral, resección completa con márgenes libres, así como los factores de riesgo cardiopulmonares del paciente, llevaron a desestimar la quimioterapia adyuvante. Tras un año de seguimiento el paciente se encuentra libre de enfermedad.

D. Martínez-Ramos

2005-10-01

122

Primary diffuse large B-cell lymphoma of the oral cavity Linfoma difuso de grandes células B primário de boca  

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Full Text Available Lymphomas arising within the oral cavity account for only 3.5% of all oral malignancies. Diffuse large B-cell lymphoma is a non-Hodgkin lymphoma subtype characterized by diffuse proliferation of large neoplastic B lymphoid cells. This paper reports a case of diffuse large B-cell lymphoma affecting the oral cavity of a Brazilian woman, along with its clinical, microscopical, immunohistochemical, and molecular features.Linfomas correspondem a 3,5% de todos os casos de lesões malignas de boca. O linfoma difuso de grandes células B é um subtipo de linfoma não-Hodgkin caracterizado pela proliferação difusa de células linfóides B. Este artigo relata um caso de linfoma difuso de grandes células B localizado na cavidade bucal de uma mulher brasileira, incluindo os achados clínicos, microscópicos, imuno-histoquímicos e moleculares.

Bruno Correia Jham

2007-10-01

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Primary central nervous system lymphomas in immunocompetent patients / Linfomas primarios del sistema nervioso central en pacientes immunocompetentes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivos. En este trabajo presentamos nuestra casuística de linfomas cerebrales primarios en pacientes immunocompetentes comparandolo con los datos previos de la literatura, con especial enfoque en los recientes avaces, investigaciones, y controversias acerca del diagnóstico y manejo terapéutico de [...] estas patologías. Material y método. Nueve pacientes operados el año pasado en nuestra clínica con diagnóstico de PCNLS son analizados en relación al sexo, edad, tiempo de sintomatología, procedimientos y tratamiento. Posteriormente, los resultados son comparados con los de la literatura. Resultados. La edad varió entre 44-68 años (media de 60,6 años); 62,5% de los pacientes fueron del sexo femenino; el tiempo medio de duración de los síntomas antes del diagnóstico de la enfermedad varió de 1-6 meses, con un rango medio de 3,2 meses. Los síntomas clínicos más frecuentes fueron : hemiparesia (75%), cefalea (37,5), crisis convulsivas (25%) y ataxia (25%). Las localizaciones predominaron en las superficies de los lóbulos parietal, temporal y frontal con un 25% para cada una de las localizaciones citadas. Cinco pacientes (50%) fueron tratados con biopsia estereotáxica, tres con cirugía (37.5%) y uno (12.5%) con ambas. Cinco pacientes (62,5%) fueron sometidos a radioterapia postoperatoria como tratamiento adyuvante. En relación con el tipo histológico predominó el linfoma de células difusas tipo B. Conclusiones. Este estudio demostró que la resección quirúrgica, combinada con biopsia por esterotaxia y la radioterapia dan buenos resultados. Los autores recomiendan la quimioterapia solamente como segunda línea de tratamiento, en pacientes seleccionados. Abstract in english Objectives. Primary central nervous system lymphoma (PCNSL) is a rare pathology and is most often seen in immunodeficient patients. This article presents our casuistic of PCNSL in immunocompetent patients and make a literature review on this issue with focus on recent advances, investigations, and c [...] ontroversies in diagnosis and management of this pathology. Matherial and methods. Nine patients operated in the last years in our clinics are analysed in relation to sex, age, time of symptoms, procedures and adjuvant treatment. Posteriorly the results are compared with those in the preview literature. Results. The age ranged from 44-68 years (middle of 66 years); 62,5% of the patients were female. The mean time of symptoms, when the diagnostic was made, was 3.2 months (range 1-6 months). The most common symptoms were hemiparesis (present in 75% of the patients) headache (37.5%) seizures (25%) and ataxia (25%). The most common localization was the parietal, frontal and temporal lobe surface with 25% of the patients for each localization. Five patients (50%) were treated with stereotactic biopsy, three with surgery (37.5%) and one (12.5%) with both of them. Five patients (62,5%) were submitted to pos-operative radiotherapy as adjuvant treatment. In relation to the hystology, the most common cell type was Difuse B Cells. Conclusions. This study demonstrated that complete surgical ressection followed by radiotherapy have shown good results. In opposition to the literature, the authors regard chemotherapy as a secondary line treatment and recommend its use only in some selected cases.

Alécio-Mattei, T.; Alécio-Mattei, J.; Aguiar, P.H.; Ramina, R..

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Biópsia estereotáxica para linfomas primários do sistema nervoso central Stereotactic biopsy for primary lymphomas of the central nervous system  

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Os linfomas primários do SNC são raros, mas sua incidência tem aumentado nos últimos anos, Estes tumores frequentemente se localizam nos gânglios da base e tálamo ou se apresentam de forma multifocal. O tratamento atual para eles é a radioterapia, associada ou não a quimioterapia. Devido à sua extremamente baixa morbidade, a biópsia estereo-táxica é o método ideal para determinar o diagnóstico histológico em pacientes com suspeita de linfomas do SNC. Os autores apresentam estud...

1992-01-01

125

Hiperplasia endotelial papilar intravascular oral: uma entidade rara Intravascular papillary endothelial hyperplasia: a rare entity  

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A hiperplasia endotelial papilar intravascular (HEPI) é uma lesão vascular reativa caracterizada pela proliferação endotelial excessiva localizada no interior de vasos sangüíneos comumente dilatados, associada a trombos em organização, ou secundária a outras lesões vasculares, como hemangiomas e granulomas piogênicos. A HEPI é um achado incomum na cavidade oral, onde os lábios são o principal sítio de acometimento, e surge clinicamente sob a forma de nódulos azulados de aspect...

2006-01-01

126

Education and Propagation of Intravascular Surgery in Okinawa  

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Okinawa is an island located on the southwest edge of the Japanese Islands in which about 1,300,000 people live, and is an area where self-conclusion type medical treatment is desired. In this area, intravascular surgery was only performed for several cases per year until 1998. From May 1999, intravascular surgery started being performed in earnest, and 140 or more cases of intravascular surgery per year were performed in 2002. In the meantime, various measures for the propagation and develop...

2004-01-01

127

Intravascular ultrasound for angiographically indeterminant left main coronary artery disease.  

Science.gov (United States)

The precise diagnosis of the presence of significant left main coronary artery disease has profound prognostic and therapeutic implications. Coronary cineangiography has shown to be imprecise and inaccurate to determine the percent stenosis of the left main coronary artery. We report a case with significant left main coronary artery disease in whom coronary cineangiography was in discordance with the clinical data and intravascular ultrasonography. Based on the intravascular ultrasound findings, the patient underwent coronary artery bypass graft surgery. Therefore, the intravascular ultrasonography may be the procedure of choice for assessing indeterminant left main coronary artery lesions by coronary angiography. PMID:10146661

Parashara, D K; Jacobs, L E; Ledley, G S; Yazdanfar, S; Oline, J; Kotler, M N

1994-01-01

128

Death following intravascular administration of contrast media  

International Nuclear Information System (INIS)

Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

1985-01-01

129

Positron autoradiography for intravascular imaging: feasibility evaluation  

International Nuclear Information System (INIS)

he sensitivity of the storage phosphor detector to the positrons of 18F-FDG is sufficient to detect coronary plaques with 1 mm and 2 mm sizes and 590 Bq and 1180 Bq activities in the arteries with 2 mm and 3 mm diameters, respectively. An experimental study was performed using plastic tubes with 2 mm diameter filled with an FDG solution, which simulates blood. FDG spots simulating plaques were placed over the surface of the tube. A phosphor tip was inserted into the tube and imaged the plaques. Exposure time was 1 min in all simulations and experiments. Experiments showed that detecting the coronary plaques using the proposed technique is possible. The proposed technique has the potential for fast and accurate detection of vulnerable coronary and other intravascular plaques

2006-02-21

130

Transducer for harmonic intravascular ultrasound imaging.  

Science.gov (United States)

A recent study has shown the feasibility of tissue harmonic imaging (THI) using an intravascular ultrasound (IVUS) transducer. This correspondence describes the design, fabrication, and characterization of a THI-optimized piezoelectric transducer with oval aperture of 0.75 mm by 1 mm. The transducer operated at 20 MHz and 40 MHz, and was comprised of a single piezoelectric layer with additional passive layers. The Krimholtz-Leedom-Matthaei (KLM) model was used to iteratively find optimal material properties of the different layers. The transducer characterization showed -6 dB fractional bandwidths of 30% and 25%, and two-way insertion losses of -20 dB and -36 dB, respectively. PMID:16463509

Vos, Hendrik J; Frijlink, Martijn E; Droog, Erik; Goertz, David E; Blacquière, Gerrit; Gisolf, Anton; de Jong, Nico; van der Steen, Antonius F W

2005-12-01

131

Características epidemiológicas, clínicas y patológicas de los linfomas en el Hospital Nacional Cayetano Heredia del año 1998 al 2008 / Epidemiological, clinical, and pathologic characteristics of lymphoma cases in Cayetano Heredia National Hospital from 1998 to 2008  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivo: Conocer las características epidemiológicas, clínicas y patológicas de los pacientes con linfoma diagnosticados en el Hospital Nacional Cayetano Heredia. Material y métodos: Se realizó un estudio descriptivo, retrospectivo, tipo serie de casos de 433 pacientes portadores de linfoma del año [...] 1998 al 2008. Resultados: El promedio de edad fue de 44,8 años, 60,04% eran de sexo masculino. El lugar de nacimiento y procedencia más frecuente fue Lima con 61,5% y 90% respectivamente. Los síntomas más frecuentes son la baja de peso y la presencia de linfoadenopatías (40,5% y 3,7% respectivamente). El 55,08% de los pacientes se encontraban en estadio clínico I - II. La localización más frecuente fue ganglionar (55,1%). Las localizaciones extraganglionares más frecuentes fueron: gastrointestinal (15,2%) y piel (10,8%). Se hallo que el inmunofenotipo B fue de 57.8% de los linfoma no Hodgkin y el patrón histológico más común fue el linfoma de células grandes difuso (35,8%), enfermedad de Hodgkin fue el 14,08%. De los pacientes tratados, 78,12% tuvieron respuesta completa y parcial de la enfermedad. El tratamiento en la enfermedad de Hodgkin fue ABVD con 90,97% de respuesta completa y parcial. Solo se reportó que el 23,45% de los pacientes han fallecido al momento. Conclusiones: Los pacientes con linfoma atendidos en el Hospital Nacional Cayetano Heredia tienen características similares a lo reportado a nivel mundial. Abstract in english Objective: To determine the epidemiological, clinical and pathological characteristics of lymphoma cases in Cayetano Heredia National Hospital. Material and methods: We conducted a descriptive and retrospective case series including 433 patients with lymphoma diagnosed from 1998 to 2008. Results: Av [...] erage age of patients was 44.8 years, and 60.04% were male. Most frequent birthplace and living area was Lima, with 61.5% and 90% of all patients, respectively. Most frequent symptoms were weight loss and lymph node enlargement (40.5% and 3,7%, respectively). More than half of all patients (55.08%) were in I-II clinical stages. The most frequent location of the disease was in the lymph nodes (55.1%). Extranodal locations were the gastrointestinal tract (15.2%) and the skin (10.8%). The B immunophenotype corresponded to 57.8% o all non-Hodgkin lymphoma cases, and the most common histological type was diffuse large cell lymphoma (35.8%), and Hodgkin’s disease accounted for 14.08%. Of all treated patients, 78.12% had complete and partial response. Therapy for Hodgkin’s disease was ABVD, with 90.97% of all patients achieving complete and/or partial response. Only 23.45% of all patients were reported as dead. Conclusions: Lymphoma patients seen in Cayetano Heredia National Hospital have similar characteristics compared to was is reported in a worldwide basis.

Juan José, Padilla Valdez; Victor, Ulloa Pérez; Diego, Venegas Ojeda.

132

Human Intravascular Immunoglobin Responses to Exercise-Heat and Hypohydration,  

Science.gov (United States)

The effects of prolonged treadmill exercise in the heat and hypohydration on changes in the intravascular mass of immunoglobins were examined. Five heat acclimated males attempted two Heat Stress Tests (HSTs). One HST was completed when subjects were euhy...

A. J. Young K. B. Pandolf M. N. Sawka R. C. Dennis R. R. Gonzalez

1988-01-01

133

Disseminated intravascular coagulation in malaria: A case report  

Science.gov (United States)

Disseminated intravascular coagulation (DIC) is seen in <5% of patients with severe Plasmodium falciparum malaria and is more common in cerebral malaria. Here, we report the diagnosis and management of a case of severe P. falciparum malaria with DIC.

Sailo, Laltanpuii; Pradhan, Debasis; Nongthombam, Rakesh; Bhattacharyya, Prithwis

2014-01-01

134

Hepatic metastases in a case of intravascular bronchioloalveolar tumour.  

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This report describes the clinical and pathological findings in a patient with an intravascular bronchioloalveolar tumour who presented with hepatic metastases. These were originally diagnosed as hepatic veno-occlusive disease.

Gledhill, A.; Kay, J. M.

1984-01-01

135

A Fatal Case of Intravascular Coagulation After Bee Sting Acupuncture  

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Bee stings can cause severe adverse reactions, leading to anaphylaxis, cardiovascular collapse, and death. In some cases, bee venom also induces disseminated intravascular coagulation (DIC). However, to our knowledge, there has been no fatal case of intravascular coagulation accompanied by anaphylaxis caused by bee sting acupuncture. Here, we report a fatal case of a 65-year-old woman with DIC, following anaphylactic shock after bee sting acupuncture. This case emphasizes that practitioners s...

Jung, Jae Woo; Jeon, Eun Ju; Kim, Jeong Wook; Choi, Jae Chol; Shin, Jong Wook; Kim, Jae Yeol; Park, In Won; Choi, Byoung Whui

2012-01-01

136

Linfomas B y T: Diagnóstico inmunofenotípico de los linfomas no hodgkinianos B-and T-lymphomas. Immunophenotypical diagnosis of non-Hodgkin lymphomas  

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Full Text Available Los linfomas no hodgkinianos son neoplasias linfoides que pueden presentar fenotipo de células B ó T; las de tipo B son más frecuentes, mientras que los linfomas de tipo T tienen peor pronóstico y por lo general son más agresivos. En el ámbito internacional, la sobrevida de estas enfermedades es de aproximadamente 5 años, y en nuestro país se encuentran entre las 10 primeras causas de cáncer en ambos sexos, con prevalencia ligeramente mayor en el sexo masculino (1,3:1. Se destaca además, entre algunos aspectos, la importancia del estudio inmunofenotípico para determinar la naturaleza de estos procesos neoplásicos y distinguir entre enfermedad de Hodgkin, linfomas no hodgkinianos e infiltraciones por otros procesos linfoides, también para poder establecer factores pronósticos y de progresión en estos desórdenes linfoproliferativosThe non-Hodgkin lymphomas are lymphoid neoplasias that may present phenotype of cells B or T. The B-lymphomas are more frequent, whereas the T-lymphomas have a worse prognosis and they are generally aggressive. The survival of these diseases is of approximately 5 years at the international level. In our country, it is among the first 10 causes of death in both sexes, with a slightly higher prevalence in males (1.3:1. It is also stressed, among some other aspects, the importance of the immunophenotypical study to determine the nature of these neoplastic processes and to distinguish between Hodgkin disease, non-Hodgkin lymphomas and infiltrations due to other lymphoid processes, and to establish prognostic and progression factors in these lymphoproliferative disorders

Bertha B Socarrás Ferrer

2003-04-01

137

Primary cardiac lymphoma in dogLinfoma cardíaco primário em cão  

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Full Text Available Lymphomas are malignant neoplasm characterized by proliferation of lymphocytes that originate primarily in lymphoid organ such as lymph nodes, liver, spleen and bone marrow. However the feature of continuous migration of lymphocytes in different organs, this tumor can develop in any organ. Although lymphoma is a very common hematopoietic neoplasm in dogs, cardiac location is rare. The diagnosis of primary cardiac lymphoma may be performed when there is involvement of the heart and / or the pericardium without evidence of involvement in other organs. In veterinary medicine there are few reports on the diagnosis, treatment and prognosis of cardiac lymphoma. Therefore, the purpose of this report is to describe a case of cardiac lymphoma in which the patient responded favorably to chemotherapy employee with disease-free interval of 19 months and highlight the importance of including this neoplasm in the differential diagnosis of diseases that affect the cardiovascular system. Os linfomas são neoplasias caracterizadas pela proliferação maligna de linfócitos, que originamse principalmente em órgão linfóides como linfonodos, fígado, baço e medula óssea. Entretanto pela característica de contínua migração dos linfócitos por diferentes órgãos, esta neoplasia pode se desenvolver em qualquer órgão. Embora o linfoma seja a neoplasia hematopoiética de maior incidência em cães, a localização cardíaca é rara. O diagnóstico de linfoma cardíaco primário pode ser realizado quando há envolvimento do coração e/ou pericárdio sem evidências de ocorrência de órgãos linfáticos ou extranodais. Em medicina veterinária existem poucos relatos sobre o diagnóstico, tratamento e prognóstico desta neoplasia cardíaca. Portanto o objetivo do presente relato é descrever um caso de linfoma cardíaco em que o paciente respondeu favoravelmente ao tratamento quimioterápico empregado com intervalo livre de doença de 19 meses e salientar a importância de incluir essa neoplasia na lista de diagnósticos diferenciais de doenças que acometem o sistema cardiovascular.

Mirela Tinucci Costa

2013-10-01

138

Primary pulmonary AIDS-related lymphoma / Linfoma primario de pulmón en un paciente con sida  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in spanish El compromiso extranodal es frecuente en los linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana y su consecuencia, el síndrome de inmunodeficiencia adquirida. Sin embargo, el linfoma pulmonar primario es muy raro y solo existen pocos casos publicados en la literatura [...] . La presentación clínica de esta complicación es inespecífica, con síntomas "B" y manifestaciones respiratorias. Generalmente, la radiografía de tórax muestra nódulos periféricos o masas que pueden cavitarse y los pacientes presentan inmunodeficiencia severa al momento del diagnóstico. El linfoma pulmonar primario asociado con el sida es un tumor de alto grado, de células B y asociado en su patogenia con el virus de Epstein-Barr. Se relata un caso de linfoma primario de pulmón que se presentó bajo la forma radiológica de una atelectasia global del pulmón izquierdo. Abstract in english Extranodal involvement is common in lymphomas associated with human immunodeficiency virus infection (HIV) and acquired immunodeficiency syndrome (AIDS). However, primary pulmonary AIDS-related non-Hodgkin's lymphoma is very rare and only few reports were published in the medical literature. Clinica [...] l presentation is nonspecific, with "B" and respiratory symptoms. Also, patients were with advanced immunodeficiency at the time of diagnosis. Generally, chest radiography showed peripheral nodules or cavitary masses. Primary pulmonary lymphoma associated with AIDS is generally a high-grade B-cell non-Hodgkin lymphoma and Epstein-Barr virus is strongly associated with the pathogenesis of these tumors. We report a patient with AIDS and primary pulmonary lymphoma which clinical presentation was a total atelectasis of the left lung.

Marcelo, Corti; María F., Villafañe; Norberto, Trione; Ricardo, Schtirbu; Marina, Narbaitz.

139

Linfoma cutâneo de células B: relato de caso Cutaneous B-cell lymphoma: a case report  

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Full Text Available Os linfomas cutâneos são classificados em linfomas de células B ou de células T, sendo os primeiros menos freqüentes. O linfoma cutâneo de células B (LCCB pode ser primário ou secundário, tendo o último história natural mais agressiva, com pior prognóstico. Os autores apresentam um caso de LCCB secundário com três anos de evolução, curso indolente, sem envolvimento de outros órgãos além da pele, com ótima resposta ao tratamento quimioterápico. A distinção entre LCCB primário e secundário é muito difícil de ser realizada, uma vez que eles são clínica e histopatologicamente indistinguíveis. Deve-se sempre pesquisar o acometimento de órgãos internos para então definir o prognóstico.Cutaneous lymphomas are classified as either type B cell or T cell lymphoma, the former type being less frequent. Cutaneous B cell lymphoma (CBCL may be primary or secondary. The latter has a more aggressive natural history with a worse prognostic. In this paper, the authors present a secondary CBCL case with a three-year evolution, indolent course, without involvement of other organs beside the skin and with optimal response to chemotherapeutic treatment. The distinction between primary and secondary CBCL is very difficult to determine insofar as they are clinically and histopathologically indistinguishable. It is always necessary to investigate whether internal organs have been affected prior to defining the prognosis.

Mariana de Gusmão Nunes

2004-12-01

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Linfoma primario de célula B grande de próstata. Comunicación de un caso  

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Full Text Available El linfoma prostático representa 0.09% de los tumores malignos de ese órgano. La forma de presentación habitual consta de signos de prostatismo y se descubre, predominantemente, de manera incidental por medio de tejido obtenido por resección transuretral de próstata. La sensibilidad de la biopsia transrectal es de 22%. El linfoma de próstata casi siempre es indistinguible de un adenocarcinoma, e incluso, puede encontrarse una próstata pétrea, fija y mal delimitada. En el estudio anatomopatológico se observan intensos infiltrados linfohistiocitarios. En estos pacientes debe tomarse en cuenta la posible existencia de una afectación linfática sistémica, por lo que es conveniente realizar mielograma, biopsia de médula ósea, tomografía computada toracoabdominal y gammagrama óseo. El diagnóstico se corrobora por medio de inmunohistoquímica con la detección de linfocitos B en el inmunomarcaje. El tratamiento consiste en la desobstrucción con alivio de los síntomas urinarios, así como de quimioterapia a base de ciclofosfamida, adriamicina, vincristina y prednisona con rituximab. Se comunica un caso de linfoma prostático destacando su infrecuencia con el fin de llamar la atención de la comunidad médica para realizar un abordaje diagnóstico y terapéutico adecuado. En el caso que se comunica, tras seis ciclos de quimioterapia, no se encontró actividad tumoral ni adenopatías retroperitoneales en los seguimientos radiológicos.

Salim Antonio Villacis Fonseca

2012-01-01

 
 
 
 
141

Linfoma tipo MALT de la glándula parótida / Lymphoma type MALT of the parotid gland  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Los linfomas tipo MALT (tejido linfoideo asociado a mucosa), constituyen la variedad más recientemente descubierta de los linfomas no Hodgkin, tienen lugar fundamentalmente en la mucosa gástrica asociados a infección por Helycobacter pylori, y en la glándula tiroides en relación con la tiroiditis de [...] Hashimoto. Sin embargo, internacionalmente se han descrito casos en glándulas salivales asociados a linfoadenitis. La naturaleza de la lesión a menudo no puede ser determinada solo por el estudio citológico; se hace necesario el análisis histopatológico para el diagnóstico definitivo en la mayoría de los casos. El presente estudio muestra un paciente masculino con aumento de volumen bilateral de ambas glándulas parótidas y diagnóstico citohistopatológico de un proceso linfoepitelial benigno, el cual desarrolló un linfoma tipo MALT en relación con la glándula parótida derecha. Abstract in english The lymphomas type MALT or the mucosa-associated lymphoid tissue, are the most recent variety of non-Hodgkin lymphomas present mainly in the gastric mucosa associated with Helycobacter pylori infection and in the thyroid gland in relation to Hashimoto's thyroiditis. Frequently the origin of this les [...] ion can't be determined only by cytology study, thus it is necessary the histopathology analysis for a definitive diagnosis in most cases. Present paper includes the case of male patient with bilateral volume increase of both parotid glands and a diagnosis cytopathological of a benign lymphoepithelial process and the development of a type MALT lymphoma in relation to the right parotid gland.

Carlos, Frómeta Neira; Juan Manuel, González Gómez; Miguel, Arredondo López.

142

Linfoma tipo MALT de la glándula parótida Lymphoma type MALT of the parotid gland  

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Full Text Available Los linfomas tipo MALT (tejido linfoideo asociado a mucosa, constituyen la variedad más recientemente descubierta de los linfomas no Hodgkin, tienen lugar fundamentalmente en la mucosa gástrica asociados a infección por Helycobacter pylori, y en la glándula tiroides en relación con la tiroiditis de Hashimoto. Sin embargo, internacionalmente se han descrito casos en glándulas salivales asociados a linfoadenitis. La naturaleza de la lesión a menudo no puede ser determinada solo por el estudio citológico; se hace necesario el análisis histopatológico para el diagnóstico definitivo en la mayoría de los casos. El presente estudio muestra un paciente masculino con aumento de volumen bilateral de ambas glándulas parótidas y diagnóstico citohistopatológico de un proceso linfoepitelial benigno, el cual desarrolló un linfoma tipo MALT en relación con la glándula parótida derecha.The lymphomas type MALT or the mucosa-associated lymphoid tissue, are the most recent variety of non-Hodgkin lymphomas present mainly in the gastric mucosa associated with Helycobacter pylori infection and in the thyroid gland in relation to Hashimoto's thyroiditis. Frequently the origin of this lesion can't be determined only by cytology study, thus it is necessary the histopathology analysis for a definitive diagnosis in most cases. Present paper includes the case of male patient with bilateral volume increase of both parotid glands and a diagnosis cytopathological of a benign lymphoepithelial process and the development of a type MALT lymphoma in relation to the right parotid gland.

Carlos Frómeta Neira

2010-09-01

143

T- Lymphoblastic lymphoma in adults / Linfoma linfoblástico T dos adultos  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O linfoma linfoblástico de célula T é raro e com prognóstico ruim. Após introdução de terapêutica quimioterápica seqüencial e intensificada, remissões completas passaram a ser obtidas em 75%-95% dos pacientes. Entretanto, muitos pacientes, particularmente aqueles com a chamada doença avançada, conti [...] nuaram a recair tanto durante a terapia de indução como na manutenção. Além disso, todos estes estudos iniciais não foram capazes de detectar qualquer índice prognóstico capaz de prever a evolução dos pacientes. No sentido de reduzir as taxas de recidiva, o transplante autólogo de célula progenitora hematopoética em pacientes em remissão completa foi introduzido. Os resultados obtidos com esta abordagem foram bastante homogêneos, indicando uma probabilidade de sobrevida livre de doença de 65%-75% e uma sobrevida global de 60%. Sucessivos tratamentos desenhados já nos anos 2000, foram capazes de obter remissões completas acima de 90%, com taxas de recidivas da ordem de 30% e uma sobrevida global comparável à obtida com o transplante. Ainda, estes estudos também não foram capazes de detectar fatores prognósticos relacionados à evolução válidos. Mais ainda, qualquer estudo com perfil biológico foi desenvolvido. Para melhorar o prognóstico do LLB-T parece ser necessário esforço multicêntrico, de caráter nacional ou internacional, para coletar dados clínicos e biológicos. Nesta linha, é possível alcançar número crítico de dados com valor estatístico que poderiam ser capazes de detectar fatores com influência prognóstica. Finalmente, grupos de pacientes necessitam ser identificados para selecionar aqueles que poderiam se beneficiar do transplante de célula progenitora hematopoética detectados ao diagnóstico. Abstract in english Adult T-lymphoblastic lymphoma is rare and has a poor prognosis. In the 80s, following the introduction of sequential, intensified chemotherapy, complete remissions in the order of 75%-95% of treated patients, were achieved. However, several patients, namely those with advanced disease, continued to [...] relapse either in remission or during maintenance therapy. Moreover, all these early studies were not able to detect any valuable prognostic index to predict the outcome. In an attempt to reduce the relapse rate, upfront autologous stem cell transplantation in patients in complete remission was introduced. The results obtained with this approach were quite homogeneous, indicating a probability of disease-free survival of about 65%-75% and an overall survival rate of 60%. Successive therapies designed since 2000 were able to obtain complete remissions of above 90%, with a relapse rate in the order of 30% and an overall survival comparable to that obtained with the transplant procedure. Yet, these studies were also unable to detect valuable prognostic factors predictive of the outcome. Moreover, no study on the biologic profile of the disease has been developed. To improve the prognosis of T-lymphoblastic lymphoma it seems necessary to create national registries to collect both clinical and biological data of all lymphoblastic lymphoma patients. In this way it will be possible to reach critical numbers of data with which valid statistical analysis may be performed that is able to detect factors influencing the outcome. Moreover, subsets of patients needing intensified procedures such as stem cell transplant may be detected at diagnosis.

Gino, Santini; Adolfo, Porcellini; Simona, Zupo; Mauro, Truini.

144

Intravascular imaging with a storage phosphor detector  

International Nuclear Information System (INIS)

ed for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm-2 were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 3600 circumference. Spatial resolution was 0.6-1.2 mm FWHM with a readout pixel resolution of 80 ?m. The detector is flexible, reusable and easy to handle; it provides virtually real-time imaging. An intravascular imaging detector based on storage phosphor has shown a potential for imaging human coronary artery plaques. The detector provides the sensitivity, spatial resolution, flexibility and short imaging times necessary for clinical applications. Future research will decrease the detector diameter from 2 mm to 1 mm, and will apply the design to in vivo animal experiments.

2010-05-21

145

Micromachined capacitive transducer arrays for intravascular ultrasound  

Science.gov (United States)

Intravascular ultrasound (IVUS) imaging has become an essential imaging modality for the effective diagnosis and treatment of cardiovascular diseases during the past decade enabled by innovative applications of piezoelectric transducer technology. The limitations in the manufacture and performance of the same piezoelectric transducers have also impeded the improvement of IVUS for emerging clinically important applications such as forward viewing arrays for guiding interventions and high resolution imaging of arterial structure such as vulnerable plaque and fibrous cap, and also implementation of techniques such as harmonic imaging of the tissue and of the contrast agents. Capacitive micromachined ultrasonic transducer (CMUT) technology shows great potential for transforming IVUS not only to satisfy these clinical needs but also to open up possibilities for low-cost imaging devices integrated to therapeutic tools. We have developed manufacturing processes with a maximum process temperature of 250°C to build CMUTs on the same silicon chip with integrated electronics. Using these processes we fabricated CMUT arrays suitable for forward viewing IVUS in the 10-20MHz range. We characterized these array elements in terms of pulse-echo response, radiation pattern measurements and demonstrated its volumetric imaging capabilities on various imaging targets.

Degertekin, F. Levent; Guldiken, R. Oytun; Karaman, Mustafa

2005-01-01

146

High sensitivity intravascular photoacoustic imaging of macrophages  

Science.gov (United States)

In atherosclerosis, tracking and locating the activity of macrophages that are highly involved in plaque development will help to identify the pathology of the disease. Intravascular photoacoustic (IVPA) imaging has shown potential to detect atherosclerosis and to determine plaque composition. Furthermore, using optical absorbers as contrast agents, IVPA can also be used for molecular imaging. In this paper, we study the feasibility of using gold nanoparticles as contrast agent for high sensitivity IVPA imaging of macrophages. The artery was modeled using a cylindrical tube made out of polyvinyl alcohol. Within the vessel wall, several compartments were made to mimic plaques. After incubating murine macrophages with 50 nm spherical gold nanoparticles overnight, macrophages loaded with particles were filled into the compartments of the arterial phantoms. Because of the plasmon resonance coupling of aggregated nanoparticles inside the macrophages, these macrophages can be detected by IVPA imaging using 680 nm wavelength. The sensitivity of the molecular IVPA imaging was tested using phantoms with different concentrations of nanoparticles and macrophages. Finally, to address the feasibility of in-vivo IVPA imaging with gold nanoparticles, the viability of the macrophages loaded with nanoparticles exposed to laser irradiation was studied. The results show that IVPA imaging can safely image macrophages loaded with gold nanoparticles with relatively high sensitivity.

Wang, Bo; Yantsen, Evgeniya; Sokolov, Konstantin; Emelianov, Stanislav

2009-02-01

147

Manifestação bucal de linfoma difuso de grandes células B Oral manifestation of diffuse large B-cell lymphoma  

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Full Text Available O linfoma de células B acomete cerca de 90% de todos os casos de linfoma. O aparecimento da lesão bucal deste tipo de linfoma é pouco comum e raras vezes se manifesta em região anterior de mandíbula. Neste relato de caso, o paciente de 22 anos, sexo masculino, com diagnóstico de linfoma de grandes células B em mediastino e pleura, após um ano de tratamento apresentou lesão nodular em região anterior de mandíbula, comprometendo os dentes incisivos inferiores. O diagnóstico histológico e imuno-histoquímico confirmou a forma secundária do linfoma. O paciente foi submetido a tratamento quimioterápico com regressão completa da lesão mandibular e está sob acompanhamento odontológico reabilitador.B-cell lymphomas account for around 90% of all cases of lymphoma. The appearance of oral lesions with this type of lymphoma is uncommon but in cases where involvement is seen, the anterior region of lower jaw is most frequently affected. Here the case of a 22-year-old male patient is reported; he was diagnosed with large B cell lymphoma in the mediastinal pleura and after 1 year of treatment he evolved with a nodular lesion in the anterior region of the lower jaw involving the incisors. Histological diagnosis and immunohistochemistry confirmed secondary lymphoma. The patient was submitt.

Paulo Sérgio S. Santos

2009-01-01

148

Burkitt-like lymphoma in an infant: a case report Linfoma burkitt-like em um lactente: relato de caso  

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Full Text Available Childhood non-Hodgkin's lymphomas, including Burkitt and Burkitt-like, are rarely diagnosed in infants. A case of B-cell lymphoma in a 13-month-old girl with extensive abdominal disease, ascites, pleural effusion, and tumor lysis syndrome is reported. Phenotypic analysis showed a germinal center B-cell phenotype, and a B-cell clonality was confirmed by polymerase chain reaction. There was no evidence of Epstein-Barr and HIV infection. The case herein reported emphasizes the need for considering the diagnosis of lymphoma even in very young children.Os linfomas não Hodgkin da infância, incluindo os linfomas de Burkitt e Burkitt-like são raros em lactentes. Um caso de linfoma não Hodgkin B em uma lactente de 13 meses de idade é descrito. Ao diagnóstico a paciente apresentava extenso comprometimento abdominal associado à ascite, derrame pleural e síndrome de lise tumoral. A análise imunofenotípica mostrou um fenótipo compatível com células linfóides oriundas do centro germinativo e a origem clonal dessas células foi demonstrada por reação em cadeia da polimerase. Não foi demonstrada associação do linfoma com infecção pelo vírus Epstein-Barr e/ou virus da imunodeficiência adquirida. O caso apresentado enfatiza a necessidade de considerar o diagnóstico de linfoma mesmo em lactentes.

Claudete Esteves Klumb

2003-01-01

149

Burkitt-like lymphoma in an infant: a case report / Linfoma burkitt-like em um lactente: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os linfomas não Hodgkin da infância, incluindo os linfomas de Burkitt e Burkitt-like são raros em lactentes. Um caso de linfoma não Hodgkin B em uma lactente de 13 meses de idade é descrito. Ao diagnóstico a paciente apresentava extenso comprometimento abdominal associado à ascite, derrame pleural e [...] síndrome de lise tumoral. A análise imunofenotípica mostrou um fenótipo compatível com células linfóides oriundas do centro germinativo e a origem clonal dessas células foi demonstrada por reação em cadeia da polimerase. Não foi demonstrada associação do linfoma com infecção pelo vírus Epstein-Barr e/ou virus da imunodeficiência adquirida. O caso apresentado enfatiza a necessidade de considerar o diagnóstico de linfoma mesmo em lactentes. Abstract in english Childhood non-Hodgkin's lymphomas, including Burkitt and Burkitt-like, are rarely diagnosed in infants. A case of B-cell lymphoma in a 13-month-old girl with extensive abdominal disease, ascites, pleural effusion, and tumor lysis syndrome is reported. Phenotypic analysis showed a germinal center B-c [...] ell phenotype, and a B-cell clonality was confirmed by polymerase chain reaction. There was no evidence of Epstein-Barr and HIV infection. The case herein reported emphasizes the need for considering the diagnosis of lymphoma even in very young children.

Claudete Esteves, Klumb; Lídia Maria Magalhães de, Resende; Claudio Gustavo, Stefanoff; Carlos Humberto, Vicuña; Ilana Zalcberg, Renault; Raquel Ciuvalschi, Maia.

150

Laparoscopic colectomy for primary colonic lymphoma / Tratamiento del linfoma primario de colon mediante colectomía laparoscópica  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish El linfoma primario colorrectal es una enfermedad muy infrecuente, de causa desconocida y con una incidencia en aumento. Diferenciar entre el linfoma primario y la afectación colorrectal secundaria en el linfoma sistémico es de elevada importancia terapéutica y pronóstica. El diagnóstico ha de ser s [...] iempre histológico. Se han descrito diferentes formas de presentación, pero todas ellas inespecíficas. No existe un total acuerdo sobre cuál es el mejor tratamiento del linfoma colorrectal. La resección quirúrgica suele ser el procedimiento de elección, sin haberse definido el papel de la quimioterapia. Presentamos un caso de linfoma primario localizado en el ciego, cuyas manifestaciones clínicas fueron meteorismo y saciedad precoz, siendo diagnosticado mediante colonoscopia y biopsia. La resección asistida por laparoscopia fue el tratamiento de elección. La no afectación ganglionar, tamaño tumoral, resección completa con márgenes libres, así como los factores de riesgo cardiopulmonares del paciente, llevaron a desestimar la quimioterapia adyuvante. Tras un año de seguimiento el paciente se encuentra libre de enfermedad. Abstract in english Primary colorectal lymphoma is an infrequent disease of unknown origin and with a growing incidence. Differentiation be-tween primary lymphoma and secondary colorectal involvement is of great therapeutic and prognostic importance. The diagnosis must always be based on histological findings. Differen [...] t forms of presentation have been described, though all are nonspecific. While full agreement on the best management approach for colorectal lymphoma is lacking, surgical resection is usually the treatment of choice. The role of chemotherapy has not been defined. This study reports on a case of primary lymphoma in the cecum, with clinical manifestations in the form of meteorism and early satiety. The diagnosis was established by colonoscopy and biopsy. The absence of lymph-node involvement, tumor size, existing cardiopulmonary risk factors, and the fact that a full resection of the malignancy proved possible, with tumor-free resection margins, led us to exclude adjuvant chemotherapy. After one year of follow-up the patient remains disease-free.

D., Martínez-Ramos; J., Gibert-Gerez; J. M., Miralles-Tena; M., Martínez-Banaclocha; J., Escrig-Sos; J. L., Salvador-Sanchís.

151

Linfoma conjuntival tipo MALT bilateral en adolescente / Bilateral Conjunctival MALT Lymphoma in an Adolescent  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Los linfomas tipo MALT primarios de conjuntiva son infrecuentes y es mucho menor la afectación conjuntival exclusiva, su bilateralidad es poco común, representan el 5% del total de los linfomas no Hodgkin extranodales; son linfomas B de bajo grado derivados de linfocitos de la zona marginal con alte [...] raciones moleculares que han bloqueado su apoptosis. Se presentó un caso de linfoma tipo MALT primario de la conjuntiva tarsal inferior de ambos ojos, en un niño de 12 años de edad, que acudió por enrojecimiento y molestias en ambos ojos de un año de evolución. Al realizar el examen físico presentó discreta ptosis del ojo izquierdo de un milímetro, masa de color anaranjada-salmón en fondo saco conjuntival inferior en ambos ojos, no adherida a planos profundos. El rayo x de órbita y la tomografía axial de cráneo no arrojó alteraciones. Se realizó hematología completa, pruebas de coagulación, bioquímica elemental y toda la analítica fue normal. El estudio anatomopatológico reportó: infiltrado linfoide denso y extenso constituido por linfocitos pequeños, algunos de aspecto plasmocitoide, sin nucléolo y sin indentación, dichos datos sugieren proliferacion linfoide maligna. Se confirmó el diagnóstico de linfoma B de bajo grado de tipo MALT. Abstract in english The primary MALT lymphomas of the conjunctiva are uncommon, the conjunctival affection is less frequent, and its bilaterality is uncommon, representing 5% of all extranodal non- Hodgkin lymphomas. Low-grade B lymphomas derived from marginal zone lymphocytes with molecular alterations are those that [...] have blocked its apoptosis. A 12 -year- old patient with primary MALT type lymphoma of the lower tarsal conjunctiva of both eyes was presented in this paper. The patient was healthy and presented redness and discomfort in both eyes in a year of evolution. The physical examination showed discrete ptosis of the left eye of a millimeter. Mass of orange - salmon color in lower conjunctival sac of both eyes, not adhered to deep planes was observed. Orbital X-ray and cranial CT were unaltered. Complete hematology, coagulation tests, and all elemental analytical biochemistry were performed, the results were normal. The pathological study reported: dense and extensive infiltrate lymphoid, composed of small lymphocytes, some without nucleolus plasmacytoid appearance without indentation, these data suggested a malignant lymphoid proliferation. The diagnosis of low-grade B-cell lymphoma of MALT type was confirmed.

Hiram Luis, Mena Estévez; Mabel Marilín, Calderín López; Deysi Mayle, Oquendo Calderín; Hiram Alejandro, Mena Calderín; Diagnis, Rodriguez Verdecia.

152

Hepatitis C: crioglobulinemia y linfoma no-Hodgkin / Hepatitis C: cryoglobulinemia and non-Hodgkin lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La infección por el virus de la hepatitis C juega un papel principal en la patogénesis de la crioglobulinemia mixta, promoviendo la activación y expansión de las células B. Estos reajustes moleculares inducen la síntesis de crioglobulinas y la aparición de la vasculitis crioglobulinémica. El aclaram [...] iento del virus provoca la resolución de las manifestaciones clínicas y de las alteraciones inmunológicas observados en la crioglobulinemia mixta en un alto porcentaje de los pacientes, pero no en todos. En algunos casos, la crioglobulinemia puede aparecer tras la respuesta virológica sostenida. Muchos mecanismos de la patogénesis de la crioglobulinemia mixta están fuertemente relacionados con la infección por VHC y, cuando el virus es eliminado, hay una mejoría en el curso de la enfermedad. Aun así, los pasos independientes relacionados con otros factores no mejoran tras la erradicación del virus. En algunos tipos de linfomas no-Hodgkin de bajo grado (linfoma linfoplasmocítico y linfoma de la zona marginal) la respuesta sostenida tras el aclaramiento viral induce una remisión de la neoplasia. El VHC tiene un papel secundario en los linfomas agresivos y el aclaramiento del virus puede no inducir la remisión, pero puede disminuir la hepatotoxicidad asociada a la quimioterapia. Por tanto, en la hepatitis C crónica, la combinación de interferón pegilado y ribavirina es altamente recomendable en el tratamiento de la crioglobulinemia mixta sintomática y los linfomas no-Hodgkin asociados al VHC. Abstract in english Hepatitis C virus infection plays a major role in the pathogenesis of mixed cryoglobulinemia, promoting activation and expansion of B cells. These molecular rearrangements induce synthesis of cryoglobulins and the appearance of cryoglobulinemic vasculitis. Clearance of the virus promotes resolution [...] of the clinical manifestations and immunological disorders seen in mixed cryoglobulinemia in a large percentage of patients, but not in all. In some cases, cryoglobulinemia could appear after sustained response. Several steps in the pathogenesis of mixed cryoglobulinemia are strongly related to HCV infection and when the virus is eliminated, the disease course improves. However, independent steps related to other factors do not improve following viral clearance. In some types of low-grade non-Hodgkin lymphoma (lymphomoplasmocytic lymphoma, marginal zone lymphoma) sustained response following antiviral treatment induces remission of the neoplasm. HCV has a minor role in aggressive lymphomas and clearance of the virus may not induce remission, but could decrease the hepatotoxicity associated with the chemotherapy. Therefore, in chronic hepatitis C, the combination of peginterferon + ribavirin is strongly recommended in treating symptomatic mixed cryoglobulinemia and HCV-related non-Hodgkin lymphomas.

M., Romero-Gómez; D., García-Romero.

153

Hepatitis C: crioglobulinemia y linfoma no-Hodgkin Hepatitis C: cryoglobulinemia and non-Hodgkin lymphoma  

Directory of Open Access Journals (Sweden)

Full Text Available La infección por el virus de la hepatitis C juega un papel principal en la patogénesis de la crioglobulinemia mixta, promoviendo la activación y expansión de las células B. Estos reajustes moleculares inducen la síntesis de crioglobulinas y la aparición de la vasculitis crioglobulinémica. El aclaramiento del virus provoca la resolución de las manifestaciones clínicas y de las alteraciones inmunológicas observados en la crioglobulinemia mixta en un alto porcentaje de los pacientes, pero no en todos. En algunos casos, la crioglobulinemia puede aparecer tras la respuesta virológica sostenida. Muchos mecanismos de la patogénesis de la crioglobulinemia mixta están fuertemente relacionados con la infección por VHC y, cuando el virus es eliminado, hay una mejoría en el curso de la enfermedad. Aun así, los pasos independientes relacionados con otros factores no mejoran tras la erradicación del virus. En algunos tipos de linfomas no-Hodgkin de bajo grado (linfoma linfoplasmocítico y linfoma de la zona marginal la respuesta sostenida tras el aclaramiento viral induce una remisión de la neoplasia. El VHC tiene un papel secundario en los linfomas agresivos y el aclaramiento del virus puede no inducir la remisión, pero puede disminuir la hepatotoxicidad asociada a la quimioterapia. Por tanto, en la hepatitis C crónica, la combinación de interferón pegilado y ribavirina es altamente recomendable en el tratamiento de la crioglobulinemia mixta sintomática y los linfomas no-Hodgkin asociados al VHC.Hepatitis C virus infection plays a major role in the pathogenesis of mixed cryoglobulinemia, promoting activation and expansion of B cells. These molecular rearrangements induce synthesis of cryoglobulins and the appearance of cryoglobulinemic vasculitis. Clearance of the virus promotes resolution of the clinical manifestations and immunological disorders seen in mixed cryoglobulinemia in a large percentage of patients, but not in all. In some cases, cryoglobulinemia could appear after sustained response. Several steps in the pathogenesis of mixed cryoglobulinemia are strongly related to HCV infection and when the virus is eliminated, the disease course improves. However, independent steps related to other factors do not improve following viral clearance. In some types of low-grade non-Hodgkin lymphoma (lymphomoplasmocytic lymphoma, marginal zone lymphoma sustained response following antiviral treatment induces remission of the neoplasm. HCV has a minor role in aggressive lymphomas and clearance of the virus may not induce remission, but could decrease the hepatotoxicity associated with the chemotherapy. Therefore, in chronic hepatitis C, the combination of peginterferon + ribavirin is strongly recommended in treating symptomatic mixed cryoglobulinemia and HCV-related non-Hodgkin lymphomas.

M. Romero-Gómez

2008-03-01

154

Linfoma não Hodgkin primário da coluna vertebral Primary non-Hodgkin's lymphoma of the vertebral column  

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Full Text Available O linfoma primário do osso (LPO é uma condição extremamente rara, habitualmente confundida com outras lesões ósseas primárias. É responsável por cerca de 3%-5% de todos os tumores malignos no osso e 4%-7% de todos os linfomas nãoHodgkin extranodais. Caracteriza-se pelo envolvimento de um ou vários locais ósseos, com ou sem comprometimento de linfonodos regionais e vísceras. Histopatologicamente, o linfoma non Hodgkin de grandes células B representa a maioria dos casos de LPO. Ossos longos são mais frequentemente comprometidos, e o fêmur é o sítio mais acometido. Osso ilíaco e da coluna vertebral também podem ser atingidos. Relatamos um caso raro de linfoma não Hodgkin da vértebra em mulher de 41 anos. A imuno-histoquímica revelou CD20 e CD45 positivos. Ela foi diagnosticada com linfoma primário difuso de grandes células B da coluna vertebral. O estudo histopatológico da medula óssea não detectou infiltração por hemopatia linfoide. A paciente foi tratada com quimioterapia CHOP juntamente com etoposide, seguida de radioterapia (dose total = 3600cGy na região tóraco-lombar. Não houve evidência de recidiva em um período de vinte meses de acompanhamento.Primary bone lymphoma (PBL is an extremely rare condition, commonly confused with other primary bone injuries. It accounts for approximately 3-5% of all malignant bone tumors and 4-7% of all extranodal non-Hodgkin's lymphomas. It is characterized by the involvement of one or multiple bone locations, with or without the involvement of regional lymph nodes and viscera. Histopathologically, diffuse large-B-cell lymphomas account for the majority of cases of PBL. Long bones are usually involved, with the femur being the most commonly affected site. Pelvic bones and the vertebral column can also be involved. We report on a rare case of PLB of the vertebra in a 41-year-old woman. Immunohistochemistry examinations revealed CD20 and CD45 positive cells. She was diagnosed with primary diffuse large B-cell lymphoma presenting as a vertebral column tumor. The histopathologic analysis of the bone marrow did not show lymphoproliferative disorders. The patient was treated with a CHOP plus etoposide regimen. Systemic chemotherapy was followed by radiotherapy (total dose = 3600 cGy in the thoracolumbar region. There was no evidence of recurrence in the 20-month follow up.

Ronald F. Pinheiro

2009-01-01

155

78 FR 53773 - Select Updates for Non-Clinical Engineering Tests and Recommended Labeling for Intravascular...  

Science.gov (United States)

...Select Updates for Non-Clinical Engineering Tests and Recommended Labeling for Intravascular...Select Updates for Non- Clinical Engineering Tests and Recommended Labeling for Intravascular...substantial updates to the ``Non-Clinical Engineering Tests and Recommended Labeling for...

2013-08-30

156

Intravascular brachytherapy for peripheral vascular disease  

Directory of Open Access Journals (Sweden)

Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy vs. no brachytherapy after stenting did not show significant results for the rate of restenosis at six months. Both, early and late thrombotic occlusions appeared more frequently in the brachytherapy group. Health economic evaluation: Additional costs of brachytherapy were estimated to be 1,655 or 1,767 Euro according to the used G-DRG. The incremental cost-effectiveness ratio per avoided restenosis was calculated to be 8,484 Euro or 9,058 Euro for brachytherapy use after successful balloon dilatation, 19,027 Euro or 20,314 Euro for brachytherapy after PTA with optional stenting and -39,646 Euro or -48,330 Euro for brachytherapy after stenting. Discussion: Partially poor performing and reporting quality of the RCT exacerbate the interpretation and the transferability of the study results. The used methodical approach enables the highest evidence level for the determined results and presents a good approximation of the current brachytherapy related costs for the German health care system. Conclusions: Brachytherapy after successful balloon dilatation in PAOD can be recommended from a medical point of view for the reduction of the rate of restenosis at one year. However from a health economic view the answer is not yet clear. Based on the current data the use of brachytherapy after stenting in PAOD cannot be recommended neither from a medical nor from a health economic point of view. The informed consent of the patients is an important ethical aspect in the use of brachytherapy.

Hagen, Anja

2008-09-01

157

Spectroscopic intravascular photoacoustic imaging to differentiate atherosclerotic plaques.  

Science.gov (United States)

The potential of intravascular photoacoustic (IVPA) imaging to detect atherosclerosis was previously demonstrated using a 532 nm nanosecond pulsed laser and an intravascular ultrasound (IVUS) imaging catheter. However, to differentiate vulnerable plaques, the composition of plaques needs to be imaged. Therefore, we introduce a multi-wavelength photoacoustic imaging method to distinguish various types of plaques. Multi-spectral IVPA imaging of ex vivo samples of normal and atherosclerotic rabbit aorta was performed at several wavelengths within 680-900 nm range. The spectral variation of photoacoustic response was extracted and a spectroscopic analysis was performed. The results of our preliminary study suggest that the spectroscopic intravascular photoacoustic imaging technique can be used to differentiate fibrous and lipid components of the atherosclerotic plaques. PMID:18542427

Sethuraman, Shriram; Amirian, James H; Litovsky, Silvio H; Smalling, Richard W; Emelianov, Stanislav Y

2008-03-01

158

Intravascular staining for discrimination of vascular and tissue leukocytes.  

Science.gov (United States)

Characterization of the cellular participants in tissue immune responses is crucial to understanding infection, cancer, autoimmunity, allergy, graft rejection and other immunological processes. Previous reports indicate that leukocytes in lung vasculature fail to be completely removed by perfusion. Several studies suggest that intravascular staining may discriminate between tissue-localized and blood-borne cells in the mouse lung. Here we outline a protocol for the validation and use of intravascular staining to define innate and adaptive immune cells in mice. We demonstrate application of this protocol to leukocyte analyses in many tissues and we describe its use in the contexts of lymphocytic choriomeningitis virus and Mycobacterium tuberculosis infections or solid tumors. Intravascular staining and organ isolation usually takes 5-30 min per mouse, with additional time required for any subsequent leukocyte isolation, staining and analysis. In summary, this simple protocol should help enable interpretable analyses of tissue immune responses. PMID:24385150

Anderson, Kristin G; Mayer-Barber, Katrin; Sung, Heungsup; Beura, Lalit; James, Britnie R; Taylor, Justin J; Qunaj, Lindor; Griffith, Thomas S; Vezys, Vaiva; Barber, Daniel L; Masopust, David

2014-01-01

159

Acute renal failure induced by disseminated intravascular coagulopathy in a patient with adenomyosis.  

Science.gov (United States)

Disseminated intravascular coagulation is most frequently associated with obstetric catastrophes, metastatic malignancy, massive trauma and bacterial sepsis, but relatively rarely related to benign tumors. We report on disseminated intravascular coagulopathy in a patient with significant adenomyosis and menometrorrhagia. An extremely rare case, disseminated intravascular coagulopathy developed in this benign case and was successfully treated with a hysterectomy and blood product transfusions. PMID:22381112

Yoo, Heon Jong; Chang, Dong Suk; Lee, Ki Hwan

2012-03-01

160

A study of intravascular brachytherapy treatment planning in peripheral arteries.  

Science.gov (United States)

A two-step method to determine the seed parameters for the planning of peripheral intravascular brachytherapy, which took the actual vessel geometry into consideration, was developed. Firstly, the characteristics of the vessel geometry was obtained by using active navigation; Then a method combined genetic algorithm with BFGS algorithm was applied to optimize the number of seeds, and the parameters associated with each seed such as the position, and the dwell time. Application of the method to a phantom model and three animal models of stenosis shows that promising result could be obtained, and the planning of peripheral intravascular brachytherapy should take actual vessel geometry into consideration. PMID:17282698

Zhou, Zhengdong; Haigron, Pascal; Acosta, Oscar; Shu, Huazhong; Yu, Wenxue; Luo, Liming; Manens, Jean-Pierre; Lucas, Antoine

2005-01-01

 
 
 
 
161

Hiperplasia endotelial papilar intravascular oral: uma entidade rara Intravascular papillary endothelial hyperplasia: a rare entity  

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Full Text Available A hiperplasia endotelial papilar intravascular (HEPI é uma lesão vascular reativa caracterizada pela proliferação endotelial excessiva localizada no interior de vasos sangüíneos comumente dilatados, associada a trombos em organização, ou secundária a outras lesões vasculares, como hemangiomas e granulomas piogênicos. A HEPI é um achado incomum na cavidade oral, onde os lábios são o principal sítio de acometimento, e surge clinicamente sob a forma de nódulos azulados de aspecto clínico semelhante ao de lesões como hemangioma, mucocele e varicosidades. Sob o aspecto histopatológico, observam-se projeções papilares de tecido conjuntivo fibroso revestidas por uma ou duas camadas de células endoteliais no interior de um lúmen vascular. A principal peculiaridade da HEPI reside em sua semelhança histológica com o angiossarcoma e na possível interpretação errônea como neoplasia maligna. Neste artigo, os autores descrevem um caso de HEPI oral e realizam uma breve revisão da literatura, enfatizando suas características histopatológicas e o diagnóstico diferencial.Intravascular papillary endothelial hyperplasia (IPEH is a reactive vascular lesion characterized by excessive endothelial proliferation within a vascular lumen of commonly dilated vessels, associated to organizing thrombi or even secondary to other vascular lesions, such as hemagiomas and pyogenic granulomas. Oral lesions of IPEH are uncommon, being lips the most frequent site, followed by, in decreasing frequency, tongue and buccal mucosa. Clinically, IPEH appears as bluish nodules that resembles clinical features of lesions as hemangioma, mucocele and varice. On histopathological examination, IPEH presents as papillary projections composed by a fibrous core lined by one or two layers of plump endothelial cells, without evidence of celullar pleomorphism, mitotic activity or necrosis. The mean peculiarity of IPEH is its histologic similarity to angiosarcoma and possible misinterpretation with malignant neoplasm. In this article, the author describe a rare case of oral IPEH and review of literature, emphasizing its histopathologic features and diferencial diagnosis.

João Augusto Vianna Goulart Filho

2006-02-01

162

Hiperplasia endotelial papilar intravascular oral: uma entidade rara / Intravascular papillary endothelial hyperplasia: a rare entity  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A hiperplasia endotelial papilar intravascular (HEPI) é uma lesão vascular reativa caracterizada pela proliferação endotelial excessiva localizada no interior de vasos sangüíneos comumente dilatados, associada a trombos em organização, ou secundária a outras lesões vasculares, como hemangiomas e gra [...] nulomas piogênicos. A HEPI é um achado incomum na cavidade oral, onde os lábios são o principal sítio de acometimento, e surge clinicamente sob a forma de nódulos azulados de aspecto clínico semelhante ao de lesões como hemangioma, mucocele e varicosidades. Sob o aspecto histopatológico, observam-se projeções papilares de tecido conjuntivo fibroso revestidas por uma ou duas camadas de células endoteliais no interior de um lúmen vascular. A principal peculiaridade da HEPI reside em sua semelhança histológica com o angiossarcoma e na possível interpretação errônea como neoplasia maligna. Neste artigo, os autores descrevem um caso de HEPI oral e realizam uma breve revisão da literatura, enfatizando suas características histopatológicas e o diagnóstico diferencial. Abstract in english Intravascular papillary endothelial hyperplasia (IPEH) is a reactive vascular lesion characterized by excessive endothelial proliferation within a vascular lumen of commonly dilated vessels, associated to organizing thrombi or even secondary to other vascular lesions, such as hemagiomas and pyogenic [...] granulomas. Oral lesions of IPEH are uncommon, being lips the most frequent site, followed by, in decreasing frequency, tongue and buccal mucosa. Clinically, IPEH appears as bluish nodules that resembles clinical features of lesions as hemangioma, mucocele and varice. On histopathological examination, IPEH presents as papillary projections composed by a fibrous core lined by one or two layers of plump endothelial cells, without evidence of celullar pleomorphism, mitotic activity or necrosis. The mean peculiarity of IPEH is its histologic similarity to angiosarcoma and possible misinterpretation with malignant neoplasm. In this article, the author describe a rare case of oral IPEH and review of literature, emphasizing its histopathologic features and diferencial diagnosis.

João Augusto Vianna, Goulart Filho; Karuza Maria Alves, Pereira; Hébel Cavalcanti, Galvão.

163

Recurrence of peripheral T-cell lymphoma as granulomas in the lower limbs Granulomas epitelióides cutâneos, como manifestação de recidiva de linfoma de células T periférico  

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Full Text Available The presence of granulomas in the skin of T-cell lymphoma patients is a rare but well-known phenomenon. The authors present the case of a 44-year-old Caucasian male, with a previously treated peripheral T-cell lymphoma, with cutaneous infiltration and extensive dyschromia on his lower limbs. Skin biopsies revealed the presence of sarcoid granulomas associated with the recurrence of the lymphoma, confirmed by immunostaining and molecular analysis. Although a new scheme of chemotherapy was started, he died 18 months later. There are two different patterns of skin granulomas associated with lymphoma: granulomatous infiltrates admixed with neoplastic cells and cutaneous granulomas constituting a nonspecific manifestation of the underlying lymphoma, but presently there is no evidence supporting their relationship with lymphoma prognosis.A presença de granulomas cutâneos associados a linfomas é um fenômeno raro, mas bem conhecido. Um homem, 44 anos de idade, com diagnóstico prévio de linfoma de células T periférico, foi enviado à nossa consulta por infiltração cutânea e extensa discromia nos membros inferiores. A biopsia cutânea revelou a presença de granulomas epitelioides associados à recidiva do linfoma, confirmada pela marcação imuno-histoquímica e estudo molecular. Apesar de iniciado novo esquema de quimioterapia, o doente faleceu 18 meses depois. Na literatura são descritos dois tipos de granulomas cutâneos na presença de linfomas: associados à infiltração cutânea pelo linfoma ou como uma manifestação não específica do linfoma. Contudo, atualmente não há evidência que suporte a sua relação com o prognóstico dos linfomas.

Ana Rita Travassos

2012-10-01

164

LINFOMA CUTÁNEO DE CÉLULAS B TIPO CENTRO FOLICULAR CON INFILTRACIÓN A MÉDULA ÓSEA: REPORTE DE UN CASO LINFOMA CUTÂNEO DE CÉLULAS B TIPO CENTRO FOLICULAR COM INFILTRAÇÃO NA MEDULA ÓSSEA PRIMARY CUTANEOUS FOLLICLE CENTER LYMPHOMA WITH BONE MARROW INFILTRATION: RELATÓRIO DE UM CASO  

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Full Text Available Los linfomas cutáneos primarios de células B constituyen cerca del 2025% de todos los linfomas. El linfoma cutáneo primario de células B tipo centro folicular es el subtipo más frecuente y se manifiesta principalmente en pacientes adultos con una edad media de 58 años (1, la diseminación extracutánea es muy rara y se presenta con nódulos, tumores o placas solitarios o en grupo usualmente localizados en cabeza o tronco. Presentamos el caso de una paciente con un linfoma primario cutáneo tipo centro folicular con infiltración a médula ósea.Os linfomas cutâneos primários de células B constituem cerca de 20 a 25% de todos os linfomas. O linfoma cutâneo primário de células B tipo centro folicular é o subtipo mais frequente e manifestase principalmente em pacientes adultos com uma idade média de 58 anos (1, a disseminação extracutânea é muito rara e apresentase com nódulos, tumores ou placas solitárias no grupo usualmente localizados na cabeça ou tronco. Apresentamos o caso de uma paciente com um linfoma primário cutâneo tipo centro folicular com infiltração na medula óssea.Primary B cell cutaneous lymphomas represent approximately 2025% of all lymphomas. Primary cutaneous follicle center lymphoma is the most common subtype occurring in adults with a mean age of 58 years. The disease typically presents with solitary plaques or nodules and is usually located in the head or trunk. Extra cutaneous dissemination is extremely rare. We present a case of a patient with primary cutaneous follicle center lymphoma with bone marrow infiltration.

CLAUDIA MARCELA ARENAS SOTO

2012-06-01

165

Linfoma difuso primario de hígado: Presentación de un caso / Diffuse primary hepatic lymphoma: Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish El linfoma primario de hígado (LPH) es un tumor raro y representa menos del 1% de los linfomas no Hodgkin extranodales de células B. Se reporta un caso de LPH en un paciente de sexo masculino de 32 años de edad, sin enfermedad hepática crónica, que ingresa a nuestra institución por sospecha de síndr [...] ome mononucleósico. La serología para Virus Epstein Barr fue positiva. Se observó mediante ecografía hepatoesplenomegalia con parénquima hepático heterogéneo en forma difusa. La RM demostró hepatoesplenomegalia y alteraciones en lóbulo derecho hepático, compatibles con infiltración linfoproliferativa. Se realizó biopsia hepática con guía ecográfica y el estudio histopatológico reveló un linfoma no Hodgkin difuso de células grandes con inmunofenotipo B. Se presentan las características clínicas y patológicas del caso, así como una revisión de los aspectos clínicos, hallazgos patológicos y radiológicos. Abstract in english Primary hepatic lymphoma (PHL) is a rare tumor that represents less than 1% of extranodal non-Hodgkin B-cell lymphoma. We report a case of PHL in a 32 year-old male patient without chronic liver disease, who was admitted into our institution for suspected mononucleosis syndrome. Serology for Epstein [...] -Barr virus was positive. Ultrasound revealed hepatosplenomegaly with diffuse heterogeneous liver parenchyma. The MRI showed hepatosplenomegaly and alterations in the right lobe of the liver compatible with lymphoproliferative infiltration. Liver biopsy was performed under ultrasound guidance, and histopathologic examination revealed a diffuse non-Hodgkin lymphoma of large cells with immunophenotype B. A clinical and a pathological case as well as a review of the clinical, pathological and radiological findings of this disease are presented.

Romero Vidomlansky, Silvana I.; Nielsen, Ana Julia; Gallo, Juan Cruz; Kozima, Shigeru.

166

Linfoma leptomeníngeo en un niño con infección por el virus de la inmunodeficiencia humana  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish El linfoma primario del sistema nervioso central en pacientes pediátricos VIH positivos es poco frecuente. Se presenta un paciente, de siete años de edad, de sexo masculino, con síndrome de inmunodeficiencia adquirida, que desarrolló un linfoma de células B con localización leptomeníngea. El niño in [...] ició el cuadro con síntomas de alteración del sensorio, hipertensión endocraneana y amaurosis bilateral. El diagnóstico se efectuó por biopsia cerebral, inmunofenotipo de las células B del líquido cefalorraquídeo, además de PCR positiva para virus de Epstein Barr en el líquido. Realizó tratamiento con quimioterapia intratecal y sistémica. Mejoraron los síntomas durante quince meses y luego recidivó en la región talámica. Cumplió radioterapia craneoespinal y falleció cuatro meses después de la recidiva. En este artículo se realiza una revisión de la bibliografía sobre esta enfermedad, señalando el carácter excepcional de este paciente por tratarse de un linfoma localizado en forma exclusiva en el sistema nervioso central y, más precisamente, en la leptomeninges. Abstract in english Primary non-Hodgkin lymphoma in the central nervous system is rare in children and in AIDS pediatric patients. We report a seven years old boy, HIV-positive, C3 stage, who developed a non- Hodgkin lymphoma in the central nervous system, with leptomeningeal location. The patient started with signs an [...] d symptoms related to increased intracranial pressure, his conscience worsened and he became blind. The diagnosis was made through brain biopsy, immunophenotype of B cells in cerebrospinal fluid, and PCR for Epstein Barr virus in the fluid. The boy was treated with intrathecal and systemic chemotherapy. His condition improved during fifteen months, and then he presented a talamic relapse. He was treated with radiotherapy and finally died four months later. In this article we review the literature about this disease, pointing to the exceptional nature of this patient because of his lymphoma exclusively located in the central nervous system, specifically leptomeningeal.

Adriana, Scrigni; Mariana, Nastri; Susana, Rodríguez de Schiavi; Liliana, Czornyj; María, Felice; Beatriz, Mantese.

167

Linfoma cerebral en paciente postrasplante renal Primary brain lymphoma in a patient after renal transplantation  

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Full Text Available El linfoma primario del sistema nervioso central (LPSNC ha tenido un aumento en la incidencia en los últimos 40 años asociado con estados de inmunosupresión, principalmente en pacientes infectados con el virus de inmunodeficiencia humana (VIH y con trasplante de órganos. La tumorogénesis se relaciona con el virus de Epstein Barr (VEB. El inmunofenotipo más frecuente es el linfoma de células B. Las manifestaciones clínicas son dependientes de la localización de la masa tumoral, principalmente trastornos del comportamiento y síndrome de hipertensión endocraneana. El diagnóstico diferencial etiológico se hace con procesos infecciosos, enfermedad cerebrovascular (ECV, tumores primarios gliales del sistema nervioso central y metástasis cerebrales. Al diagnóstico se llega a través de imágenes diagnósticas principalmente resonancia magnética (RM cerebral y con estudio histopatológico. Es importante descartar infección por VIH al hacerse diagnóstico de LPSNC. En esta revisión reportamos un linfoma primario del SNC en una paciente con antecedente de trasplante renal por enfermedad poliquística ocho años antes.The incidence of primary central nervous system lymphoma (PCNSL has increased during the past 40 years. This has been associated with immunodeficiency, mainly in patients infected with the human immunodeficiency virus (HIV and in transplant patients. Tumor genesis is related with the Epstein-Barr virus (EBV. The most frequent PCNSL immunophenotype is B-cell lymphoma. Clinical manifestations depend on tumor localization, and are usually behavior dysfunctions and intracranial hypertension syndrome. Differential diagnosis must take into consideration infectious processes, stroke, primary brain tumors, and metastases. The diagnosis of PCNSL requires brain MRI and brain biopsy. It is important to assess HIV infection when diagnosing PCNSL. This review reports a case of primary brain lymphoma in a patient who underwent renal transplantation due to polycystic kidney disease 8 years before.

Carlos Arteaga

2009-03-01

168

Search of intravascular hemolysis in patients with the cutaneous form of loxoscelism Pesquisa de hemólise intravascular na forma cutânea de loxoscelismo  

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Haptoglobin assay, a highly sensitive method to detect intravascular hemolysis was carried out in the sera of 19 patients referred to Hospital Vital Brazil with the cutaneous form of loxoscelism in order to investigate the occurrence of mild intravascular hemolysis. Data from this series did not show decreased levels haptoglobin, ruling out intravascular hemolysis in these patients with cutaneous form of loxoscelism.Dezenove pacientes que apresentaram a forma clínica cutânea do loxoscel...

1994-01-01

169

Linfoma não Hodgkin simulando hanseníase virchowiana Non-Hodgkin's Lymphoma simulating Lepromatous Leprosy  

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Full Text Available Os autores relatam caso de linfoma não Hodgkin em paciente do sexo feminino, de 28 anos, ressaltando o diagnóstico diferencial com formas multibacilares de hanseníase. Além de achados clínicos passíveis de confusão, a histologia mostrava, de modo não usual, infiltrado inflamatório mononuclear perineural e perianexial.The authors report a case of a 28-year-old woman with non-Hodgkin's lymphoma, first diagnosed as multibacillary leprosy. The differential diagnosis is discussed, with emphasis on leprosy, since there were similarities in the clinical aspects. Furthermore the histopathological findings were unusual, displaying perineural and periannexal inflammatory infiltrate composed of mononuclear cells.

Vanessa Barreto Rocha

2003-06-01

170

Psoriasis, lymphoma and etanercept: is there a correlation? Psoríase, linfoma e etanercepte: existe correlação?  

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Full Text Available Psoriasis is a chronic inflammatory disease that can affect skin and joints. Their treatment varies depending on the severity and includes topical and systemic. Among the latter are the immunobiological that target the T cell We report a case that demonstrates the close relationship between psoriasis, lymphoma and biologic therapies.A psoríase é uma doença inflamatória crônica que pode afetar a pele e as articulações. Seu tratamento varia conforme a gravidade e inclui medicamentos tópicos e sistêmicos. Dentre os últimos estão os imunobiológicos, que têm como alvo a célula T. Relatamos um caso que demonstra a estreita relação entre a psoríase, o linfoma e os imunobiológicos.

Ludmilla Queirós Miranda

2012-02-01

171

Primary MALT lymphomas of the stomach: A pathological study of 18 cases Linfomas gástricos primarios tipo MALT: un estudio patológico de 18 casos  

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Full Text Available Aim: it is doubtful that whoever is suffering from gastric malt lymphoma will escape from the disease, if treated with medication against helicobacter pylori. Material and methods: a cohort of 18 patients was analysed. Ten hosts had primary gastric malt lymphoma and were treated with gastric resection as the initial therapy. Eight hosts received antibiotics against Helicobacter pylori as the initial treatment. In all 18 patients Helicobacter pylori status, endoscopic findings and pathology features were evaluated. Immunohistochemistry was performed to assess the bcl-2 and p53 status. Results: patients with low grade malt lymphoma: a were Helicobacter pylori positive (5 of 5; b had a superficial lesion (5 of 5; c had no lymph node involvement (5 of 5; and d were downstaged by comparison to patients with high grade tumor. Bcl-2 was positive in 4 of 5 low grade tumors, and p53 was positive in 12 of 13 high grade ones. Investigation of patients with 5-year follow up (n = 18 revealed that all but one low-grade tumors remained superficial with no progression. These tumors were bcl-2+/p53-, and the one with a bcl-2+/p53+ immunophenotype progressed to an ulcerated low-grade tumor after disappearance of Helicobacter pylori. Complete regression was found in 6 of 8 patients from the non surgically treated group (n = 8 after Helicobacter pylori eradication. These tumors were superficial/low grade/node negative/bcl-2+/p53 inconclusive (n = 2, superficial/low grade/node negative/bcl-2+/p53- (n = 2, and ulcerative/high grade/node negative/bcl-2+/p53- (n = 2. The two persistent tumors were ulcerative/high grade/node negative/bcl-2+/p53+. Conclusion: gastric malt lymphoma Helicobacter pylori+/superficial/low grade/bcl-2+/p53- will disappear after Helicobacter pylori eradication.Objetivo: es difícil que alguien que padezca un linfoma gástrico de tipo MALT pueda librarse de la enfermedad,... a menos que se le trate con medicación para Helicobacter pylori. Material y métodos: se analizó una cohorte de 18 pacientes. Diez huéspedes tenían linfoma gástrico de tipo MALT y se trataron con resección gástrica como tratamiento inicial. Ocho recibieron antibióticos frente a Helicobacter pylori como tratamiento inicial. En los 18 pacientes se evaluaron la presencia de Helicobacter pylori, los hallazgos endoscópicos y los rasgos patológicos. Se realizó una inmunohistoquímica para valorar el bcl-2 y el p53. Resultados: los pacientes con linfoma MALT de grado bajo: a dieron positivo a Helicobacter pylori (5 de 5; b tenían una lesión superficial (5 de 5; c no tenían afectados los ganglios linfáticos (5 de 5; y d se estadificaron a la baja por comparación con los pacientes con tumores de grado alto. El bcl-2 fue positivo en 4 de los 5 tumores de grado bajo y el p53 fue positivo en 12 de 13 de los de grado alto. El estudio de los pacientes durante un seguimiento de 5 años (n = 18 reveló que todos los tumores menos uno de grado bajo siguieron siendo superficiales sin progresión. Estos tumores eran bcl-2+/p53-, mientras que el único con inmunofenotipo bcl-2+/p53+ progresó hasta convertirse en un tumor de bajo grado ulcerado tras la desaparición de Helicobacter pylori. Se observó una regresión completa en 6 de los 8 pacientes del grupo no tratado con cirugía (n = 8 tras la erradicación de Helicobacter pylori. Estos tumores eran superficiales, de bajo grado, con ganglios negativos y bcl-2+/p53 no concluyente (n = 2; superficiales, de bajo grado, con ganglios negativos y bcl-2+/p53- (n = 2, y ulcerativos, de grado alto, con ganglios negativos y bcl-2+/p53- (n = 2. Los dos tumores persistentes eran ulcerativos, de grado alto con ganglios negativos y bcl-2+/p53+. Conclusión: el linfoma gástrico de tipo MALT, Helicobacter pylori-positivo, superficial, de grado bajo y bcl-2+/p53- desaparece tras la erradicación de Helicobacter pylori.

I. Venizelos

2007-05-01

172

Burkitt's lymphoma of the duodenum in a patient with AIDS / Linfoma de Burkitt do duodeno em um paciente com AIDS  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O linfoma não-Hodgkin de células B é a segunda neoplasia mais comum em pacientes com infecção pelo vírus da imunodeficiência humana depois do sarcoma de Kaposi. A maioria dos casos de linfoma não-Hodgkin associados com a síndrome da imunodeficiência adquirida envolve locais extraganglionares, especi [...] almente o trato digestivo e o sistema nervoso central. Nós relatamos um caso de linfoma primário do duodeno em um paciente com AIDS. Uma endoscopia digestiva alta mostrou massas pseudopolipóides encontradas na segunda porção do duodeno. Um estudo diagnóstico completo incluindo exames histológicos, imunohistoquímicos e virológicos mostrou um linfoma de células B tipo Burkitt. Detectou-se genoma do vírus Epstein-Barr em biópsias por hibridização in situ e imuno-histoquímica. Abstract in english Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma, among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome involve extranodal sites, especially the digestiv [...] e tract and the central nervous system. We report a case of primary lymphoma of the duodenum in a patient with AIDS. Upper gastrointestinal endoscopy revealed pseudopolypoid masses found in the second portion of the duodenum. A complete diagnostic study including histological, immunohistochemical and virological analyses showed high-grade B-cell Burkitt's lymphoma. The Epstein-Barr virus genome was detected in biopsies by immunohistochemical and in situ hybridization.

Corti, Marcelo; Villafañe, María Florencia; Souto, Liliana; Schtirbu, Ricardo; Narbaitz, Marina; Soler, Marcela de Dios.

173

Burkitt's lymphoma of the duodenum in a patient with AIDS Linfoma de Burkitt do duodeno em um paciente com AIDS  

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Full Text Available Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma, among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome involve extranodal sites, especially the digestive tract and the central nervous system. We report a case of primary lymphoma of the duodenum in a patient with AIDS. Upper gastrointestinal endoscopy revealed pseudopolypoid masses found in the second portion of the duodenum. A complete diagnostic study including histological, immunohistochemical and virological analyses showed high-grade B-cell Burkitt's lymphoma. The Epstein-Barr virus genome was detected in biopsies by immunohistochemical and in situ hybridization.O linfoma não-Hodgkin de células B é a segunda neoplasia mais comum em pacientes com infecção pelo vírus da imunodeficiência humana depois do sarcoma de Kaposi. A maioria dos casos de linfoma não-Hodgkin associados com a síndrome da imunodeficiência adquirida envolve locais extraganglionares, especialmente o trato digestivo e o sistema nervoso central. Nós relatamos um caso de linfoma primário do duodeno em um paciente com AIDS. Uma endoscopia digestiva alta mostrou massas pseudopolipóides encontradas na segunda porção do duodeno. Um estudo diagnóstico completo incluindo exames histológicos, imunohistoquímicos e virológicos mostrou um linfoma de células B tipo Burkitt. Detectou-se genoma do vírus Epstein-Barr em biópsias por hibridização in situ e imuno-histoquímica.

Marcelo Corti

2007-06-01

174

Linfoma do tecido linfóide associado ao brônquio com evolução fatal Fatal outcome in bronchus-associated lymphoid tissue lymphoma  

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Full Text Available Linfomas primários do pulmão são raros. O tipo histológico mais freqüente é o linfoma do tecido linfóide associado ao brônquio. Este tipo de linfoma tem curso indolente e excelente resposta à terapia. Um terço dos casos é descoberto incidentalmente. Devido à raridade desta doença, no entanto, pouco se conhece sobre sua história natural em termos de disseminação e evolução. Neste relato, descrevemos o caso incomum de um homem de 61 anos que recusou o tratamento após diagnóstico de linfoma do tecido linfóide associado ao brônquio e, 2 anos após o diagnóstico, morreu por infiltração pulmonar maciça sem disseminação para outros órgãos.Primary pulmonary lymphoma is rare. The most common histological type is the bronchus-associated lymphoid tissue lymphoma. This type of lymphoma has an indolent course and excellent response to therapy. One-third of all cases are diagnosed incidentally. However, due to the rarity of this disease, little is known about its natural history in terms of dissemination and evolution. Herein, we report the unusual case of a 61-year-old man who refused treatment after being diagnosed with bronchus-associated lymphoid tissue lymphoma and died 2 years later from massive lung infiltration without dissemination to other organs.

Romulo Loss Mattedi

2007-08-01

175

Do current indications for surgery of primary gastric lymphoma exist? / ¿Existen indicaciones actuales para la cirugía en el linfoma gástrico?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivo: analizar los resultados de nuestra serie a fin de establecer si la extirpación quirúrgica continúa siendo una opción terapéutica válida para las situaciones en las que pudiera precisarse cirugía. Como objetivo secundario, analizar la prevalencia de infección por Helicobacter pylori. Pacien [...] tes y método: estudio retrospectivo de 69 pacientes consecutivos diagnosticados de linfoma gástrico primario, en estadio I E y II E de Ann Arbor, 65 de los cuales fueron tratados mediante gastrectomía entre 1974 y 1999. Edad media: 62,6 años (28-85). En 60 casos se revisó la histología de la pieza de resección con nuevas tinciones (hematoxilina-eosina, Giemsa), y estudio inmunohistoquímico de los bloques de parafina. La clasificación histológica se realizó de acuerdo con la clasificación de Isaacson. El análisis estadístico se realizó mediante las pruebas de Chi cuadrado y prueba exacta de Fisher y Kaplan-Meier y Log-Rank para el análisis de supervivencia. Resultados: la mortalidad fue de 9,2%. Se produjeron complicaciones no mortales en 10,8%. Se identificó Helicobacter pylori en 62,7%. Se produjo recaída en 7 pacientes (11,9%). La probabilidad de supervivencia fue de 87% a 5 años. El análisis estadístico no demostró influencia del estadio de Ann Arbor, invasión en la pared gástrica, infección por Helicobacter pylori, tipo histológico, ni afectación de bordes sobre la supervivencia. Conclusiones: la extirpación quirúrgica posibilita un alto grado de remisión completa y una excelente supervivencia a largo plazo, con mortalidad aceptable, por lo que es un tratamiento válido en caso de ausencia de diagnóstico histológico, hallazgo incidental o urgencia. Abstract in english Objective: to analyze the results of our series in order to assess whether surgical excision is still a valid therapeutic option in case the patient needs surgery. Secondarily, to analyze Helicobacter pylori infection rate. Patients and method: a retrospective study of 69 consecutive patients having [...] stage IE-IIE primary gastric lymphoma; of these, 65 were treated by gastrectomy between 1974 and 1999. Mean age: 62.6 years (28-85). New staining of paraffin-embedded samples from the surgical specimen were carried out (hematoxiline-eosine, Giemsa, immunohistochemistry) and reviewed. The histological classification was performed according to Isaacson's criteria. The statistical analysis was done by Chi-squared and Fisher's exact tests, as well as Kaplan-Meier and Log-Rank tests. Results: mortality was 9.2%. There were non-fatal complications in 10.8%. Helicobacter pylori was identified in 62.7%. Seven patients (11.9%) suffered a relapse. The 5-year survival probability was 87%. The statistical analysis did not show any influences of Ann Arbor stage, gastric wall invasion, Helicobacter pylori infection, histological type, or margin resection involvement on survival. Conclusions: surgical excision provides a high rate of complete remissions and excellent long-term survival with acceptable mortality. Therefore it appears to be a valid treatment in case of emergency surgery, incidental finding, or lack of histological diagnosis.

Rodríguez-Sanjuán, J. C.; García, R. A.; Trugeda, S.; Torre, F. de la; Llorca, J.; Gómez-Fleitas, M..

176

Do current indications for surgery of primary gastric lymphoma exist? ¿Existen indicaciones actuales para la cirugía en el linfoma gástrico?  

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Full Text Available Objective: to analyze the results of our series in order to assess whether surgical excision is still a valid therapeutic option in case the patient needs surgery. Secondarily, to analyze Helicobacter pylori infection rate. Patients and method: a retrospective study of 69 consecutive patients having stage IE-IIE primary gastric lymphoma; of these, 65 were treated by gastrectomy between 1974 and 1999. Mean age: 62.6 years (28-85. New staining of paraffin-embedded samples from the surgical specimen were carried out (hematoxiline-eosine, Giemsa, immunohistochemistry and reviewed. The histological classification was performed according to Isaacson's criteria. The statistical analysis was done by Chi-squared and Fisher's exact tests, as well as Kaplan-Meier and Log-Rank tests. Results: mortality was 9.2%. There were non-fatal complications in 10.8%. Helicobacter pylori was identified in 62.7%. Seven patients (11.9% suffered a relapse. The 5-year survival probability was 87%. The statistical analysis did not show any influences of Ann Arbor stage, gastric wall invasion, Helicobacter pylori infection, histological type, or margin resection involvement on survival. Conclusions: surgical excision provides a high rate of complete remissions and excellent long-term survival with acceptable mortality. Therefore it appears to be a valid treatment in case of emergency surgery, incidental finding, or lack of histological diagnosis.Objetivo: analizar los resultados de nuestra serie a fin de establecer si la extirpación quirúrgica continúa siendo una opción terapéutica válida para las situaciones en las que pudiera precisarse cirugía. Como objetivo secundario, analizar la prevalencia de infección por Helicobacter pylori. Pacientes y método: estudio retrospectivo de 69 pacientes consecutivos diagnosticados de linfoma gástrico primario, en estadio I E y II E de Ann Arbor, 65 de los cuales fueron tratados mediante gastrectomía entre 1974 y 1999. Edad media: 62,6 años (28-85. En 60 casos se revisó la histología de la pieza de resección con nuevas tinciones (hematoxilina-eosina, Giemsa, y estudio inmunohistoquímico de los bloques de parafina. La clasificación histológica se realizó de acuerdo con la clasificación de Isaacson. El análisis estadístico se realizó mediante las pruebas de Chi cuadrado y prueba exacta de Fisher y Kaplan-Meier y Log-Rank para el análisis de supervivencia. Resultados: la mortalidad fue de 9,2%. Se produjeron complicaciones no mortales en 10,8%. Se identificó Helicobacter pylori en 62,7%. Se produjo recaída en 7 pacientes (11,9%. La probabilidad de supervivencia fue de 87% a 5 años. El análisis estadístico no demostró influencia del estadio de Ann Arbor, invasión en la pared gástrica, infección por Helicobacter pylori, tipo histológico, ni afectación de bordes sobre la supervivencia. Conclusiones: la extirpación quirúrgica posibilita un alto grado de remisión completa y una excelente supervivencia a largo plazo, con mortalidad aceptable, por lo que es un tratamiento válido en caso de ausencia de diagnóstico histológico, hallazgo incidental o urgencia.

J. C. Rodríguez-Sanjuán

2006-03-01

177

Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico  

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Full Text Available Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difuso. Se inició radioterapia, no completó el tratamiento por complicaciones y falleció. Son muy pocos los casos publicados de linfoma primario del sistema nervioso central asociado a lupus eritematoso sistémico.A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

C. N. Pisoni

2003-06-01

178

Síndrome de enmascaramiento en un paciente con un linfoma primario del sistema nervioso central  

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Full Text Available Se describe el caso de un varón de 37 años con un linfoma primario del sistema nervioso central y con múltiples localizaciones supra e infratentoriales. El paciente presentaba manifestaciones de inflamación intraocular como expresión de su neoplasia intracraneana (síndrome de enmascaramiento y linfocitopenia con un recuento disminuido de CD4- como representación de una inmunodeficiencia cuya etiología no logramos identificar. El diagnóstico de linfoma se confirmó a través del estudio citológico del humor vítreo. El paciente falleció 10 meses después del comienzo de los síntomas.We report the case of a 37-year-old, white male with a primary central nervous system lymphoma with multiple supra and infratentorial locations. The patient developed manifestations of intraocular inflammation secondary to the intracranial neoplasm (masquerade syndrome and lymphocytopenia -with a low CD4 cell count- representing an immunodeficiency state which etiology was undiagnosed. The diagnosis of lymphoma was established by vitreous cytology. The patient died 10 months after the beginning of the symptoms.

J. A. Mazzei

2003-12-01

179

Síndrome de enmascaramiento en un paciente con un linfoma primario del sistema nervioso central  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se describe el caso de un varón de 37 años con un linfoma primario del sistema nervioso central y con múltiples localizaciones supra e infratentoriales. El paciente presentaba manifestaciones de inflamación intraocular como expresión de su neoplasia intracraneana (síndrome de enmascaramiento) y linf [...] ocitopenia con un recuento disminuido de CD4- como representación de una inmunodeficiencia cuya etiología no logramos identificar. El diagnóstico de linfoma se confirmó a través del estudio citológico del humor vítreo. El paciente falleció 10 meses después del comienzo de los síntomas. Abstract in english We report the case of a 37-year-old, white male with a primary central nervous system lymphoma with multiple supra and infratentorial locations. The patient developed manifestations of intraocular inflammation secondary to the intracranial neoplasm (masquerade syndrome) and lymphocytopenia -with a l [...] ow CD4 cell count- representing an immunodeficiency state which etiology was undiagnosed. The diagnosis of lymphoma was established by vitreous cytology. The patient died 10 months after the beginning of the symptoms.

J. A., Mazzei; A. L., Campos; M. J., Melero; A., Schlaen; C., Argento; J. O., Zarate.

180

Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear [...] de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difuso. Se inició radioterapia, no completó el tratamiento por complicaciones y falleció. Son muy pocos los casos publicados de linfoma primario del sistema nervioso central asociado a lupus eritematoso sistémico. Abstract in english A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. [...] CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

Pisoni, C. N.; Grinberg, A. R.; Plana, J. L.; Freue, R. D.; Manni, J. A.; Paz, L..

 
 
 
 
181

The Role of Rituximab in Lymphomas / O papel do Rituximab nos linfomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Nos últimos anos o tratamento do linfomas não Hodgkin apresentou um grande avanço no diagnóstico, classificação, quimioterapia com altas doses e o transplante de células percursoras hematopoiéticas. Simultaneamente houve o desenvolvimento de novas drogas e no tratamento de suporte o que possibilita [...] um avanço na evolução e sobrevida dos pacientes. A idéia do emprego de anticorpos monoclonais no tratamento do câncer é antiga e neste relato são apresentados os resultados e o papel do anti-CD20-Rituximab nos linfomas. Abstract in english Over the last years the treatment of non-Hodgkin's lymphoma underwent a great advance in relation to the diagnosis, classification, high-dose chemotherapy, and hematopoietic stem cell transplantation. Simultaneously with this, there was the development of new drugs and support therapy which enabled [...] an improvement in the evolution and survival of the patients. The use of monoclonal antibodies against cancer cells is an old idea and in this report the results of the role of the anti-CD20-Rituximab in lymphomas is discussed.

Bertrand, Coiffier.

182

Medio ambiente en el Tratado de Libre Comercio  

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Full Text Available Se muestran las relaciones entre la dinámica del medio ambiente y el libre comercio con ocasión de la entrada del Tratado de Libre Comercio TLC de Colombia con los Estados Unidos. Se presentan las dos posturas tanto ambientalista como comercialista y escenarios de conciliación de las mismas.

Juan Pablo Galeano Rey

2006-01-01

183

Características clínicas y resultados terapéuticos de linfomas no Hodgkin de células grandes B mediastinal primarios / Clinical features and therapeutic results of primary mediastinal large B- cells non-Hodgkin's lymphomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio observacional, descriptivo y retrospectivo para evaluar las características clinicobiológicas y los resultados terapéuticos del linfoma de células grandes B mediastinal primario, en 34 pacientes atendidos en el Hospital Clinicoquirúrgico "Hermanos Ameijeiras" desde junio de 198 [...] 9 a febrero de 2009. Se halló predominio del sexo femenino (61,8 %), edad promedio de 31,5 años (19 a 61 años) y de la raza blanca (70,6 %). Fueron más frecuentes los estadios localizados (67,7 %), sin síntomas B (64,7 %) y con gran masa tumoral (70,6 %). La supervivencia global y la supervivencia libre de progresión a los 5 años fueron 53,4 y 43,4 %, respectivamente. La supervivencia global a los 3 años de los pacientes tratados con MACOPB/VACOPB, CHOP y R-CHOP fue de 77,7; 30,4 y 100 %, respectivamente. Se comprobó que los pacientes tratados con MACOPB/VACOPB tuvieron mejores resultados que los tratados con CHOP. El índice pronóstico internacional ajustado a la edad no fue predictor de supervivencia. En el análisis multivariable, el único predictor de supervivencia fue el tratamiento utilizado (CHOP contra MACOPB). El uso rutinario de la radioterapia no tuvo impacto significativo en la supervivencia global ni en la supervivencia libre de progresión a los 5 años. Abstract in english A retrospective, descriptive and observational study was conducted to assess the clinical-biological features and the therapeutic results of the primary mediastinal of large B cells lymphoma in 34 patients seen in the "Hermanos Ameijeiras" Clinical Surgical Hospital from June, 1989 to February, 2009 [...] . There was predominance of female sex (61.8 %), mean age of 31.5 years (19 to 61 years) and of white race (70.6 %). The localized stages were more frequent (67.7 %), without B symptoms (64.7 %) and with a large tumor mass (70.6 %). Global survival and the free of progression survival at five years were of 53.4 and 43.4 %, respectively. The global survival at three years of the patients treated with MACOPB/VACOPB, CHOP and R-CHOP was of 77.7; 30.4 and 100 %, respectively. It was proved that patients treated with MACOPB/VACOPB had better results than those treated with CHOP. Age-adjusted international prognostic rate was not a survival predictor. In multivariable analysis, the only survival predictor was the applied (CHOP versus MACOPB). The routine use of radiotherapy has neither a significant impact on the global survival nor on the free of progression survival at five years.

Reysel, Chávez Medina; José, Carnot Uria; Raúl, de Castro Arenas; Jorge, Muñío Perurena; Guillermo, Pérez Román; Aramís, Núñez Quintana.

184

Linfoma primario cutáneo difuso de células B grandes, tipo pierna (LPCDCBG-TP, localizado en cuero cabelludo Diffuse primary large B-Cell cutaneous lymphoma  

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Full Text Available Los linfomas primarios cutáneos de células B se consideran actualmente como categoría distintiva de los linfomas primarios cutáneos y se reconocen subtipos característicos dentro de ellos. Se presenta un caso de linfoma primario cutáneo difuso de células B grandes, tipo pierna, con localización en el cuero cabelludo, donde se pudo disponer de estudios inmunohistoquímicos para su tipificación, que mostraron positividad para los marcadores CD20, bcl-2 y MUM-1, y negatividad para CD3 y bcl-6. Estos resultados, unidos a las características de las lesiones y el estudio histológico condujeron al diagnóstico final.Los linfomas primarios cutáneos de células B se consideran actualmente como categoría distintiva de los linfomas primarios cutáneos y se reconocen subtipos característicos dentro de ellos. Se presenta un caso de linfoma primario cutáneo difuso de células B grandes, tipo pierna, con localización en el cuero cabelludo, donde se pudo disponer de estudios inmunohistoquímicos para su tipificación, que mostraron positividad para los marcadores CD20, bcl-2 y MUM-1, y negatividad para CD3 y bcl-6. Estos resultados, unidos a las características de las lesiones y el estudio histológico condujeron al diagnóstico final.

Oristel I Felipe Fereira

2010-06-01

185

Search of intravascular hemolysis in patients with the cutaneous form of loxoscelism Pesquisa de hemólise intravascular na forma cutânea de loxoscelismo  

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Full Text Available Haptoglobin assay, a highly sensitive method to detect intravascular hemolysis was carried out in the sera of 19 patients referred to Hospital Vital Brazil with the cutaneous form of loxoscelism in order to investigate the occurrence of mild intravascular hemolysis. Data from this series did not show decreased levels haptoglobin, ruling out intravascular hemolysis in these patients with cutaneous form of loxoscelism.Dezenove pacientes que apresentaram a forma clínica cutânea do loxoscelismo foram investigados com o propósito de pesquisar hemólise intravascular sub-clínica, lançando mão da dosagem de haptoglobina, um método altamente sensível que permite detectar discreta presença de hemólise intravascular. Não foi encontrada diminuição de haptoglobina, o que descarta uma ação hemolítica do veneno da Loxosceles nestes pacientes.

Pasquale Morena

1994-04-01

186

CNS intravascular lymphoma: an underappreciated cause of rapidly progressive dementia.  

Science.gov (United States)

Intravascular lymphoma is a rare subtype of extranodal large cell non-Hodgkin's lymphoma that is usually seen in the elderly. It can occasionally present with neurological symptoms in the form of dementia, focal neurological deficit and seizure. Diagnosis is difficult because of non-specific clinical manifestation. We report a case of a 38-year-old woman presenting with rapidly progressive dementia and seizure. MRI of the brain showed bilateral diffuse involvement of cortex and subcortical white matter. Brain biopsy disclosed the aetiological confirmation of intravascular B-cell lymphoma. The patient was treated with monthly cyclophosphamide, doxorubicin, vincristine and prednisolone regimen, but unfortunately, she died after two chemotherapy cycles. So, high index of suspicion is warranted to diagnose and treat the condition early to have a better outcome. PMID:24722717

Panda, Akhila Kumar; Malik, Seema

2014-01-01

187

Retrieval of intravascular foreign bodies with goose neck snare  

International Nuclear Information System (INIS)

Purpose: to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system. Materials and methods: the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001. Results: foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered. Conclusion: the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective with low rate complications

2004-03-01

188

Retrieval of intravascular foreign bodies with goose neck snare  

Energy Technology Data Exchange (ETDEWEB)

Purpose: to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system. Materials and methods: the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001. Results: foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered. Conclusion: the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective with low rate complications.

Koseoglu, Kutsi E-mail: kutsikoseoglu@yahoo.com; Parildar, Mustafa; Oran, Ismail; Memis, Ahmet

2004-03-01

189

Intravascular Brachytherapy. A model for the calculation of the dose.  

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Full Text Available In this study we present the radiation dose distribution for a theoretical model with Montecarlo simulation, and based on an experimental model developed for the study of the prevention of restenosis post-angioplasty employing intravascular brachytherapy. In the experimental in vivo model, the atherosclerotic plaques were induced in femoral arteries of male New Zealand rabbits through surgical intervention and later administration of cholesterol enriched diet. For the intravascular irradiation we employed a 32P source contained within the balloon used for the angioplasty. The radiation dose distributions were calculated using the Monte Carlo code MCNP4B according to a segment of a simulated artery. We studied the radiation dose distribution in the axial and radial directions for different thickness of the atherosclerotic plaques. The results will be correlated with the biologic effects observed by means of histological analysis of the irradiated arteries.

Pirchio, Rosana.

2002-01-01

190

[Nonlinear finite element analysis for compression behavior of intravascular stents].  

Science.gov (United States)

The implantation of intravascular stents has become a new method to cure stenosis in arteries with its low injury and high efficiency. The mechanical behavior of the stents is studied by the finite element method. The compression behavior is simulated with stent models of different sizes and geometry structures whose material is cobalt-chromium alloy. Experiments are also carried out to verify the simulation method, which shows that the finite element model can substitute the stent to some extent in which its mechanical behavior is studied. The results show that the reaction stress of the stent increases with the thickness of the strut. Besides, the smaller metal surface area ratio will result in a smaller elongation ratio. All these are helpful and instructive to the proper designs and actual operation of intravascular stents. PMID:18438042

Ning, Jing; Zeng, Pan; Lei, Li-Ping

2008-01-01

191

A hybrid plaque characterization method using intravascular ultrasound images  

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Intravascular ultrasound (IVUS) is an invasive imaging modality that provides high resolution crosssectional images permitting detailed evaluation of the lumen, outer vessel wall and plaque morphology and evaluation of its composition. Over the last years several methodologies have been proposed which automated processing of the IVUS data and reliable segmentation of the regions of interest or characterization of the type of the plaque. In this paper we present a novel methodology for the aut...

Athanasiou, Lambros S.; Karvelis, Petros S.; Sakellarios, Antonis; Exarchos, Themis; Siogkas, Panagiotis K.; Tsakanikas, Vassilis D.; Naka, Katerina K.; Bourantas, Christos V.; Papafaklis, Michail I.; Koutsouri, Georgia; Michalis, Lampros K.; Parodi, Oberdan; Fotiadis, Dimitrios I.

2013-01-01

192

A study of intravascular brachytherapy treatment planning in peripheral arteries.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A two-step method to determine the seed parameters for the planning of peripheral intravascular brachytherapy, which took the actual vessel geometry into consideration, was developed. Firstly, the characteristics of the vessel geometry was obtained by using active navigation; Then a method combined genetic algorithm with BFGS algorithm was applied to optimize the number of seeds, and the parameters associated with each seed such as the position, and the dwell time. Application of the method t...

Zhou, Zhengdong; Haigron, Pascal; Acosta, Oscar; Shu, Huazhong; Yu, Wenxue; Luo, Limin; Manens, Jean-pierre; Lucas, Antoine

2005-01-01

193

A hybrid plaque characterization method using intravascular ultrasound images  

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BACKGROUND: Intravascular ultrasound (IVUS) is an invasive imaging modality that provides high resolution cross-sectional images permitting detailed evaluation of the lumen, outer vessel wall and plaque morphology and evaluation of its composition. Over the last years several methodologies have been proposed which allow automated processing of the IVUS data and reliable segmentation of the regions of interest or characterization of the type of the plaque. OBJECTIVE: In this paper we present a...

Athanasiou, Lambros S.; Karvelis, Petros S.; Sakellarios, Antonis; Exarchos, Themis; Siogkas, Panagiotis K.; Tsakanikas, Vassilis D.; Naka, Katerina K.; Bourantas, Christos V.; Papafaklis, Michail I.; Koutsouri, Georgia; Michalis, Lampros K.; Parodi, Oberdan; Fotiadis, Dimitrios I.

2013-01-01

194

An Axial Array for Volumetric Intravascular Ultrasound Imaging:  

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Intravascular ultrasound (IVUS) is a medical imaging modality aimed at imaging blood vessel walls from within the vessel. Current commercial IVUS catheters are designed to yield two-dimensional cross-sectional images perpendicular to the vessel wall. By pulling the catheter back through the artery (in the ‘axial direction’), and stacking the resulting cross-sectional images, a three-dimensional image of the artery can be obtained. However, in non-stationary blood vessels like, e.g., the c...

Alles, E. J.

2012-01-01

195

Optimization of intravascular brachytherapy treatment planning in peripheral arteries.  

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This work deals with the treatment planning optimization for intravascular brachytherapy (IVB) in peripheral arteries. The objective is both to quantitatively study the validity of different hypotheses required for a reliable application of the treatment with current techniques, and to contribute to the definition and the specification of a new optimized procedure taking into account the actual patient's vessel geometry. The detection of vascular luminal surface was performed by an image anal...

2007-01-01

196

A study of intravascular brachytherapy treatment planning in peripheral arteries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A two-step method to determine the seed parameters for the planning of peripheral intravascular brachytherapy, which took the actual vessel geometry into consideration, was developed. Firstly, the characteristics of the vessel geometry was obtained by using active navigation; Then a method combined genetic algorithm with BFGS algorithm was applied to optimize the number of seeds, and the parameters associated with each seed such as the position, and the dwell time. Application of the method t...

2005-01-01

197

Silent Intravascular Lymphoma Initially Manifesting as a Unilateral Adrenal Incidentaloma  

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Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that th...

Takahashi, Yoshiko; Iida, Keiji; Hino, Yasuhisa; Ohara, Takeshi; Kurahashi, Toshifumi; Tashiro, Takashi; Chihara, Kazuo

2012-01-01

198

Cutaneous collagenous vasculopathy associated with intravascular occlusive fibrin thrombi.  

Science.gov (United States)

Cutaneous collagenous vasculopathy (CCV) is a rare cutaneous microangiopathy that clinically resembles generalized essential telangiectasia with only 12 cases reported to date. The perivascular fibrosis is thought to be due to production of abnormal collagen by veil cells in the outer vessel walls as a result of unknown factors. This report is of an 84-year-old male with progressive telangiectasia. Biopsies showed characteristic features of CCV. In addition, there were multiple intravascular fibrin thrombi, some organizing and associated with endothelial cell hyperplasia with recanalization reminiscent of glomeruloid bodies and simulating reactive angioendotheliomatosis (RAE). Histochemically and ultrastructurally fibrin was noted within the vessel walls integrating into the fibrous tissue around the vessels; however, the patient had no evidence of coagulation disorder, cryoglobulinemia or cold agglutinemia. Immunofluorescence showed fibrinogen within the vessel walls but no immunoglobulins or C3. As well, there were minimal inflammatory cells. This suggests pauci-inflammatory injury to the endothelial cells by unknown angiogenic factors causing local intravascular fibrin thrombi with fibrin leaking and incorporating into the vessel walls, eventually leading to reparative perivascular fibrosis. This case suggests that some cases of CCV are related to a primary local intravascular occlusive thrombotic microangiopathy. However, the primary triggering factor causing the endothelial cell damage has yet to be elucidated. PMID:24350781

Salama, Samih; Chorneyko, Kathy; Belovic, Brian

2014-04-01

199

Extramedullary Hematopoiesis in Uterine Leiomyoma Associated with Numerous Intravascular Thrombi  

Science.gov (United States)

We report a case of extramedullary hematopoiesis (EMH) in uterine leiomyoma and associated numerous intravascular thrombi. A 29-year-old nulliparous female presented with heavy vaginal bleeding and a hematocrit of 22%. No bone marrow biopsy has been performed. She had a history of uterine leiomyomata and menorrhagia for a year. A transvaginal ultrasound confirmed the presence of a uterine leiomyoma. The patient was treated conservatively with oral contraceptive pills due to desire for fertility. However, she continued to have heavy vaginal bleeding and developed bilateral upper extremity deep vein thrombosis and multiple superficial vein thromboses after two months. An exploratory laparotomy with uterine myomectomy was performed. Gross examination of the specimen revealed a single nodular mass measuring 10.0 × 9.5 × 7.5?cm with a white-tan swirling cut surface. Microscopic examination revealed benign smooth muscle consistent with leiomyoma and numerous intravascular thrombi both with areas of EMH. Immunohistochemical stains confirmed the presence of all three benign lineages of hematopoietic cells. Occurrence of EMH in uterine leiomyoma and intravascular thrombi is very rare. It may be related to systemic hematopoietic stimulation due to severe chronic anemia and local presence of hematopoietic growth factors and/or cytokines.

Cui, Xiaoyan; Peker, Deniz; Greer, Heather O.; Conner, Michael G.; Novak, Lea

2014-01-01

200

Síndrome hemofagocítico y linfoma cutáneo de células T / Haemophagocytic syndrome and cutaneous T-cell lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El síndrome hemofagocítico (SHF) es un trastorno infrecuente de la inmunorregulación, cuyas manifestaciones clínicas son fiebre, hemofagocitosis, hepatoesplenomegalia, pancitopenia, linfadenopatías, hipertrigliceridemia y coagulopatía. Puede cursar también con afectación pulmonar, fracaso renal agud [...] o o síndrome de secreción inadecuada de ADH (SIADH). Se ha descrito asociado a múltiples enfermedades, destacando los linfomas, sobre todo de células T, infecciones y enfermedades sistémicas, entre otras entidades. Las células hematopoyéticas son fagocitadas por monocitos y macrófagos en los ganglios linfáticos, médula ósea, hígado y bazo, lo que constituye un criterio diagnóstico del SHF. El tratamiento es difícil e incluye medidas de soporte y de las alteraciones de coagulación así como corticoides sistémicos a altas dosis e inmunosupresores, aunque en la mayoría de ocasiones no hay respuesta al tratamiento y la evolución es fatal. Los linfomas T que afectan al tejido celular subcutáneo y simulan una paniculitis han sido clasificados recientemente como linfomas cutáneos de células T (LCCT), siendo infrecuente su presentación como nódulos inflamatorios en extremidades inferiores. Abstract in english Haemophagocytic syndrome is a rare disorder of immune regulation. Clinical features are fever, haemophagocytosis, hepatosplenomegaly, pancitopenia, lymph nodes enlargement, hypertriglyceridaemia and coagulopaty. Systemic findings may also include pulmonary infiltrates, renal failure and an inappropr [...] iate antidiuretic state. It has been described associated to many diseases, like lymphomas, most of them T-cell lymphomas, infections and systemic diseases, among other entities. Haemopoietic cells are actively ingested by monocites and macro-phages in lymph nodes, bone marrow, liver and spleen. This is a diagnostic criteria for haemophagocytic syndrome. The treatment of Haemophagocytic syndrome is difficult and requires intensive supportive therapy, treatment of coagulopaty disorders, high-dose corticosteroids and immunosuppressive treatment, although in most cases there is no response to treatment and the evolution is fatal. The T-cell lymphomas that involve subcutaneous tissue and simulate panniculitis are classified recently as primary cutaneous T-cell lymphomas, and their presentation as inflammatory nodules of the legs are uncommon.

Artigues Barceló, A.; Ferragut Reus, M.; Sánchez, C.; Amengual, I.; Matanza, I.; Sanz Parras, M. S..

 
 
 
 
201

Linfoma primario de bazo. Presentación de un caso / Primary lymphoma of the spleen. Case presentation  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: en el bazo se pueden observar diferentes tipos de tumores, dentro de los cuales están los linfomas primarios del mismo, enfermedad infrecuente, de ahí la importancia de su presentación. Presentación de caso: paciente femenina de 66 años, raza blanca, con antecedentes de hipertensión arte [...] rial, lobectomía derecha del tiroides, que refiere venía presentando desde hacía más de un año dolor abdominal alto izquierdo que se hacía más intenso tras el esfuerzo físico, tos, presentando toma del estado general por lo que se ingresa en el servicio de cirugía. Se toman muestras para biopsia, después de ser intervenido quirúrgicamente de una esplenectomía, dando como resultado un Linfoma no Hodgkin de células grandes CD20 positivo, sin infiltración hepática, ganglionar ni epiplóica. Se realizó esplenectomía y quimioterapia. La paciente ha evolucionado favorablemente. Conclusiones: el linfoma primario de bazo es una entidad infrecuente y su diagnóstico es aún más raro en pacientes por encima de los 60 años, como ocurrió en el caso presentado. A medida que casos como este se divulguen entre los profesionales de la salud permitirán una aproximación diagnóstica más precisa a esta enfermedad poco común. Abstract in english Background: in the spleen you can see different types of tumors; primary lymphomas are an example of them. This is an infrequent disease, hence the importance of its presentation. Case presentation: 66 year old white female patient with history of hypertension, thyroid right lobectomy that refers to [...] have been suffering from high left abdominal pain for a year that became more intense after physical exertion, cough, presenting general malaise by what is admitted to the surgical service. Some samples for biopsy are taken, after being surgically operated of a splenectomy, showing as a result a non-Hodkin lymphoma of big cells resulting cell non-Hodgkin lymphoma CD20 Positive, without hepatic, ganglionic or epiploic infiltration. Splenectomy and chemotherapy were made. The patient has improved favorably. Conclusions: primary lymphoma of the spleen is a rare entity and its diagnosis is still rarer in patients over 60 years, as it happened in the case presented. As cases like these are disseminated among health professionals will allow a more accurate diagnostic approach to this rare disease.

Vicente Joaquín, Más Medina; Mirelquis, Rodríguez Rodríguez; Ania Inés, Cuellar Armas; Ariana Ofelia, Gómez Mutis; Ramsés Manuel, Más Herrera.

202

Linfoma Extranodal de Células NK/T tipo Nasal / Extranodal Nasal type NK/T-Cell Lymphoma  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O Linfoma Extranodal de Células NK/T tipo Nasal tem uma distribuição geográfica peculiar, ocorrendo mais frequentemente em países orientais e na população nativa de alguns países da América Central e da América do Sul. Sua localização preferencial é na cavidade nasal e nos seios paranasais, mas pode [...] acometer outras estruturas da chamada região médio-facial. Tem um padrão de disseminação com "homing" característico, incluindo pele, testículo, SNC e trato digestivo. Este linfoma, menos frequentemente, pode acometer primariamente estas regiões. A maioria destas neoplasias apresenta um fenótipo NK, mas alguns poucos casos podem ter sua origem em células T verdadeiras, por este motivo é designado "linfoma NK/T". O genoma do vírus Epstein-Barr é detectado na maioria dos casos, sugerindo uma relação etiológica. Embora este linfoma seja sensível à radioterapia, apresenta mais frequentemente resistência a agentes quimioterápicos que outros linfomas. Uma possível explicação para a resistência é a usual expressão de glicoproteína-p. O prognóstico destes linfomas é pobre, sendo necessária a investigação de novas modalidades terapêuticas. Abstract in english Extranodal Nasal type NK/T-Cell Lymphoma has a peculiar geographic distribution, occurring more frequently in Eastern countries and in the native populations of some Central and South American countries. It is commonly found in the nasal cavity and paranasal sinuses, but may also compromise other st [...] ructures in the mid-facial region. The disease has a characteristic homing dissemination pattern, including skin, testis, CNS and digestive tract. This lymphoma can, less frequently, primarily compromise these regions. The majority of these neoplastic diseases present an NK phenotype, but a few cases can be truly of T-cell origin, because of which it is designed "NK/T-cell lymphoma". The Epstein-Barr virus genome can be detected in most of the cases, suggesting an etiological relationship. Although this lymphoma is responsive to radiotherapy, it is more resistant to conventional chemotherapy than other lymphomas. A possible explanation for this is the frequent expression of the p-glycoprotein. The prognosis of these lymphomas is still poor, making further investigation of new therapies imperativ.

Chiattone, Carlos S..

203

Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica / Lymphoma in patients harboring hepatosplenic mansonic schistosomiasis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RACIONAL: Cada vez mais se estabelece a correlação entre agentes infecciosos e doenças linfoproliferativas, sobretudo vírus e bactérias, através da ativação de linfócitos. OBJETIVO: Descrever 6 novos casos, de uma série de 254 pacientes (2,36%) com esquistossomose mansônica na forma hepatoesplênica. [...] CASUÍSTICA E MÉTODOS: São descritos 6 pacientes, dentre os 254 portadores de esquistossomose mansônica na forma hepatoesplênica, acompanhados nos últimos 13 anos no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE. RESULTADOS: Todos os seis casos ocorreram em mulheres. Os exames histopatológicos evidenciaram dois casos de linfomas de zona marginal esplênica, um de linfoma de grandes células com imunoblastos, um de linfoma difuso de grandes células, um de linfoma maligno de grandes células não clivadas, e um outro caso de doença de Hodgkin. Metade das seis pacientes evoluiu para o óbito entre 4 a 15 meses após o diagnóstico. As outras três persistem em acompanhamento no Serviço de Oncologia da mesma instituição. CONCLUSÃO: A incidência de linfoma nos 254 pacientes acompanhados foi de 2,36%. Pretende-se chamar a atenção para a ocorrência de linfomas nos baços de pacientes com esquistossomose mansônica, na forma hepatoesplênica. Abstract in english BACKGROUND: Correlation between infectious agents and linfoproliferative diseases are more stablished, over all virus and bacteria, through the activation of linfocytes. AIM: To describe six new cases, of a series of 254 patients (2,36%) with mansonic schistosomiasis, in the hepatosplenic form. METH [...] ODS: Six patients will be described, amongst the 254 carriers of mansonic schistosomiasis, in the hepatosplenic form, followed in the last 13 years. RESULTS: All the six cases had occurred in women. The histopathologic examinations had evidenced two cases of marginal splenic zone lymphomas, one of great cells with immunoblasts lymphomas, one diffuse lymphomas, a great cells malignant lymphomas, a great not clivads cells, and another case of Hodgkin. Half of the six evolved for the death 4-15 months after the diagnosis. The others three persist in accompaniment in the Oncology Division of the Clinics Hospital. CONCLUSION: The incidence of lymphomas in the 254 mansonic schistosomiasis patients followed in our clinic was of 2,36%. At last, this article intends to call the attention, for the occurrence of lymphomas, in the spleen of patients with mansonic schistosomiasis, in the hepatosplenic form.

Álvaro Antônio Bandeira, Ferraz; Vladimir Curvêlo Tavares de, Sá; Edmundo Pessoa de Almeida, Lopes; José Guido Corrêa de, Araújo Jr; Antônio Cavalcanti de Albuquerque, Martins; Edmundo Machado, Ferraz.

204

Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica Lymphoma in patients harboring hepatosplenic mansonic schistosomiasis  

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Full Text Available RACIONAL: Cada vez mais se estabelece a correlação entre agentes infecciosos e doenças linfoproliferativas, sobretudo vírus e bactérias, através da ativação de linfócitos. OBJETIVO: Descrever 6 novos casos, de uma série de 254 pacientes (2,36% com esquistossomose mansônica na forma hepatoesplênica. CASUÍSTICA E MÉTODOS: São descritos 6 pacientes, dentre os 254 portadores de esquistossomose mansônica na forma hepatoesplênica, acompanhados nos últimos 13 anos no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE. RESULTADOS: Todos os seis casos ocorreram em mulheres. Os exames histopatológicos evidenciaram dois casos de linfomas de zona marginal esplênica, um de linfoma de grandes células com imunoblastos, um de linfoma difuso de grandes células, um de linfoma maligno de grandes células não clivadas, e um outro caso de doença de Hodgkin. Metade das seis pacientes evoluiu para o óbito entre 4 a 15 meses após o diagnóstico. As outras três persistem em acompanhamento no Serviço de Oncologia da mesma instituição. CONCLUSÃO: A incidência de linfoma nos 254 pacientes acompanhados foi de 2,36%. Pretende-se chamar a atenção para a ocorrência de linfomas nos baços de pacientes com esquistossomose mansônica, na forma hepatoesplênica.BACKGROUND: Correlation between infectious agents and linfoproliferative diseases are more stablished, over all virus and bacteria, through the activation of linfocytes. AIM: To describe six new cases, of a series of 254 patients (2,36% with mansonic schistosomiasis, in the hepatosplenic form. METHODS: Six patients will be described, amongst the 254 carriers of mansonic schistosomiasis, in the hepatosplenic form, followed in the last 13 years. RESULTS: All the six cases had occurred in women. The histopathologic examinations had evidenced two cases of marginal splenic zone lymphomas, one of great cells with immunoblasts lymphomas, one diffuse lymphomas, a great cells malignant lymphomas, a great not clivads cells, and another case of Hodgkin. Half of the six evolved for the death 4-15 months after the diagnosis. The others three persist in accompaniment in the Oncology Division of the Clinics Hospital. CONCLUSION: The incidence of lymphomas in the 254 mansonic schistosomiasis patients followed in our clinic was of 2,36%. At last, this article intends to call the attention, for the occurrence of lymphomas, in the spleen of patients with mansonic schistosomiasis, in the hepatosplenic form.

Álvaro Antônio Bandeira Ferraz

2006-06-01

205

Linfoma Extranodal de Células NK/T tipo Nasal Extranodal Nasal type NK/T-Cell Lymphoma  

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Full Text Available O Linfoma Extranodal de Células NK/T tipo Nasal tem uma distribuição geográfica peculiar, ocorrendo mais frequentemente em países orientais e na população nativa de alguns países da América Central e da América do Sul. Sua localização preferencial é na cavidade nasal e nos seios paranasais, mas pode acometer outras estruturas da chamada região médio-facial. Tem um padrão de disseminação com "homing" característico, incluindo pele, testículo, SNC e trato digestivo. Este linfoma, menos frequentemente, pode acometer primariamente estas regiões. A maioria destas neoplasias apresenta um fenótipo NK, mas alguns poucos casos podem ter sua origem em células T verdadeiras, por este motivo é designado "linfoma NK/T". O genoma do vírus Epstein-Barr é detectado na maioria dos casos, sugerindo uma relação etiológica. Embora este linfoma seja sensível à radioterapia, apresenta mais frequentemente resistência a agentes quimioterápicos que outros linfomas. Uma possível explicação para a resistência é a usual expressão de glicoproteína-p. O prognóstico destes linfomas é pobre, sendo necessária a investigação de novas modalidades terapêuticas.Extranodal Nasal type NK/T-Cell Lymphoma has a peculiar geographic distribution, occurring more frequently in Eastern countries and in the native populations of some Central and South American countries. It is commonly found in the nasal cavity and paranasal sinuses, but may also compromise other structures in the mid-facial region. The disease has a characteristic homing dissemination pattern, including skin, testis, CNS and digestive tract. This lymphoma can, less frequently, primarily compromise these regions. The majority of these neoplastic diseases present an NK phenotype, but a few cases can be truly of T-cell origin, because of which it is designed "NK/T-cell lymphoma". The Epstein-Barr virus genome can be detected in most of the cases, suggesting an etiological relationship. Although this lymphoma is responsive to radiotherapy, it is more resistant to conventional chemotherapy than other lymphomas. A possible explanation for this is the frequent expression of the p-glycoprotein. The prognosis of these lymphomas is still poor, making further investigation of new therapies imperativ.

Carlos S. Chiattone

2009-08-01

206

Psoriasis, lymphoma and etanercept: is there a correlation? / Psoríase, linfoma e etanercepte: existe correlação?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A psoríase é uma doença inflamatória crônica que pode afetar a pele e as articulações. Seu tratamento varia conforme a gravidade e inclui medicamentos tópicos e sistêmicos. Dentre os últimos estão os imunobiológicos, que têm como alvo a célula T. Relatamos um caso que demonstra a estreita relação en [...] tre a psoríase, o linfoma e os imunobiológicos. Abstract in english Psoriasis is a chronic inflammatory disease that can affect skin and joints. Their treatment varies depending on the severity and includes topical and systemic. Among the latter are the immunobiological that target the T cell We report a case that demonstrates the close relationship between psoriasi [...] s, lymphoma and biologic therapies.

Ludmilla Queirós, Miranda; Aline Lopes, Bressan; Fernanda Valente da Silva, Rehfeldt; Bárbara Nader, Vasconcelos; Alexandre Carlos, Gripp.

207

Granuloma anular asociado a linfoma no Hodgkim difuso de células B grandes  

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Full Text Available Se presenta el caso de un paciente de 55 años con antecedentes de ser hipertenso controlado, atendido en servicio de hematología por adenopatías de características linfomatosas distribuidas en cadenas ganglionares, axilares, inguinales y epitrocleares distribuidas de forma bilateral. Los exámenes permitieron arribar al diagnóstico de un linfoma no Hogdkin difuso de células B grandes y de un granuloma anular.Granuloma Annulare Associated with non Hodgkin Diffuse Large B-cell LymphomaThe case of a male, 55 years old patient, with a history of controlled hypertension is presented. The patient was treated in the hematology service for adenopathies of lymphomatous type distributed in nodal chains: axillary, inguinal and epitrochlear and bilaterally distributed. Tests allowed to conclude a final diagnose of non Hodgkin diffuse large B-cell lymphoma and a granuloma annulare.  

Liermis M. Dita Salabert

2011-12-01

208

Diagnóstico y tratamiento de pacientes con linfomas primarios del sistema nervioso central (LPSN) y sindrome de inmunodeficiencia adquirida (SIDA) / Diagnostic and treatment of patients with primary lymphomas of the central nervous system and required inmunodeficiency syndrome  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish La incidencia del linfoma primario del sistema nervioso central (LPSNC) ha crecido rápidamente. El LPSNC as una complicación letal en pacientes con SIDA. Objetivo: Nuestro objetivo fue estudiar la historia natural, métodos diagnósticos, al tratamiento y los factores pronósticos para la sobrevida de [...] 75 pacientes con LPSNC y SIDA seguidos en el Jackson Memorial Hospital/Universidad de Miami. Resultados: La edad media fue de 37 años. El 84% de los pacientes eran hombres y el 55% hispanos. Factores de riesgo más comunes para SIDA fueron homosexualidad y múltiples compañeros sexuales. La cuenta promedio de CD4 fue de 15/ul y al promedio de LDH fue 1.5 veces al normal. La tomografía computarizada del cerebro mostraba lesiones múltiples en el 44% de los pacientes. Gammagrafia computarizada de emisión de fotones con talio-201 (SPECT) del cerebro se realizó en 2/3 de los pacientes. Las histologías más comunes en las biopsias fueron: linfoma inmunoblástico y linfoma de células grandes. La radiación craneana fue ineficiente en el 50% de los pacientes tratados. La sobrevida promedio del grupo fue de 2.2 meses. Análisis univariado y multivariado mostraron que la mayor sobrevida se asociaba con una buena capacidad funcional (ECOG=1-2 vs 3-4). La presencia previa de infecciones oportunistas, la presencia de factores de riesgo de SIDA, las cuentas de CD4, niveles de LDH y raza no mostraron influencia en la sobrevida. Conclusiones: LPSNC es una neoplasia con pronóstico muy pobre y corta sobrevida aun con radioterapia del SNC. La capacidad funcional parece ser al factor de sobrevida más importante. No se encontraron diferencias en la presentación clínica ni el resultado entre pacientes hispanos y no hispanos. ( Rev Med Hered 1999; 10:96-104 ). Abstract in english The incidence of Primary Central Nervous System Lymphoma (PCNSL) is increasing rapidly. PCNSL is an important lethal complication in AIDS patients. Objective: Our objective was to study the natural history and prognostic factors for survival in patients with AIDS related PCNSL. Material and methods: [...] This is a retrospective cohort study of 75 patients with the diagnosis of AIDS related PCNSL followed at Jackson Memorial Hospital University of Miami. Results: The median age was 37 years. Males comprised 84% of the patients and 55% of the patients were Hispanic. The most common HIV risk factors were homosexuality and multiple sexual partners. The median CD4 count was 15/~L and the median LDH were 1.5x normal. CT Scans of the brain showed multiple lesions in 44% of the patients. Single-Photon Emission CT Scan (SPECT) Thallium-201 of the brain was performed in 2/3 of patients. The most common histologies were immunoblastic and large cell lymphoma. Cranial radiation was given to 72% of the patients and 55% of them did not completed. The median survival of the group was 1.3 months. Univariate and multivariate analysis showed that longer survival was associated with good performance status (ECOG=1-2 Vs 3-4). The presence of prior opportunistic infections, risk factors for AIDS, CD4 counts, level of LDH, ethnicity, gender, duration of symptoms before diagnosis, and race did not influence survival. Conclusions: PCNSL is a neoplasm with a very poor prognosis and short survival even with CNS radiation therapy. Performance status appears to be the main prognostic factor for survival. No significant differences in presentation or outcome were detected between the Hispanic and non-Hispanic patients. ( Rev Med Hered 1999; 10: 96-104 ).

Luis E, Raez; Juanita, Angulo; Alvaro, Restrepo.

209

Linfoma Linfocítico, bien diferenciado de la próstata: Presentación de un caso y breve revisión de la literatura / Well-differentiated lymphocytic lymphoma of the prostate: Case report and bibliographic review  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Presentar un caso portador de un linfoma de próstata, en un paciente de 70 años de edad y hacer una breve revisión de la literatura. Método/resultados: Se trata de un paciente varón de 70 años de edad, que es visto en consulta de Urología por presentar un cuadro de prostatismo, llegando a [...] la retención aguda de orina (RAO). Es intervenido quirúrgicamente realizándosele una prostatectomía retropúbica, obteniéndose como resultado anatomopatológico un linfoma primario de próstata, el paciente fue remitido a Oncología, siendo tratado con radioterapia, llevando actualmente seguimiento en consulta de Urología. Se hace una breve revisión bibliográfica, donde analizamos las manifestaciones clínicas de esta entidad, las pruebas complementarias que nos ayudan a hacer el diagnóstico (exámenes de laboratorio, biopsia prostática transrectal, resección transuretral, ecografía, tomografía axial computarizada), los tratamientos que se aplican (cirugía, radioterapia, poliquimioterapia) así como la supervivencia de estos pacientes. Conclusiones: La edad promedio de diagnóstico en la casuística revisada por nosotros fue de 57 años. La forma clínica de debut son síntomas de prostatismo, pudiendo estar presente la RAO y en algunos casos manifestaciones de insuficiencia renal por uropatía obstructiva, así como manifestaciones generales (astenia, anorexia, pérdida de peso). Las cifras de antígeno específico prostático (PSA) no sufren alteraciones en los linfomas prostáticos. El diagnóstico histológico se puede realizar a través de la biopsia de próstata transrectal, aunque puede ser necesario la resección transuretral (RTU) de próstata para una mejor confirmación. La ultrasonografía y la tomografía axial computarizada (TAC) son de gran utilidad para el diagnóstico tanto local como de extensión de estos tumores. Desde el punto de vista del tratamiento puede ser necesario la cirugía desobstructiva (RTU, prostatectomía a cielo abierto), asociación con corticoides y otros citostáticos, la radioterapia y también se ha utilizado la quimioterapia intratecal, el transplante autólogo de médula ósea como complemento. Abstract in english Objective: To report a case of prostate lymphoma and a brief review of the literature. Methods/results: A 70 year-old mele patient was referred to the Urology departament with a clinical picture of prostatism, with acute urinary retention (AUR). Surgery with retropubic prostatectomy was performed, a [...] nd pathology revealed a primary prostate lymphoma. The patient was referred to the departament of Oncology where he received polychemotherapy and radiotherapy. The patient is currently followed by regular visits to Urology outpatients service.The case study is followed by a brief bibliographic review, where we analyse clinical menifestations of this entity, complementary studies useful for diagnosis (laboratory test, trasrectal prostate biopsy, transuretral resection, ultrasound and computerised axial tomography), treatment options (surgery, polychemotherapy, radiotherapy) as well as survival in these patients. Conclusions: Of the cases reviewed, mean age at diagnosis was 57 years. Clinical debut was with prostate symptoms, with or without AUR and sometimes manifestations of renal failure due to obstructive uropathy, as well as general symptoms (astenia, anorexia, weight loss). PSA values remain unaltered in prostate lymphoma patients. Histologic diagnosis may be made by transrectal prostate biopsy, although transurethral resection (TUR) may be necessary for con.rmation. Ultrasound and CT scan are of great utility for diagnosis of both local and distant tumors. From a therapeutic point of view, surgery for the obstruction of the lower urinary tract (TURP or retropubic prostatectomy) may be necessary, as well as the cyclophosphamide based polychemotherapy with corticosteroids and other cytostatic agents, and radiotherapy; intratecal chemotherapy has also been used adjuvant bon

Otto, Ochoa Undargarain; José A., Hermida Pérez; Johannes, Ochoa Montes de Oca; Juan M., Félix León.

210

Actinomicosis vs Linfoma: presentación de un caso / Actinomycosis vs. lymphoma: a case presentation  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: el linfoma es la proliferación monoclonal neoplásica de células linfoides en localizaciones del sistema inmunitario, que incluyen ganglios linfáticos, médula ósea, bazo, hígado y tracto gastrointestinal. Caso Clínico: se presentó el caso de Linfoma no Hodgkin linfoblástico de alto grado [...] de malignidad, en una paciente de 36 años de edad con antecedentes de hepatitis viral, giardiasis y aborto provocado con implantación de dispositivo intrauterino, que ingresa en el servicio de terapia intensiva del Hospital Universitario Manuel Ascunce Domenech por ausencia de apetito, decaimiento y pérdida de peso de 30 libras aproximadamente en tres meses; en la exploración física inicial se encuentran grandes edemas blandos en miembros inferiores y caquexia, además de distensión abdominal. Después de una estadía prolongada y tórpida evolución, la paciente fallece. Abstract in english Background: lymphoma is the proliferation of neoplastic monoclonal of lymphoid cells in locations of the immune system, including lymph nodes, bone marrow, spleen, liver and gastrointestinal tract. Clinical case: is presented a case of a lymphoblastic non-Hodgkin´s lymphoma´s of high-grade of malign [...] ancy in a 36-year-old patient with a history of viral hepatitis, giardiasis and abortion caused by implantation of intra-uterine device, admitted in the intensive care unit service at Manuel Ascunce Domenech University Hospital by lack of appetite, dwindles, weight loss of 30 pounds approximately in three months, and in the initial physical examination are found large soft edema in lower limbs and cachexia and abdominal distention. After a long stay and torpid evolution, the patient died.

Manuel M, Basulto Barroso; Zaily, Fuentes Díaz; María del Carmen, Galdós Sánchez; Raúl A, Pérez Sarmiento; René, Rabasa Pérez.

211

Contribuição da medicina nuclear para a avaliação dos linfomas Contribution of nuclear medicine in lymphomas approach  

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Full Text Available A medicina nuclear permite a caracterização funcional de tecidos, acrescentando dados à avaliação anatômica realizada por outros métodos de imagem, como a tomografia computadorizada, ressonância magnética ou ultra-som. Além do diagnóstico e estadiamento, as informações funcionais fornecidas pela medicina nuclear são particularmente úteis no seguimento e avaliação de resposta terapêutica dos pacientes com linfoma. A presença de massa residual após quimioterapia ou a infiltração de linfonodos de pequenas dimensões são exemplos de situações nas quais a avaliação isolada de características anatômicas é insuficiente. Os principais métodos utilizados são a cintilografia com gálio-67, traçador com alta afinidade por transferrina e receptores de ferro, e os estudos com flúor-deoxiglicose, emissor de pósitron que permite a caracterização do metabolismo de glicose nos tecidos. Outros traçadores, como o tálio-201, sestamibi-Tc99m e octreotide-In111, também são utilizados em menor escala na avaliação dos pacientes com linfoma. Os mecanismos de captação, principais indicações dos estudos, limitações e resultados de literatura serão revistos.Nuclear medicine procedures allow functional characterization of organs and tissues, that can be compared to the anatomical evaluation provided by computed tomography, magnetic resonance imaging and ultrasonography. Functional information are usefull not only in diagnosis and staging, but mainly in the follow-up and evaluation of the therapeutic response of lymphoma patients. Persistent or residual mediastinal mass and and infiltration of small nodes are some examples of situations in which purely anatomical evaluation is insufficient. The main methods in use are scintigraphy with galium-67, a transferrin avid tracer, and PET with fluoro-desoxyglucose, indicated for the metabolic evaluation of tissues. Other tracers are also described, as thallium-201, 99mTc-sestamibi, and 111In-octreotide. Mechanisms of uptake, indications, limitations and results of the literature are and discussed in this review.

Marcelo T. Sapienza

2001-08-01

212

Non Hodgkin T cell lymphoma: an atypical clinical presentation Linfoma não Hodgkin de células T citotóxico: uma apresentação clínica atípica  

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Full Text Available Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.Os linfomas citotóxicos compreendem um espectro de linfomas de células T periféricos e linfomas Natural Killer que podem ter expressão cutânea primária ou secundária. Descrevemos o caso de um homem com 46 anos de idade, natural de Cabo Verde,com dermatose envolvendo a face e tronco constituída por pápulas monomorfas superfície lisa e polineuropatia sensitivo motora.A hipótese de Hanseníase foi colocada suportada por achados histopatológicos sugestivos sendo o doente referenciado à consulta de Doença de Hansen do nosso hospital. Em biopsia de pele e de gânglio identificou-se proliferação linfocitária cujo estudo imunohistoquímico permitiu o diagnóstico de linfoma T com expressão de marcadores citotóxicos. Iniciou quimioterapia verificando-se inicialmente remissão parcial das lesões cutâneas mas posteriormente a progressão da doença sistémica.

Paula Maio

2013-04-01

213

Non Hodgkin T cell lymphoma: an atypical clinical presentation / Linfoma não Hodgkin de células T citotóxico: uma apresentação clínica atípica  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os linfomas citotóxicos compreendem um espectro de linfomas de células T periféricos e linfomas Natural Killer que podem ter expressão cutânea primária ou secundária. Descrevemos o caso de um homem com 46 anos de idade, natural de Cabo Verde,com dermatose envolvend [...] o a face e tronco constituída por pápulas monomorfas superfície lisa e polineuropatia sensitivo motora.A hipótese de Hanseníase foi colocada suportada por achados histopatológicos sugestivos sendo o doente referenciado à consulta de Doença de Hansen do nosso hospital. Em biopsia de pele e de gânglio identificou-se proliferação linfocitária cujo estudo imunohistoquímico permitiu o diagnóstico de linfoma T com expressão de marcadores citotóxicos. Iniciou quimioterapia verificando-se inicialmente remissão parcial das lesões cutâneas mas posteriormente a progressão da doença sistémica. Abstract in english Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sen [...] sory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.

Maio, Paula; Bento, Diogo; Vieira, Raquel; Afonso, Ana; Sachse, Fernanda; Kutzner, Heinz.

2013-04-01

214

Primary liver AIDS-related lympoma / Linfoma não-Hodgkin primário do fígado em paciente com SIDA  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os linfomas não-Hodgkin (LNH) são as segundas neoplasias mais freqüentes nos pacientes com síndrome da imunodeficiência adquirida (SIDA). A maioria dos LNH associados à AIDS envolvem locais extra-ganglionares, especialmente o trato digestivo e o sistema nervoso central. O linfoma não-Hodgkin primári [...] o do fígado (LPF) é uma neoplasia incomum nestes pacientes. A ultrassonografia (US) e a tomografia computadorizada (TC) podem ser úteis no diagnóstico de linfoma não-Hodgkin hepático apresentando-se como lesões multifocais. A biópsia com agulha fina guiada por imagens (US, TC) juntamente com a histopatologia das lesões do fígado constitui o padrão-ouro para o diagnóstico de linfoma hepático. Este trabalho relata um caso de LPF como manifestação inicial de AIDS em um paciente sem infecção prévia pelo vírus da hepatite C e B, que se apresentou como massas hepáticas múltiplas e de grandes dimensões. Abstract in english Non-Hodgkin's lymphomas (NHL) are the second most frequent malignancies in AIDS patients. The majority of NHL associated with AIDS involves extranodal sites, especially the digestive tract and the central nervous system. Primary liver lymphoma (PLL) is an uncommon neoplasm among these patients. Ultr [...] asonography and computed tomography scans may be helpful in the diagnosis of focal hepatic lymphoma. Image-guided fine-needle biopsy with histopathology of the liver lesions is the gold standard for the diagnosis of hepatic lymphoma. We report a case of PLL as the initial manifestation of AIDS in a patient without any previous infection by hepatitis C or B virus, presented as multiple and large hepatic masses.

Villafañe, María Florencia; Trione, Norberto; Corti, Marcelo; Mendez, Nora; Gancedo, Elisa; Zamora, Norberto; Levin, Marta.

215

Linfoma intra-ocular primário de células tipo B: relato de caso / Primary intraocular B-cell lymphoma: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O linfoma não-Hodgkin primariamente intra-ocular é raro, e caracterizado por uma forma extranodal que pode envolver retina, espaço sub-retiniano, vítreo e nervo óptico. Ocorre independente ou associado ao linfoma do sistema nervoso central e freqüentemente na forma de uveíte de difícil tratamento. E [...] sta forma de linfoma é um dos tumores intra-oculares mais desafiantes de se diagnosticar. Relatamos um caso de linfoma não-Hodgkin intra-ocular difuso de células grandes tipo B numa paciente de 47 anos e cuja manifestação inicial foi uma uveíte posterior; enfatizamos a importância de investigação detalhada e da avaliação sistêmica; pois esta é a forma mais freqüente de acometimento ocular. Com esse relato esperamos abordar os principais aspectos desde quadro clínico até diagnóstico chamando a atenção para essa doença que muitas vezes aparece inicialmente com sintomas vagos e inespecíficos. Abstract in english Ocular non-Hodgkin's lymphoma is a rare condition that can involve the retina, the vitreous and the optic nerve. It can occur alone or can be associated with lymphoma of the central nervous system and a frequent manifestation is a posterior uveitis of difficult treatment. This kind of ocular tumor i [...] s difficult and a challenge to diagnosis. We describe a case of non-Hodgkin's intraocular B-cell lymphoma in a 47-year-old woman who had a posterior uveitis as the first manifestation. We emphasize the importance of a careful investigation and of the general clinical examination since this is the most common type in the eye. We expect to call the attention to this disease that many times appears in an unspecific form with unspecific symptoms.

Marcela, Cypel; Rubens, Belfort Jr.; Nilva, Moraes; Cristina, Muccioli.

216

Linfoma intra-ocular primário de células tipo B: relato de caso Primary intraocular B-cell lymphoma: case report  

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Full Text Available O linfoma não-Hodgkin primariamente intra-ocular é raro, e caracterizado por uma forma extranodal que pode envolver retina, espaço sub-retiniano, vítreo e nervo óptico. Ocorre independente ou associado ao linfoma do sistema nervoso central e freqüentemente na forma de uveíte de difícil tratamento. Esta forma de linfoma é um dos tumores intra-oculares mais desafiantes de se diagnosticar. Relatamos um caso de linfoma não-Hodgkin intra-ocular difuso de células grandes tipo B numa paciente de 47 anos e cuja manifestação inicial foi uma uveíte posterior; enfatizamos a importância de investigação detalhada e da avaliação sistêmica; pois esta é a forma mais freqüente de acometimento ocular. Com esse relato esperamos abordar os principais aspectos desde quadro clínico até diagnóstico chamando a atenção para essa doença que muitas vezes aparece inicialmente com sintomas vagos e inespecíficos.Ocular non-Hodgkin's lymphoma is a rare condition that can involve the retina, the vitreous and the optic nerve. It can occur alone or can be associated with lymphoma of the central nervous system and a frequent manifestation is a posterior uveitis of difficult treatment. This kind of ocular tumor is difficult and a challenge to diagnosis. We describe a case of non-Hodgkin's intraocular B-cell lymphoma in a 47-year-old woman who had a posterior uveitis as the first manifestation. We emphasize the importance of a careful investigation and of the general clinical examination since this is the most common type in the eye. We expect to call the attention to this disease that many times appears in an unspecific form with unspecific symptoms.

Marcela Cypel

2007-08-01

217

LINFOMA CUTÁNEO DE CÉLULAS B TIPO CENTRO FOLICULAR CON INFILTRACIÓN A MÉDULA ÓSEA: REPORTE DE UN CASO / PRIMARY CUTANEOUS FOLLICLE CENTER LYMPHOMA WITH BONE MARROW INFILTRATION: RELATÓRIO DE UM CASO / LINFOMA CUTÂNEO DE CÉLULAS B TIPO CENTRO FOLICULAR COM INFILTRAÇÃO NA MEDULA ÓSSEA  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in portuguese Os linfomas cutâneos primários de células B constituem cerca de 20 a 25% de todos os linfomas. O linfoma cutâneo primário de células B tipo centro folicular é o subtipo mais frequente e manifestase principalmente em pacientes adultos com uma idade média de 58 anos (1), a disseminação extracutânea é [...] muito rara e apresentase com nódulos, tumores ou placas solitárias no grupo usualmente localizados na cabeça ou tronco. Apresentamos o caso de uma paciente com um linfoma primário cutâneo tipo centro folicular com infiltração na medula óssea. Abstract in spanish Los linfomas cutáneos primarios de células B constituyen cerca del 2025% de todos los linfomas. El linfoma cutáneo primario de células B tipo centro folicular es el subtipo más frecuente y se manifiesta principalmente en pacientes adultos con una edad media de 58 años (1), la diseminación extracután [...] ea es muy rara y se presenta con nódulos, tumores o placas solitarios o en grupo usualmente localizados en cabeza o tronco. Presentamos el caso de una paciente con un linfoma primario cutáneo tipo centro folicular con infiltración a médula ósea. Abstract in english Primary B cell cutaneous lymphomas represent approximately 2025% of all lymphomas. Primary cutaneous follicle center lymphoma is the most common subtype occurring in adults with a mean age of 58 years. The disease typically presents with solitary plaques or nodules and is usually located in the head [...] or trunk. Extra cutaneous dissemination is extremely rare. We present a case of a patient with primary cutaneous follicle center lymphoma with bone marrow infiltration.

CLAUDIA MARCELA, ARENAS SOTO; MARÍA LILIANA, MARIÑO ÁLVAREZ; JORGE ENRIQUE, CALDERÓN GÓMEZ; MARÍA ISABEL, GONZÁLEZ C; MARTHA PATRICIA, ROBAYO.

218

Biópsia estereotáxica para linfomas primários do sistema nervoso central Stereotactic biopsy for primary lymphomas of the central nervous system  

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Full Text Available Os linfomas primários do SNC são raros, mas sua incidência tem aumentado nos últimos anos, Estes tumores frequentemente se localizam nos gânglios da base e tálamo ou se apresentam de forma multifocal. O tratamento atual para eles é a radioterapia, associada ou não a quimioterapia. Devido à sua extremamente baixa morbidade, a biópsia estereo-táxica é o método ideal para determinar o diagnóstico histológico em pacientes com suspeita de linfomas do SNC. Os autores apresentam estudo de 49 casos de linfomas primários do SNC, diagnosticado por biópsia estereotáxica.Primary lymphomas of the CNS are rare. However the incidence of these lesions has increased recently. These tumors are often situated in the thalamus and basal ganglia, but can be multifocal. The treatment for primary CNS lymphoma is radiotherapy alone or in association with chemotherapy. Because the associated morbidity is very low stereotactic biopsy is an ideal method for determining the histologic diagnosis in patients with suspected CNS lymphoma. The authors present a study of 49 patients with primary CNS lymphomas in which a stereotactic biopsy was performed.

Murilo S. Meneses

1992-09-01

219

Significado prognóstico dos graus histológicos do linfoma de Hodgkin do tipo esclerose nodular / Prognostic significance of histopathological grading of nodular sclerosing Hodgkin’s lymphoma  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A esclerose nodular (EN), do tipo histológico freqüente do linfoma de Hodgkin (LH), apresenta grande variabilidade em sua composição celular. Na década de 80, pesquisadores do British National Lymphoma Investigation (BNLI) propuseram uma subclassificação histológica do LH EN. Eles identi [...] ficaram dois graus histológicos - o LH EN grau I (LH EN I) e o LH EN grau II (LH EN II) - e demonstraram que os portadores de LH EN II apresentavam menor sobrevida em comparação aos portadores de LH EN I. Outros estudos, entretanto, não reproduziram esses achados. OBJETIVO: Avaliar o significado prognóstico da graduação histológica proposta pelo BNLI. MATERIAIS E MÉTODOS: Estudo retrospectivo que incluiu 69 casos de LH EN. Mais de 90% dos casos foram tratados com terapia combinada ou quimioterapia exclusiva, não havendo diferença no tipo de tratamento oferecido a depender do grau histológico. RESULTADOS: Trinta e cinco casos (51%) foram classificados com EN I e 34 (49%) como EN II. Não observamos diferenças na distribuição de outros fatores prognósticos entre os portadores dos dois graus. Remissão completa após o tratamento inicial foi obtida em 85,7% dos casos de EN I e em 82,4% dos casos de EN II (p = 0,75). A probabilidade estimada de sobrevida global em cinco anos foi de 67% para EN I e de 83,5% para EN II (p = 0,13) e a taxa de sobrevida livre de doença em cinco anos foi de 85,2% versus 87%, respectivamente (p = 0,72). CONCLUSÃO: Nesta população de pacientes uniformemente tratados a graduação histológica BNLI não esteve associada com o prognóstico do LH EN. Abstract in english BACKGROUND: Nodular sclerosis (NS), a frequent histological subtype of Hodgkin’s lymphoma (HL), presents great variability in its cellular composition. In the 80's, researchers of the British National Lymphoma Investigation (BNLI) proposed a histological-based subclassification for NS HL. They ident [...] ified two histological grades - NS HL grade I (NS HL I) and NS HL grade II (NS HL II) - and reported that NS II patients had a lower survival rate in comparison with NS I patients. Others studies, however, did not reproduce these findings. OBJECTIVE: Evaluate the prognostic significance of the BNLI grading system. MATERIAL AND METHOD: We retrospectively studied 69 NS HL patients. More than 90% of the included cases were treated with combined modality therapy or exclusive chemotherapy, the treatment type was not different for NS I and NS II patients. RESULTS: Thirty-five cases (51%) were classified as NS I and 34 (49%) as NS II. We did not observe significant differences in the distribution of other prognostic factors between the two NS grades. The complete remission rate after initial therapy was 85.7% in the NS I group and 82.4% in the NS II group (p = 0.75). The predicted 5-year overall survival rate was 67% in the NS I patients and 83.5% in the NS II patients (p = 0.13). The predicted 5-year disease free survival rate for NSI and NSII patients was 85.2% and 87%, respectively (p = 0.72). CONCLUSION: The histological BNLI grading system was not associated with the prognosis of this uniformly treated NS LH population.

Luís Fernando, Pracchia; Valeria, Buccheri; Yara de, Menezes; Sheila A. C., Siqueira; Nair Sumie, Mori; Dalton Alencar Fisher, Chamone.

220

Percutaneous removal of intravascular foreign bodies by a modified loop-snare technique  

International Nuclear Information System (INIS)

Successful percutaneous removal of embolized intravenous catheters in two patients is described. The long duration of intravascular presence of the foreign bodies necessitated an adaptation of the familiar loop-snare technique. Percutaneous, transluminal retrieval is the method of choice for the removal of intravascular foreign bodies and should be performed in preference to surgical management whenever possible. (orig.)

1988-01-01

 
 
 
 
221

Genome Sequence of Staphylococcus epidermidis Strain AU12-03, Isolated from an Intravascular Catheter  

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In recent years, Staphylococcus epidermidis has become a major nosocomial pathogen and the most common cause of intravascular catheter-related bacteremia, which can increase morbidity and mortality and significantly affect patient recovery. We report a draft genome sequence of Staphylococcus epidermidis AU12-03, isolated from an intravascular catheter tip.

Zhang, Li; Morrison, Mark; O? Cui?v, Pa?raic; Evans, Paul; Rickard, Claire M.

2012-01-01

222

Linfomas de la órbita y anexos oculares: Correlación clínico patológica de 25 casos Orbital and ocular adnexal lymphomas: Clinico-pathological correlation in 25 cases  

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Full Text Available Se evaluaron las características clínicas, histológicas y la evolución de una cohorte de pacientes con linfomas de la órbita y anexos oculares. Entre 1995 y 2008 se estudiaron 25 casos de linfomas de la órbita y anexos oculares en un centro oncológico de referencia. En cada caso se analizó el inmunofenotipo usando un panel de anticuerpos monoclonales (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138. Las lesiones fueron evaluadas utilizando el sistema de clasificación de linfomas (OMS, 2008. Se analizaron 23 linfomas primarios y dos secundarios. Los subtipos histológicos fueron: 16 linfomas B de la zona marginal asociados a las mucosas (MALT, cuatro linfomas difusos de células grandes B, dos linfomas foliculares y un paciente con linfoma Hodgkin. De los 25 casos estudiados, 22 presentaron estadios localizados. El linfoma MALT fue el subtipo más frecuente. En este estudio se observó enfermedad localizada en la mayoría de los casos y con baja progresión a distancia.Clinical, histological features and outcome of a cohort of patients with orbital and adnexal lymphoproliferative tumors were evaluated. Twenty-five cases in an oncologic referral center from 1995 to 2008, were included in the study. Each case had detailed immunophenotypic analysis using a panel of monoclonal antibodies (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138. Lesions were classified by using WHO (2008 lymphomas classification. Twenty-three patients were found to have primary and two secondary lymphomas. Histological subtypes were: 16 patients with marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma, four diffuse large B cell lymphomas, two mantle cell lymphomas, two follicular lymphomas, and one Hodgkin lymphoma. Among the 25 patients studied, 22 had localized stage. Extranodal marginal zone lymphoma was the most frequent type of primary orbital and adnexal lymphoma. In this study localized disease was observed in most cases, and distant spread of the lymphomas was infrequent.

Erica A. Rojas Bilbao

2010-08-01

223

Focal Renal Arterial Fibromuscular Dysplasia Demonstrated via Intravascular Ultrasound Image.  

Science.gov (United States)

A young male suffering from renovascular hypertension was admitted. His initial arteriogram highlighted a focal stenosis of the right renal artery. His intravascular ultrasound (IVUS) revealed increasing medial layer thickness accompanied by a mixture of both high and low echoic materials in this layer. There was also mild thickening of the intimal layer. The diagnosis of medial fibroplasia and intimal fibromuscular dysplasia (FMD) was made. Balloon angioplasty decreased the volume of dysplastic tissue. The IVUS images facilitated both the initial diagnosis of focal renal arterial stenosis and the evaluation of the mechanism of dilatation by angioplasty. PMID:23555464

Ogawa, Osamu; Watanabe, Ritsuo; Shimizu, Hiroshi; Masani, Fumiaki

2011-01-01

224

Histamine release and endothelial leakage from an intravascular contrast medium  

International Nuclear Information System (INIS)

The endothelial injury produced by meglumine iodamide was studied in the rat aorta. A mixture of blood and contrast medium was more toxic to the endothelium than the pure contrast agent. This difference disappeared after premedication with antihistamine, which did not affect the injury produced by the pure contrast agent. Meglumine iodamide appears to cause a release of histamine from blood but not from the aortic endothelium nor from surrounding tissues in amounts demonstrable by this method. Leucocytes are a source of histamine after intravascular contrast medium administration. (orig.)

1981-01-01

225

Histamine release and endothelial leakage from an intravascular contrast medium  

Energy Technology Data Exchange (ETDEWEB)

The endothelial injury produced by meglumine iodamide was studied in the rat aorta. A mixture of blood and contrast medium was more toxic to the endothelium than the pure contrast agent. This difference disappeared after premedication with antihistamine, which did not affect the injury produced by the pure contrast agent. Meglumine iodamide appears to cause a release of histamine from blood but not from the aortic endothelium nor from surrounding tissues in amounts demonstrable by this method. Leucocytes are a source of histamine after intravascular contrast medium administration.

Raininko, R.

1981-04-01

226

Method for Observing Intravascular BongHan Duct  

CERN Document Server

A method for observing intra blood vessel ducts which are threadlike bundle of tubules which form a part of the BongHan duct system. By injecting 10% dextrose solution at a vena femoralis one makes the intravascular BongHan duct thicker and stronger to be easily detectable after incision of vessels. The duct is semi-transparent, soft and elastic, and composed of smaller tubules whose diameters are of 10$\\mu$m order, which is in agreement with BongHan theory.

Jiang, X; Shin, H; Lee, B; Choi, C; Soh, K; Cheun, B; Baik, K; Soh, K; Jiang, Xiaowen; Kim, Hee-kyeong; Shin, Hak-soo; Lee, Byong-chon; Choi, Chunho; Soh, Kyung-soon; Cheun, Byeung-soo; Baik, Ku-youn; Soh, Kwang-sup

2002-01-01

227

Insuficiencia suprarrenal causada por un linfoma no-Hodgking B primario suprarrenal: presentación de un caso y revisión de la literatura / Adrenal faillure caused by primary adrenal non-hodgking lymphoma: a case report and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos el caso de un varón de 78 años que ingresa por un cuadro de debut de insuficiencia suprarrenal. Se realizó un estudio TC que mostró masas suprarrenales bilaterales de hasta 10 cm. Se completó estudio con biopsia percutanea de masa suprarrenal y biopsia de médula ósea, siendo diagnosticad [...] o de Linfoma no Hodgkin B difuso de células grandes primario suprarrenal con afectación suprarrenal bilateral. El paciente fue tratado con quimioterapia según esquema R-CHOP (Rituximab, Ciclofosfamida, Doxorrubicina liposomal, Vincristina y Prednisona). Tras 4 ciclos de quimioterapia se objetivo una respuesta parcial radiológica. Se suspendió la quimioterapia por toxicidad grado IV, completándose el tratamiento con RT sobre masa suprarrenal derecha. El paciente falleció por cuadro séptico pocos días después de finalizar la radioterapia, sin objetivarse progresión de la enfermedad. Abstract in english We report a case of 78-year old man who presented with symptoms of adrenal insufficiency. The computed tomography (CT) scan showed the presence of bilateral adrenal masses. A CT-scan guided needle biopsy revealed diffuse large- B cell lymphoma. The absence of pathological findings in clinical, bone [...] marrow and CT scan examinations supported the diagnosis of primary non- Hodgkin Lymphoma of the adrenal glands. The patient was treated with four cycles of R-CHOP chemotherapy with Rituximab, liposomal Doxorubicin, Cyclophosphamide, Vincristine and Prednisolone. At the end of fourth cycle there was radiological improvement but the chemotherapy was stopped because of IV grade toxicity. He completed treatment with radiotherapy of right adrenal mass. Few days after finishing radiation therapy the pacient died due to a disseminated infection. No progressive disease was founded.

Hernández Marín, B.; Díaz Muñoz de la Espada, V.M.; Álvarez Álvarez, R.; Encinas García, S.; Khosravi Shahi, P.; Pérez Fernández, R.; Pérez Manga, G..

228

Los tratados silogísticos de Boecio y su interdependencia temática  

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Full Text Available En este artículo se discuten las más importantes hipótesis modernas que han intentado explicar la interrelation doctrinal que los tratados silogísticos escritos por Boecio tienen entre sí, el De sylhgismo categórico y la Introductio ad syllogismos categóricos. Se revisan las hipótesis que señalan una dependencia fuerte entre ambos tratados y también las que apuntan hacia una dependencia más débil y, luego de criticar estas posiciones, la discusión abre la posibilidad cierta de que los tratados tengan objetos temáticos diferentes y estén relacionados de una manera más extrínseca que lo que se había creído hasta aquí, ya que el segundo de ellos estaría pensado como un complemento al primero. El argumento se basa tanto en la manifiesta falta de utilidad que los términos indefinidos tendrían en las premisas silogísticas como en la casi nula noticia de que, alguna vez en la antigüedad, se desarrolló una silogística con términos indefinidos en las premisas.In this article, the most important hypotheses concerning the doctrinal relation between Boethius' two syllogistic treatises are discussed: De syllogismo categórico and the Introductio ad syllogismos categóricos. By means of a review of both, I discard the hypothesis pointing out a strong dependence and the other hypotheses resting on a weaker dependence. I conclude that the relation between both treatises is more extrinsic than what has been believed up to here, because the second treatise is thought to be an appendage of the first one. The argument is supported on both the apparent lack of utility in using indefinite terms in the premises of a syllogism and the almost entirely absence of textual evidences that a syllogistic with indefinite terms in the premises was developed some time in ancient times.

Manuel Correia

2009-01-01

229

Retinal and choroidal intravascular spectral-domain optical coherence tomography  

DEFF Research Database (Denmark)

Purpose:â?? To examine retinal and choroidal blood vessels using spectral-domain optical coherence tomography (SD-OCT). Methods:â?? Retrospective case series. Results:â?? Scans through retinal blood vessels in healthy subjects demonstrated vessel wall reflexes and a tri-layer profile of the blood column on longitudinal scans and a figure-of-eight configuration on cross-sectional scans. Intravascular reflectivity decreased with increasingly oblique angles of observation and was absent when blood flow was parallel to the line of sight. The high blood flow in the choroidal vessels in healthy subjects and the low flow in the retinal vessels in patients with ocular ischaemic syndrome and central retinal artery occlusion were both associated with lower reflectivity of the blood and an unstructured intravascular SD-OCT profile. Discussion:â?? This qualitative in vivo study found a characteristically structured SD-OCT profile of the blood column in retinal vessels with normal blood flow. Both structure and total reflectivityfaded when blood flow was lower or higher than normal or at oblique angles to the line of sight. In conclusion, SD-OCT scans of the vessels in the posterior pole of the eye may assist the clinical assessment of gross abnormalities of ocular blood flow, e.g. in carotid artery stenosis.

Willerslev, Anne; Li, Xiao Q

2013-01-01

230

Late adverse reactions to intravascular iodinated contrast media  

International Nuclear Information System (INIS)

Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

2003-01-01

231

Intravascular hemolysis in the late course of aortic valve.  

Science.gov (United States)

The degree of intravascular hemolysis was evaluated in 315 patients in the late course of aortic valve replacement. Starr-Edwards aortic ball valves of series 2300 caused significantly more hemolysis than did those of series 1200, as estimated from the serum lactate dehydrogenase levels. Smaller valves of series 2300 caused a higher degree of hemolysis than did the larger ones. Aortic disc valves induced a more moderate red cell destruction than did the ball valves, the Lillehei-Kaster significantly more than the Bjørk-Shiley prostheses. Crushing of red cells is thought to be a more important cause of hemolysis than shearing forces in turbulent blood. Hemolytic anemia represented a problem only in some patients with Starr-Edwards valve type 2300, although iron substitution was necessary also in some with other prostheses, since the hemoglobin-binding capacity of haptoglobin was exceeded in several patients. Valvular or paravalvular leakage was associated with stronger hemolysis in some patients, and should be suspected whenever the rate of red cell destruction increases. Longstanding intravascular hemolysis did not seriously affect renal function. PMID:655106

Dale, J; Myhre, E

1978-07-01

232

Development of {sup 192}Ir radiation sources for intravascular irradiation  

Energy Technology Data Exchange (ETDEWEB)

Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing {sup 192}Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten {sup 192}Ir seed sources ({phi}0.4 mm x 2.5 mm) were positioned between nylon spacers ({phi}0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production method of the radiation source, which is practical to use in the clinics was also established. (author)

Kogure, Hiroto; Sorita, Takami; Iwamoto, Seikichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Nagata, Yasushi; Hiraoka, Masahiro [Kyoto Univ., Kyoto (Japan); Iwata, Kazuro [Nara Medical Univ., Nara (Japan); Kawauchi, Yukimasa; Suzuki, Kazutoshi [Chiyoda Technol Corp., Tokyo (Japan)

2003-03-01

233

Development of 192Ir radiation sources for intravascular irradiation  

International Nuclear Information System (INIS)

Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing 192Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten 192Ir seed sources (?0.4 mm x 2.5 mm) were positioned between nylon spacers (?0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production method of the radiation source, which is practical to use in the clinics was also established. (author)

2003-01-01

234

Correlación clinicopatológica de las alteraciones hepáticas en las autopsias de pacientes con linfomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se revisaron las alteraciones histopatológicas del hígado en las necropsias de 71 pacientes con linfomas malignos, 24 con enfermedad de Hodgkin (EH) y 47 con linfomas no Hodgkin (LNH). Se constató la infiltración linfomatosa en 6 pacientes (8 %) en la biopsia hepática inicial y en 44 (62 %) en las n [...] ecropsias y este último hallazgo fue mayor en la EH (16/24,67 %) que en los LNH (28/47,60 %). Se encontraron sólo 8 fallecidos (11 %) que no tenían ninguna alteración y 19 (27 %) presentaron alteraciones histológicas no infiltrativas, aisladas o combinadas. Se observaron la fibrosis y la necrosis con una frecuencia significativamente mayor en la EH (16/24,67 % p = 0,0000 y 13/24,54 %, p = 0,0208) y se sugirió la posibilidad de que la enfermedad tenga un papel patogénico en las mismas. Se comprobó que la congestión y la esteatosis tuvieron mayor incidencia en los LNH (28/47,60 % y 24/47,49 %) y que la congestión fue la alteración inespecífica más frecuente en todos los pacientes (53,5 %) seguida de la necrosis (45 %). No hubo correlación entre los hallazgos histológicos de las necropsias con el estado de la enfermedad, presencia de visceromegalia, infiltración hepática inicial y terapéutica y tampoco se evidenció interacción entre diagnóstico y extensión de la enfermedad con respecto a las alteraciones histológicas. Se confirmó el incremento de la infiltración hepática con la progresión de la enfermedad en los pacientes con linfomas malignos y que 85 % de estos casos tiene algún tipo de alteración histopatológica en el hígado, infiltrativas y no infiltrativas, al momento del fallecimiento. Abstract in english Liver histopathological alterations were examined in 71 autopsies of patients with malignant lymphomas of whom 24 had Hodgkin´s disease (HD) and 47 non Hodgkin´s lymphomas. Lymphomatous infiltration was observed in 6 patients by initial liver biopsy (8 %) and in 44 patients by autopsies [...] (62 %). This condition was higher in HD with 16 out of 24 patients (67 %) than in NHL with 28 out of 47 patients (60 %). Only 8 deceased (11 %) did not present any kind of alterations whereas 19 (27 %) had non-infiltrating histological alterations either isolated or combined. Frequency of fibrosis and necrosis was observed to be significantly higher in HD with 16 out of 24 patients (67 %, p = 0.0000) and 13 out of 24 patients (54 %), p = 0.0208) respectively, thus it was suggested that this disease is likely to have a pathogenic role in both processes. It was proved that congestion and steatosis had higher incidence on NHL with 28 out of 47 patients (60 %) and 24 out of 47 patients (49 %) respectively and that congestion was the most frequent non-specific alteration in all patients (53.5 % followed by necrosis (45 %). Neither correlation between histological findings from autopsies and disease status, visceromegaly, initial and therapeutical hepatic infiltration nor interaction between disease lenght and diagnosis, and histological alterations were found. It was confirmed that the increase of hepatic infiltration was linked to the course of the disease in patients with malignat lymphomas and that 85 % of these cases had some type of histopathological alteration either infiltrating or non-infiltrating in the liver at the time of their death.

Spec Frías, Ariel; Carnot Uria, José; Domínguez Álvarez, Carlos; Castro Arenas, Raúl; Muñio Perurena, Jorge; Pérez Román, Guillermo.

235

Actividad laboral en una cohorte de pacientes con linfoma non Hodgkin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción. La actividad laboral en el cáncer es un aspecto psicosocial que ha recibido poca atención hasta el momento actual, a pesar de considerarse una dimensión de la calidad de vida para estos pacientes. Objetivos. La reinserción y adaptación al entorno laboral fueron investigados en una coho [...] rte de pacientes con linfoma no Hodgkin para describir los factores que influyen en la vuelta al trabajo de estos enfermos. Pacientes y métodos. El estudio incluyó 37 pacientes consecutivos diagnosticados de un linfoma no Hodgkin y empleados en el momento del diagnóstico. El cuestionario incluyó aspectos epidemiológicos, clínicos y laborales (32 variables en total). El estudio fue aprobado por el Comité Ético y de Investigación Cínica del Hospital La Paz. Todos los pacientes dieron su consentimiento para participar en el estudio y para la utilización de los datos de su historia clínica. Resultados. El 86,5% de los pacientes pasaron a inactivos tras comenzar el tratamiento de la enfermedad y un 32,5% lo seguían estando tras éste. No hubo diferencias en la influencia de las distintas variables analizadas con respecto a la actividad laboral tras el diagnóstico. Sin embargo, el realizar un trabajo predominantemente físico y la presencia de secuelas derivadas del tumor o del tratamiento de éste, sí influyeron en la reinserción laboral una vez finalizado el tratamiento específico. La mayoría de los pacientes no creían que el tener la enfermedad les perjudicaría en su puesto de trabajo y, en casi todos los casos, tanto sus compañeros como sus jefes conocían que tenían un tumor. Conclusiones. Éste es el primer estudio exploratorio en nuestro país acerca de la reinserción laboral de los pacientes diagnosticados de un linfoma. Son necesarios más trabajos para establecer las dificultades que tienen este tipo de enfermos en la reinserción laboral y establecer las medidas adecuadas para la mejora de este proceso. Abstract in english Background. Cancer affects many dimensions determining quality of life, including work. However, the importance of work to cancer survivors has received little attention. Aim. Employment and work-related disability were investigated in a cohort of non-Hodgkin´s lymphoma patients to describe a possib [...] le discrimination and other work issues. Patients and Methods. The study included consecutively 37 non-Hodgkin´s lymphoma patients who were employed at diagnosis. The questionnaire included cancerrelated symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face and 32 variables were recorded. The study was approved by the Ethical Committee of Hospital La Paz. All patients gave consent to participate. Results. Eighty six per cent of patients were unable to work after diagnosis, but 68% returned to work at the end of treatment. The type of worker and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. None reported job discrimination. Conclusions. This is the first exploratory study in Spain about labour reintegration in non-Hodgkin´s lymphomas. Further studies are necessary.

R., Molina Villaverde; J., Feliu Batle; A., Villalba Yllan; A.M., Jiménez Gordo; B., San José Valiente; M., González Barón.

236

Linfoma primário do sistema nervoso central / Primary central nervous system lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O linfoma primário do sistema nervoso central (LPSNC) é um linfoma extralinfonodal que, ao diagnóstico, encontra-se restrito ao parênquima cerebral, às meninges e/ou cordão espinhal e/ou olhos. Sua incidência triplicou nas últimas três décadas para 0,4 casos por 100.000 habitantes, representando 4% [...] dos tumores do sistema nervoso central (SNC). Embora pacientes infectados pelo HIV tenham 3.600 vezes maior risco para o desenvolvimento do LPSNC, a incidência não aumentou apenas neste grupo de pessoas. Dados sugerem reduções da incidência de LPSNC em pacientes infectados após a introdução de drogas anti-retrovirais. Cerca de 90% dos casos de LPSNC são classificados como linfoma difuso de grandes células B, 10% têm envolvimento ocular e 10% são HIV positivos. A apresentação clínica depende da localização tumoral, prevalecendo os sintomas neurológicos em detrimento aos sistêmicos. Os exames de tomografia computadorizada (TC) e ressonância nuclear magnética (RNM) são essenciais para o diagnóstico, porém o exame confirmatório deve ser o anatomopatológico. O estadiamento deve ser feito com exames de imagem e biópsia de medula óssea (BMO) bilateral. Os principais fatores de mau prognóstico são: performance status do paciente acima de 1, idade superior a 60 anos, DHL elevada, hiperproteinorraquia e acometimento de área cerebral não hemisférica. Alguns fatores de prognóstico biológicos também podem influenciar na sobrevida, a exemplo da expressão de Bcl-6, que confere melhor prognóstico. O tratamento de escolha é a combinação de quimioterapia contendo altas doses de metotrexate e radioterapia (RDT). Devido às altas taxas de neurotoxicidade associada à RDT, seu uso tem ficado mais restrito aos pacientes idosos, e os recidivados ou refratários. Abstract in english Primary Central Nervous System lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma in the brain, leptomeninges, spinal cord or eyes. The incidence of PCNSL increased approximately three-fold in the last decades. Nowadays, it represents 0.4 case per 100,000 people and accounts for 4% of all primar [...] y brain tumors. Although individuals infected with HIV have a 3,600-fold increased risk of developing PCNSL compared with the general population, the incidence has not increased only in AIDS group. Recent data suggest that the incidence of PCNSL declined in the AIDS group after the introduction of anti-retroviral drugs. Around 90% of PCNSL cases are classified as diffuse large B-cell lymphoma, 10% involve the eyes and 10% of patients are HIV positive. The clinical presentation depends on the location of the tumor with neurological rather than systemic symptoms. Computed tomography (CT) and magnetic resonance imaging (RMI) are essential in diagnosis, however the gold standard is tumor biopsy. Staging should be made with imaging and bilateral biopsy of bone marrow. The main poor prognosic parameters are performance status greater than 1, age older than 60 years, elevated DHL, high liquor protein concentration and tumor located within the deep regions of the brain. BCL-6 expression identified in the tumor confers a better prognosis. Currently, a combined therapy with high doses of methotrexate and whole-brain radiotherapy is the therapy of choice. Nowever, whole-brain radiotherapy should be carefully analyzed because neurotoxity is a frequent problem in the elderly and in relapsed and refractory patients.

Bellesso, Marcelo; Bizzetto, Renata; Pereira, Juliana; Beitler, Beatriz; Pracchia, Luis Fernando; Chamone, Dalton A. S..

237

Linfoma no hodgkin difuso Virus de inmunodeficiencia humana: Uso del factor estimulante de colonia de granulocitos  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish OBJETIVO: El uso rutinario de factor estimulante de colonias de granulocitos y macrófagos por 10 días durante el tratamiento con dosis completas de ciclofosfamida, doxorrubicina, vincristina, prednisona en pacientes con linfoma no Hodgkin difuso asociado a la infección por el virus de inmunodeficien [...] cia es muy costoso para ser financiado en países del tercer mundo. El objetivo del presente trabajo es evaluar la forma más adecuada de indicar este factor estimulante. MÉTODOS: Tratamos 22 pacientes con linfoma no Hodgkin difuso asociado a la infección por virus de inmunodeficiencia con dosis estándar del esquema de quimioterapia antes mencionado, usamos el factor estimulante de colonias después de un episodio de neutropenia febril hasta alcanzar una cifra absoluta de neutrófilos de 1 000/mm3. RESULTADOS: Obtuvimos una respuesta clínica: completa (36 %), parcial (32 %), enfermedad estable (14 %) y progresión (18 %). No hubo muertes relacionadas con la toxicidad. Neutropenia grado 3 ó 4 se observó en el 16 % de los ciclos, 8 % de los pacientes se complicaron con neutropenia febril. Diecisiete pacientes han muerto (sobrevida media 15 meses; rango, 2-70 meses). Cinco pacientes están vivos (sobrevida media 24+ meses; rango, 17 - 36+ meses). CONCLUSIONES: Podemos tratar pacientes con linfomas no Hodgkin asociados a la infección de virus de inmunodeficiencia con dosis completas de quimioterapia, alcanzar una buena respuesta tener un excelente perfil de toxicidad, con la utilización de factor estimulante de colonias de acuerdo a la necesidad y no de uso rutinario. Abstract in english OBJECTIVE: The routine use of stimulant colonies factor of macrophages and granulocytes for 10 days during complete treatment doses of ciclofosfamide doxorubicin vincristine and prednisone in patients with lymphomas diffuse no Hodgkin immune deficiency virus acquired associated is very expensive to [...] be financiered in the third world countries. The main objective of this paper is to define the more rational use of this stimulant factor. METHODS: We treated 22 patients with lymphomas diffuse no Hodgkin associated with virus immune deficiency acquired with standard dose of the chemotherapy regimen before mention for us, and the used of stimulant colonies factor after an episode of febrile neutropenia until the neutrophilos achieved and absolute count of 1 000/mm3. RESULTS: A clinical response was obtained: complete response (36 %), partial response (32 %), stable disease (14 %) and progression (18 %). There was no death related with the toxicity. Grade 3 or 4 neutropenia was observed in 16 % of the cycles but only 8% of the patients were complicated with febrile neutropenia. Seventeen patients were died (median survival 15 months; range, 2 - 70 months). There are five patients still alive (median survival 24+ months; range, 17 - 36+ months). CONCLUSIONS: Our experience showed that we can treat lymphoma no Hodgkin diffuse associated with immune deficiency acquired virus with complete dose of chemotherapy, achieve good responses and have excellent and acceptable toxicity profile, with the use of stimulant colonies factors as needed and not for routine.

Hernández, Dimas.

238

Linfoma malt gastrico: Presentación de un caso y revision de literatura  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Escolar masculino de 9 años, con mielomeningocele corregido e hidrocefalia, enfermedad actual de 3 años de evolución, caracterizada por epigastralgia intermitente, recibe tratamiento sin mejoría. Dos días antes del ingreso se asocian vómitos, hematemesis y fiebre. Al examen físico, signos de desnutr [...] ición crónica, anemia, hepatomegalia y dolor en epigastrio. Se realiza endoscopia digestiva superior, revela reflujo gastroesofágico, tumoración gástrica ulcerada y duodenitis inespecífica; se realizan ecosonograma abdominal, Rx esófago-estomago-duodeno contrastado y tomografía abdominal, donde se evidenció tumor en antro pilórico de 6 por 7 cm, estenosante y distensión gástrica. Recibe hemoderivados, por anemia aguda. Se realiza laparotomía exploradora, se evidencia gran tumoración friable, se extraen muestras para biopsia gástrica que reveló fragmento fibroadiposo con inflamación crónica y granulosa, reacción gigantocelular de tipo Langhans y tipo cuerpo extraño, necrosis y reagudización focal, las biopsias de ganglios, hígado y epiplón revelaron signos de inflamación crónica multifocal. Hemocultivos negativos, Anticore y Antigeno de superficie VHB negativos, PCR para CMV, estudio para BK y hongos negativos, examen de heces Blastocystis hominis, títulos de IgG contra Helicobacter pylori positivo 1.61 U/L, se inicio terapia con Metronidazol, Claritromicina y Omeprazol VEV, con remisión del tumor gástrico, todo lo cual sugiere Linfoma MALT gástrico o MALTOMA. Abstract in english Masculine student of 9 years, with mielomeningocele correted and hydrocephaly, present disease of 3 years of evolution, characterized by intermittent epigastralgia, receives treatment without improvement. Two days before the entrance vomits, hematemesis and fever are associated. To the physical exam [...] ination, signs of chronic undernourishment, anemia, hepatomegalia and pain in epigastrio. Superior digestive endoscopia is made, reveals gastroesfágico ebb tide, ulcerada gastric tumoración and unspecific duodenitis; ecosonograma abdominal, Rx resisted esophagus-stomach-duodeno and tomography abdominal are made, where it demonstrated tumor in pyloric caven of 6 by 7 cm, estenosante and gastric distension. It receives hemoderivados by acute anemia. Exploratory laparotomía is made, demonstrated great coldable tumoración, samples for gastric biopsy are extracted that revealed fibroadiposo fragment with chronic and granular inflammation, reaction to gigantocelular of Langhans type and type strange body, necrosis and focal reagudización, the biopsies of ganflia, liver and epiplón revealed signs of multifocal chronic inflammation. Hemocultivos negative, Anticore and Antigeno of surface VHB negative, negative PCR for CMV, study for BK and fungi, examination Blastocystis hominis and Giardia lamblia positive, titles of IgG and biopsy Helicobacter pylori positive , beginning therapy with Metronidazol, Clarotromicina and Omeprazol VEV, remission of the gastric tumor, which suggests gastric Linfoma MALT or MALTOMA.

Mariela, Hernández; Yubisay, Rosendo; Fabiola, Cordero; Margarita, Vásquez; Cesar, Delgado; Iraheny, Alvirez.

239

Linfoma nasal de células T/NK / Nasal T/NK cell lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El linfoma nasal de células T/ natural killer (NK) (LNT/NK), tras haber recibido múltiples denominaciones, ha sido definido y caracterizado en el año 2001 por la Organización Mundial de la Salud (OMS), basándose en una clasificación previa de la Revised European-American Lymphoma Classification (REA [...] L), de la manera en que se le conoce actualmente. Su incidencia en el mundo occidental es baja, mientras que en Asia supone el segundo grupo de linfomas más frecuente, tras los gastrointestinales. Se localiza preferentemente en las fosas nasales y senos maxilares, mostrando un curso clínico agresivo, definido por una destrucción de los tejidos circundantes. Su diagnóstico definitivo se realiza por medio de técnicas de hibridación in situ, llegando a la determinación de su inmunofenotipo. Se ha observado una frecuente asociación con el virus de Epstein-Barr (VEB). El pronóstico de esta enfermedad viene definido por el índice pronóstico internacional (IPI) y por el volumen alcanzado por el tumor. A pesar de ser radiosensible, su pronóstico es infausto, aconteciendo la muerte del paciente poco tiempo después del diagnóstico, generalmente como consecuencia de las complicaciones del tratamiento. Abstract in english Nasal T-cell and Natural Killer cell lymphoma (NT/NKL), having been given many names, was defined and described in the year 2001 by the World Health Organization (WHO), on the basis of a previous classification by the Revised European-American Lymphoma Classification (REAL) as it is known today. Its [...] incidence in the western world is low, while in Asia it represents the second most frequent group of lymphomas, followed by the gastrointestinal [lymphoma]. It is typically located in the nasal cavity and maxillary sinuses. It is associated with an aggressive clinical course, characterized by the destruction of surrounding tissue. The definitive diagnosis is made by means of in situ hybridization techniques, in order to determine the immunophenotype. Its association with the Epstein-Barr virus (EBV) has frequently been observed. The prognosis of this disease is determined by the International Prognosis Index (IPI) and by the size of the tumor. In spite of being responsive to irradiation therapy, its prognosis is gloomy, and the death of the patient occurs shortly after the diagnosis, generally as a result of treatment complications.

A., Torre Iturraspe; S., Llorente Pendás; J.C. de, Vicente Rodríguez; L.M., Junquera Gutiérrez; J.S., López-Arranz Arranz.

240

Linfoma nasal de células T/NK Nasal T/NK cell lymphoma  

Directory of Open Access Journals (Sweden)

Full Text Available El linfoma nasal de células T/ natural killer (NK (LNT/NK, tras haber recibido múltiples denominaciones, ha sido definido y caracterizado en el año 2001 por la Organización Mundial de la Salud (OMS, basándose en una clasificación previa de la Revised European-American Lymphoma Classification (REAL, de la manera en que se le conoce actualmente. Su incidencia en el mundo occidental es baja, mientras que en Asia supone el segundo grupo de linfomas más frecuente, tras los gastrointestinales. Se localiza preferentemente en las fosas nasales y senos maxilares, mostrando un curso clínico agresivo, definido por una destrucción de los tejidos circundantes. Su diagnóstico definitivo se realiza por medio de técnicas de hibridación in situ, llegando a la determinación de su inmunofenotipo. Se ha observado una frecuente asociación con el virus de Epstein-Barr (VEB. El pronóstico de esta enfermedad viene definido por el índice pronóstico internacional (IPI y por el volumen alcanzado por el tumor. A pesar de ser radiosensible, su pronóstico es infausto, aconteciendo la muerte del paciente poco tiempo después del diagnóstico, generalmente como consecuencia de las complicaciones del tratamiento.Nasal T-cell and Natural Killer cell lymphoma (NT/NKL, having been given many names, was defined and described in the year 2001 by the World Health Organization (WHO, on the basis of a previous classification by the Revised European-American Lymphoma Classification (REAL as it is known today. Its incidence in the western world is low, while in Asia it represents the second most frequent group of lymphomas, followed by the gastrointestinal [lymphoma]. It is typically located in the nasal cavity and maxillary sinuses. It is associated with an aggressive clinical course, characterized by the destruction of surrounding tissue. The definitive diagnosis is made by means of in situ hybridization techniques, in order to determine the immunophenotype. Its association with the Epstein-Barr virus (EBV has frequently been observed. The prognosis of this disease is determined by the International Prognosis Index (IPI and by the size of the tumor. In spite of being responsive to irradiation therapy, its prognosis is gloomy, and the death of the patient occurs shortly after the diagnosis, generally as a result of treatment complications.

A. Torre Iturraspe

2005-04-01

 
 
 
 
241

Alterações histológicas e imunoistoquímicas em pâncreas de ratos normais e diabéticos tratados com Syzygium cumini  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Avaliou-se o efeito da administração oral do extrato da casca de Syzygium cumini sobre o pâncreas de ratos normais e diabéticos. Os animais foram divididos em grupo controle (C), controle tratado (CT), diabético controle (DC) e diabético tratado (DT). Os tratados receberam dose diária de 1g kg-1 de peso vivo, durante 30 dias. Os animais foram submetidos à eutanásia e o pâncreas retirado para análise histológica e imunoistoquímica para insulina. Neste estudo observou-se uma diminu...

2004-01-01

242

Análise de achados de imagem e alterações clínicas em pacientes com linfoma Analysis of imaging findings and clinical abnormalities in patients with lymphoma  

Directory of Open Access Journals (Sweden)

Full Text Available A tomografia computadorizada é atualmente o estudo de imagem de escolha para a detecção e estadiamento de linfomas. A tomografia computadorizada é capaz de mensurar com acurácia significativa a extensão e o volume do tumor e prover informações que possam ser usadas para planejar uma estratégia terapêutica apropriada. O presente trabalho teve como objetivo descrever e analisar os achados de imagem obtidos por meio de tomografia computadorizada de tórax e abdome, acompanhada de ultra-sonografia de abdome total de pacientes com diagnóstico de linfoma e com sorologia negativa para o vírus HIV, alterações clínicas, como a queixa que levou o paciente a procurar o serviço de saúde, já revelando sinais de acometimento da doença linfocitária, neste momento ainda não diagnosticada, e alterações ao exame físico nesta primeira consulta. A amostra estudada foi composta por 30 pacientes, sendo que, destes, 40% teriam o diagnóstico de linfoma não-Hodgkin, 46,6% de linfoma Hodgkin, 10% de linfoma de Burkitt e 3,3% com o diagnóstico de linfoma linfoblástico.Computed tomography is currently the method of choice for the diagnosis and staging of lymphomas. Computed tomography enables accurate measurement of both tumor extent and volume and provides information that can be used to plan an appropriate strategy for the treatment. The purpose of the present article is to describe and analyze the chest and abdomen computed tomography and ultrasound findings in HIV-negative patients with lymphoma. Clinical abnormalities, such as the reason the patient sought medical assistance already showing evidence of lymphocytic disease (not yet diagnosed at this point and the physical examination abnormalities seen on the first consultation were also studied. This study comprised 30 patients: 40% with non-Hodgkin lymphoma, 46.6% with Hodgkin lymphoma, 10% with Burkitt's lymphoma and 3.3% with lymphoblastic lymphoma.

Flávio Augusto Ataliba Caldas

2002-03-01

243

Intercambio de Comercio Agroalimentario entre Canadá y México bajo el Tratado de Libre Comercio  

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Full Text Available Este ensayo enlista y describe el intercambio de productos de comercio agro-alimentario entre Canadá y México bajo el Tratado de Libre Comercio de Norte América. (NAFTA: iniciales en inglés. Aquí se presenta una descripción en detalle de las barreras existentes de la estructura de dicho tratado ( tanto previas como posteriores . Se ha encontrado que bajo este nuevo tratado, el intercambio en la mayoría de los sectores del comercio agro-alimentario ha crecido significativamente. Este documento nos dice que el TLC ( Tratado de Libre Comercio, equivalente a NAFTA alcanzó sus objetivos planteados para reducir barreras de intercambio entre estos dos socios comerciales.

Jared Carlberg

2004-01-01

244

Linfoma no Hodgkin primario de mama, revisión de la literatura y presentación de un caso Primary non-Hodgkin breast lymphoma, literature review and a case a presentation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

El linfoma no Hodgkin primario de la mama es una entidad poco frecuente en pediatría y representa el 0,4 al 0,5 % de todos los tumores mamarios malignos. Debido a que carecen de características propias, tanto clínicas, citológicas como ecográficas, resulta muy difícil establecer el diagnóstico preoperatorio. Se presenta el caso de un linfoma no Hodgkin primario de la mama en una paciente de 3 años que llegó en estadio avanzado de la enfermedad, y se subraya la importancia del tratami...

2011-01-01

245

Linfoma intestinal de células T e doença celíaca / Intestinal t-cell lymphoma and celiac disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese O linfoma de células T associado a enteropatia (LTAE) é uma neoplasia rara, com origem nos linfócitos T intestinais intraepiteliais e que está frequentemente associado a doença celíaca (DC). Os autores relatam o caso de um doente com quadro de desconforto abdominal, perda de peso acentuada, intolerâ [...] ncia ao glúten, com anticorpos antigliadina positivos e múltiplas adenomegálias mesentéricas, ao qual foi diagnosticado DC e LTAE após ressecção cirúrgica de segmento do jejuno com cerca de 15 centímetros, envolvido por implantes tumorais. Com a descrição deste caso, salienta-se a dificuldade no diagnóstico clínico e anatomopatológico desta entidade, alicerçando o tema numa revisão da literatura. Abstract in english Enteropathy associated T-cell lymphoma (EATL) is a rare tumor. It develops in intestinal intra-epithelial T-cells and is commonly associated with celiac disease (CD). The authors report a patient presenting with abdominal discomfort, weight loss, intolerance to gluten, positive gliadin antibodies an [...] d mesenteric lymph node enlargement. CD with EALT was diagnosed after surgical resection of 15 centimeters of jejuno with tumor implants. This case brings out to discussion the difficulty of clinical and histological diagnosis of this entity based on a literature review.

Flávia, Semedo; Cláudio, Quintaneiro; Rosário Santos, Silva; Luísa, Loureiro; Raquel, Dias; Fátima, Guedes; Amélia, Pereira.

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Neuroimagen del linfoma primario del sistema nervioso central en pacientes inmunodeprimidos  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Objetivos: El linfoma primario del sistema nervioso central (LPSNC) es una entidad rara con un pronóstico fatal. Dado el aumento en el número de casos con inmunosupresión adquirida, nuestros objetivos son estudiar las características epidemiológicas y neurorradiológicas de aquellos pacientes inmunod [...] eprimidos con diagnóstico de LPSNC con afectación cerebral e investigar si existen diferencias entre los pacientes con el virus de la inmunodefi ciencia humana (VIH) positivo y negativo. Materiales y métodos: Se realizó un estudio descriptivo y retrospectivo de los pacientes inmunodeprimidos con afectación cerebral por LPSNC, diagnosticados durante los últimos 13 años en 2 hospitales de referencia. Se evaluaron múltiples variables. El nivel de significación estadística utilizado fue p Abstract in english Purposes: Primary central nervous system lymphoma (PCNSL) is a rare tumour with poor prognosis. Due to the increased number of patients with acquired immunodeficiency, our purposes are to describe epidemiological and imaging findings in immunodeficient patients with PCNSL of the brain and to study t [...] he differences between HIV-positive and HIV-negative patients with PCNSL. Materials and methods: A retrospective, descriptive study was performed with immunodeficient patients diagnosed of PCNSL of the brain during the last 13 years in two reference hospitals. Twenty-one patients fulfilled the inclusion criteria. Multiple variables were evaluated. Significance was defined as p

C, Sobrido Sampedro; J.D, Corroto; M, Arias González; A, Iglesias Castañón; J, Corroto Murua; J.M, Pumar Cebreiro.

247

Linfoma no Hodgkin tipo anaplásico de localización cutánea: Presentación de 1 caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se describió un caso de linfoma maligno no Hodgkin tipo anaplásico (LMnH), de localización principal en la piel de la región torácica posterior de un paciente de 56 años de edad, masculino, raza negra, proveniente de la provincia de Manica, Mozambique. El cuadro lesional y topográfico hizo pensar en [...] otros tipos de tumores o micosis profundas. Se corroboró el diagnóstico de LMnH tipo anaplásico de grandes células, CD 30+, por la histología, inmunocitoquímica y la inmunohistoquímica. Se inició el tratamiento con poliquimioterapia, CHOP (ciclofosfamida, doxorrubicina, vincristina y prednisona), 6 ciclos con intervalos de 3 semanas entre ellos. Se logró evolución satisfactoria, la totalidad de las lesiones dermatológicas involucionaron. Actualmente, se encuentra en observación. Abstract in english The case of a 56-year-old black male patient from the province of Manica, Mozambique, that presented an anaplastic malignant non-Hodgkin?s lymphoma mainly located in the skin of the posterior thoracic region, was described. The lesion and topographic picture made us think about other types of tumors [...] or deep mycosis. The diagnosis of CD 30+ anaplastic malignant large-cell non-Hodgkin?s lymphoma was corroborated by histology, immunocytochemistry and immunohistochemistry. The treatment was initiated with combination chemotherapy, CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone), 6 cycles at intervals of 3 weeks among them. A satisfactory evolution was attained. It was observed an involution of all the skin lesions. At present, this patient is under observation.

Castillo Menéndez, María Dolores; Díaz de Villegas Álvarez, Eunice; Vigueras Fajardo, Magdalena; Sabatés Martínez, Manuel.

248

Leucemia linfóide crônica e linfoma linfocítico de pequenas células Chronic lymphocytic leukemia and small lymphocytic lymphoma  

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Full Text Available O linfoma linfocítico de pequenas células (LLPC é considerado uma variante tumoral da leucemia linfocítica crônica e, por conseguinte, a mesma doença. Existem similaridades clínicas, morfológicas, imunofenotípicas e genéticas que parecem resistir até mesmo a uma análise mais aprofundada com o instrumental técnico atualmente disponível para o estudo da biologia molecular. Talvez o refinamento das técnicas de análise da expressão de multiplos genes, incluindo genes para microRNAs, tanto das células malignas quanto das remanescentes benignas do microambiente, e os avanços no conhecimento de determinantes da diferenciação celular possam, em um futuro próximo, esclarecer afinal se LLPC e LLC são doenças diferentes.Small lymphocytic lymphoma (SLL and chronic lymphocytic leukemia (CLL are thought to be different expressions of the same disease. There are clinical, morphological, immuno-phenotypical and genotypical similarities that seem to resist even to advanced molecular biology techniques. It still needs to be defined, through a more refined understanding of the gene profile expression and microRNA biology of the malignant and surrounding micro-environment benign cells and a better understanding of the new paradigms of cell differentiation relativity, if SLL and CLL are different diseases.

Lucia M. R. Silla

2005-12-01

249

Leucemia linfóide crônica e linfoma linfocítico de pequenas células / Chronic lymphocytic leukemia and small lymphocytic lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O linfoma linfocítico de pequenas células (LLPC) é considerado uma variante tumoral da leucemia linfocítica crônica e, por conseguinte, a mesma doença. Existem similaridades clínicas, morfológicas, imunofenotípicas e genéticas que parecem resistir até mesmo a uma análise mais aprofundada com o instr [...] umental técnico atualmente disponível para o estudo da biologia molecular. Talvez o refinamento das técnicas de análise da expressão de multiplos genes, incluindo genes para microRNAs, tanto das células malignas quanto das remanescentes benignas do microambiente, e os avanços no conhecimento de determinantes da diferenciação celular possam, em um futuro próximo, esclarecer afinal se LLPC e LLC são doenças diferentes. Abstract in english Small lymphocytic lymphoma (SLL) and chronic lymphocytic leukemia (CLL) are thought to be different expressions of the same disease. There are clinical, morphological, immuno-phenotypical and genotypical similarities that seem to resist even to advanced molecular biology techniques. It still needs t [...] o be defined, through a more refined understanding of the gene profile expression and microRNA biology of the malignant and surrounding micro-environment benign cells and a better understanding of the new paradigms of cell differentiation relativity, if SLL and CLL are different diseases.

Silla, Lucia M. R..

250

Spectroscopic intravascular photoacoustic imaging of neovasculature: phantom studies  

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An acceleration of angiogenesis in the adventitial vasa-vasorum is usually associated with vulnerable, thin-cap fibroatheroma in atherosclerotic plaques. Angiogenesis creates microvasculature too small to be detected and differentiated using conventional imaging techniques. However, by using spectroscopic photoacoustic imaging, we take advantage of the wavelength-dependent optical absorption properties of blood. We used a vessel-mimicking phantom with micro blood vessels. The phantom was imaged with intravascular photoacoustic imaging across a range of wavelengths. The image intensities were cross-correlated with the known absorption spectra of blood. The resulting cross-correlation image was able to reveal the location of the artificial blood vessels differentiated from non-blood vessel components.

Su, Jimmy L.; Wang, Bo; Emelianov, Stanislav Y.

2009-02-01

251

Brachytherapy optimal planning with application to intravascular radiation therapy  

DEFF Research Database (Denmark)

We have been studying brachytherapy planning with the objective of manimizing the maximum deviation of the delivered dose from prescribed dose bounds for treatment volumes. A general framework for optimal treatment planning is presented and the minmax optimization is formulated as a linear program. Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes determination of an optimal dwell-time sequence for a train of seeds that deliver ratiation while stepping through the vessel lesion. The results illustrate the advantage of this strategy over the common approach of delivering radiation by positioning a single train of seeds along the whole lesion.

Sadegh, Payman; Mourtada, Firas A.

1999-01-01

252

Design and implementation of an intravascular brachytherapy installation in cardiology  

International Nuclear Information System (INIS)

Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

2001-09-01

253

Acute renal failure and intravascular hemolysis following henna ingestion.  

Science.gov (United States)

The powder of henna plant (Lawsonia inermis Linn.) is extensively used as a decorative skin paint for nail coloring and as a hair dye. Most reports of henna toxicity have been attributed to adding a synthetic dye para-phenylenediamine (PPD). PPD is marketed as black henna added to natural henna to accentuate the dark color and shorten the application time. PPD toxicity is well known and extensively reported in medical literature. We report a case of a young Saudi male who presented with characteristic features of acute renal failure and intravascular hemolysis following ingestion of henna mixture. Management of PPD poisoning is only supportive and helpful only if instituted early. Diagnosis requires a high degree of clinical suspicion, as the clinical features are quite distinctive. PMID:23640630

Qurashi, Hala E A; Qumqumji, Abbas A A; Zacharia, Yasir

2013-05-01

254

Design and implementation of an intravascular brachytherapy installation in cardiology  

International Nuclear Information System (INIS)

Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

2001-03-01

255

A pumping intravascular artificial lung with active mixing.  

Science.gov (United States)

Intravascular, as well as extracorporeal, artificial lungs need to be effective and efficient in transferring both oxygen and carbon dioxide. This paper describes the preliminary development of a device that not only is efficient in gas transfer, but also can reduce any pressure loss by providing its own pumping action. The exchange surfaces of the device consist of many short, microporous, hollow fibers arranged in layers like the threads of a screw and placed in a cross-flow configuration. Rotation of the device greatly increases gas transfer efficiency, by increasing the relative velocity between the blood and the fiber surfaces, and pushes the blood along a path similar to that of an Archime-dean screw. In vitro water tests of prototype devices indicate that the rotation can enhance the gas transfer rates by as much as a factor of six. In vitro blood studies indicate moderate blood pumping against zero pressure head, a simulation of veno-venous bypass. PMID:8268580

Makarewicz, A J; Mockros, L F; Anderson, R W

1993-01-01

256

Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas  

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Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

Faruk Altinel

2014-06-01

257

Pulmonary intravascular lymphomatosis: presentation with dyspnea and air trapping.  

Science.gov (United States)

Intravascular lymphomatosis (IVL) is a rare lymphoid neoplasm that is typically of B-cell lineage and characterized by proliferation of malignant cells within small arterioles, capillaries, and venules. We report a patient with pulmonary IVL who presented clinically with progressive dyspnea, fever, and a dry cough. Pulmonary function tests revealed a marked decrease in diffusion capacity with airflow obstruction and severe air trapping. High-resolution CT (HRCT) of the chest with inspiratory and expiratory images revealed mosaic attenuation consistent with air trapping. Transbronchial biopsies revealed the diagnosis of IVL with capillary expansion in the alveolar and peribronchiolar interstitial tissue. IVL should be considered in the differential diagnosis of a patient with an interstitial lung disease, air trapping on pulmonary function tests, and mosaic attenuation on HRCT. Transbronchial biopsies may be the initial diagnostic procedure of choice. PMID:10208234

Walls, J G; Hong, Y G; Cox, J E; McCabe, K M; O'Brien, K E; Allerton, J P; Derdak, S

1999-04-01

258

Two cases of intravascular lymphoma diagnosed by random liver biopsy.  

Science.gov (United States)

The pathogenesis of intravascular lymphoma (IVL) remains inadequately understood. Furthermore, its prognosis remains extremely poor despite combination chemotherapy. Lymphoma cells and hemophagocytosing cells are commonly observed in the livers of IVL patients and less frequently in the bone marrow. We recently encountered an 83-year-old female and a 78-year-old female with IVL, both of whom presented with fever of unknown origin. Following examination, we decided to perform random liver biopsy for diagnostic purposes. The former patient died because of rapid tumor growth, while the latter achieved remission following treatment with a modified R-VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone, and bleomycin plus rituximab) regimen. Considering the possibility of IVL is important when examining a patient presenting with fever of unknown origin. This report demonstrates that random liver biopsy represents a useful diagnostic strategy, particularly in patients with elevated liver enzyme levels. PMID:24998735

Hoshi, Tomoko; Fujii, Yoshinori; Okuyama, Shunsuke; Tanaka, Yuichi; Kimura, Noboru; Mouri, Youichi; Takaya, Haruo; Kajimura, Kouzou

2014-07-01

259

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue  

Science.gov (United States)

Operative hysteroscopy has emerged as an effective alternative to hysterectomy and has become standard surgical treatment for varied gynaecological conditions like abnormal uterine bleeding and uterine myomas. This procedure requires distention of the uterine cavity for adequate visualization of the operative field. 1.5% glycine is a widely used distention medium because it has good optical properties and is non-conductive. However, the intraoperative absorption of this electrolyte-free fluid can cause hyponatraemia, hypoosmolality, hyperglycinaemia and volume overload, including pulmonary oedema. We report a case of operative hysteroscopy intravascular absorption (OHIA) syndrome, presenting abruptly during hysteroscopic myomectomy, employing 1.5% glycine as the fluid distention medium. Successful management of the case and prevention strategies are discussed.

Sethi, Navdeep; Chaturvedi, Ravindra; Kumar, Krishna

2012-01-01

260

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue.  

Science.gov (United States)

Operative hysteroscopy has emerged as an effective alternative to hysterectomy and has become standard surgical treatment for varied gynaecological conditions like abnormal uterine bleeding and uterine myomas. This procedure requires distention of the uterine cavity for adequate visualization of the operative field. 1.5% glycine is a widely used distention medium because it has good optical properties and is non-conductive. However, the intraoperative absorption of this electrolyte-free fluid can cause hyponatraemia, hypoosmolality, hyperglycinaemia and volume overload, including pulmonary oedema. We report a case of operative hysteroscopy intravascular absorption (OHIA) syndrome, presenting abruptly during hysteroscopic myomectomy, employing 1.5% glycine as the fluid distention medium. Successful management of the case and prevention strategies are discussed. PMID:22701213

Sethi, Navdeep; Chaturvedi, Ravindra; Kumar, Krishna

2012-03-01

 
 
 
 
261

Fetal outcome following intrauterine intravascular transfusion in rhesus alloimmunization.  

Science.gov (United States)

The outcome of 14 pregnancies with severe rhesus alloimmunization was analyzed over a period of 16 months. Group A consisted of 7 cases who received ultrasound guided intravascular intrauterine packed red blood cell transfusions via the umbilical vein after determining fetal blood group and hematocrit. The outcome of these cases was compared with another 7 cases (Group B), who did not require intrauterine transfusions. The 7 cases in Group A received a total of 25 intrauterine transfusions between 25 to 33 weeks gestation. Procedure related complications encountered were transient fetal bradycardia on 4 occasions, difficulty in cord cannulation due to fetal movements in 2 cases and transient bleeding at puncture site in 2 cases. These complications were not associated with any maternal or fetal consequences. There was no procedure related mortality. Mean cord hemoglobin in Group A (12.52 g/dl) was significantly higher (p < 0.05) than in Group B (8.5 g/dl), and mean cord indirect serum bilirubin was significantly lower (p < 0.1) in Group A (2.5 mg/dl) than in Group B (5.8 mg/dl). Three neonates in Group A required one exchange transfusion each, as compared to all 7 in Group B who required a total of 12 exchange transfusions. All neonates in Group B survived, whereas 2 expired in Group A, one of severe intravascular coagulopathy and the other due to prematurity and hyaline membrane disease. Percutaneous ultrasound guided umbilical blood transfusions directly into the vascular system appears to be safe in experienced hands and has the potential to improve the prognosis of the severely alloimmunized fetus. PMID:8935259

Merchant, R H; Lulla, C P; Gupte, S C; Krishnani, R H

1995-09-01

262

Hunting for necrosis in the shadows of intravascular ultrasound.  

Science.gov (United States)

Coronary artery disease leads to failure of coronary circulation secondary to accumulation of atherosclerotic plaques. In adjunction to primary imaging of such vascular plaques using coronary angiography or alternatively magnetic resonance imaging, intravascular ultrasound (IVUS) is used predominantly for diagnosis and reporting of their vulnerability. In addition to plaque burden estimation, necrosis detection is an important aspect in reporting of IVUS. Since necrotic regions generally appear as hypoechic, with speckle appearance in these regions resembling true shadows or severe signal dropout regions, it contributes to variability in diagnosis. This dilemma in clinical assessment of necrosis imaged with IVUS is addressed in this work. In our approach, fidelity of the backscattered ultrasonic signal received by the imaging transducer is initially estimated. This is followed by identification of true necrosis using statistical physics of ultrasonic backscattering. A random forest machine learning framework is used for the purpose of learning the parameter space defining ultrasonic backscattering distributions related to necrotic regions and discriminating it from non-necrotic shadows. Evidence of hunting down true necrosis in shadows of intravascular ultrasound is presented with ex vivo experiments along with cross-validation using ground truth obtained from histology. Nevertheless, in some rare cases necrosis is marginally over-estimated, primarily on account of non-reliable statistics estimation. This limitation is due to sparse spatial sampling between neighboring scan-lines at location far from the transducer. We suggest considering the geometrical location of detected necrosis together with estimated signal confidence during clinical decision making in view of such limitation. PMID:24035737

Sheet, Debdoot; Karamalis, Athanasios; Eslami, Abouzar; Noël, Peter; Virmani, Renu; Nakano, Masataka; Chatterjee, Jyotirmoy; Ray, Ajoy K; Laine, Andrew F; Carlier, Stephane G; Navab, Nassir; Katouzian, Amin

2014-03-01

263

Linfoma de colon como causa de fiebre de origen desconocido / Colon lymphoma as a cause of fever of unknown origin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos el caso de un varón de 49 años que presentó un cuadro de fiebre de dos meses de evolución, acompañado de nauseas, vómitos y perdida de 10 kilogramos de peso. Con el diagnostico de fiebre de origen desconocido ingresó. En la TAC abdominal se objetivó un extenso engrosamiento de la pared d [...] e colon transverso y ángulo hepático, sugestivo de neoplasia de colon y una gran lesión sólida en lóbulo hepático izquierdo. Se realizó una colonoscopia observándose una neoplasia circunferencial, tomándose biopsias. La anatomía patológica fue informada de linfoma de células grandes difuso tipo B. El linfoma primario de colon es un tumor muy poco frecuente del tracto gastrointestinal, no superando el 1% en las series consultadas. Basándonos en este caso se hizo una revisión de los artículos más recientes sobre linfoma gastrointestinal. Abstract in english We present a case of a 49 year old man who presented with a 2 month history of fever, nausea vomiting and weight loss (10 kg). He was admitted to the Hospital with the diagnosis of fever of unknown origin. A CT scan showed a wide thickening of the colonic wall (transverse colon and hepatic flexure) [...] suggesting a colon tumor, and a solid mass in the left liver lobe. A colonoscopy was performed showing a circumferential neoplasm and biopsies were taken. The histopathology was informed as a diffuse large B cell lymphoma. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Based on this case, we reviewed the most recent articles about gastrointestinal lymphomas.

S., Casallo Blanco; L. de, Matías Salces; F., Marcos Sánchez; M. J., Martín Barranco; E., Núñez Cuerda; F., Solano Ramos.

264

Nódulos pulmonares fluctuantes como forma de presentación de un linfoma MALT / Fluctuant pulmonary nodules as presentation of a MALT lymphoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish El linfoma tipo MALT, o del tejido asociado a mucosas, es un linfoma no Hodking de bajo grado de malignidad, cuya localización más frecuente es el tracto gastrointestinal, principalmente el estómago; su presentación primaria pulmonar es infrecuente, localización en la que puede presentar distintas i [...] mágenes radiológicas. Presentamos el caso de una mujer de 61 años, con antecedentes personales de vitíligo, ulcus gástrico, cirrosis hepática por virus de la hepatitis C, que ingresó por un cuadro de disnea súbita, dolor en punta de costado derecho de carácter pleurítico y fiebre de 38,5º C, cuya radiografía de tórax y TAC torácico mostraban imágenes nodulares en "suelta de globos", que afectaban a distintos lóbulos pulmonares. En la citología por PAAF se confirma su naturaleza maligna. En controles radiológicos posteriores se observó una desaparición completa de los nódulos y reaparición en localizaciones pulmonares distintas en cada recidiva a lo largo de tres años de evolución. La presentación en forma de nódulos pulmonares fluctuantes es excepcional en un linfoma tipo MALT. Se ha descrito una mayor incidencia de infección por virus de la hepatitis C y neoplasias adicionales. La existencia de una hepatitis crónica por virus C, procesos inflamatorios crónicos locales, así como enfermedades de base autoinmune, podrían considerarse como factores que pueden contribuir a desencadenar un linfoma tipo MALT. Abstract in english Mucosa associated lymphoid tissue (MALT) lymphomas are a group of non- Hodgkin?s lymphomas of low malignancy degree. The most frequent location is the gastrointestinal tract. Its primary pulmonary presentation is unusual and heterogeneous from point of view radiological. Woman 61 years old with ante [...] cedents of vitiligo, gastric ulcus, cirrhosis by VHC, that go into the hospital by sudden disnea, thoracic paint with pleural characterises and fever of 38.5º C, Her thorax radiography and thoracic TAC showed nodes that affect to different pulmonary lobes. The cytology by PAAF confirms their malignant nature. In subsequent radiological controls it was notice the nodels took away completely and returns in different pulmonary place in each recurrence. The presentation like fluctuant pulmonary nodes is exceptional in a MALT lymphoma. It was described a higher incidence of VHC infection and tumour. The evidence of chronic hepatitis by virus C disease, and local chronic inflammatory process as well as autoimmune disorders may be considerate like a factor that contribute to MALT lymphoma.

Dolz Aspas, R.; Toyas Miazza, C.; Ruiz Ruiz, F.; Morales Rull, J. L.; Pérez Calvo, J. I..

265

Primary diffuse large B-cell lymphoma of the oral cavity Linfoma difuso de grandes células B primário de boca  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Lymphomas arising within the oral cavity account for only 3.5% of all oral malignancies. Diffuse large B-cell lymphoma is a non-Hodgkin lymphoma subtype characterized by diffuse proliferation of large neoplastic B lymphoid cells. This paper reports a case of diffuse large B-cell lymphoma affecting the oral cavity of a Brazilian woman, along with its clinical, microscopical, immunohistochemical, and molecular features.Linfomas correspondem a 3,5% de todos os casos de lesões malignas de bo...

Bruno Correia Jham; Eliza Carla Barroso Duarte; Anacélia Mendes Fernandes; Aline Cristina Batista Rodrigues Johann; Maria Cássia Ferreira de Aguiar; Ricardo Santiago Gomez; Ricardo Alves Mesquita

2007-01-01

266

Forma tumoral encefálica esquistossomótica: apresentação de um caso tratado cirurgicamente  

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Full Text Available Os relatos da esquistossomose mansônica acometendo o sistema nervoso central (SNC são pouco frequentes, sendo raramente descrito no encéfalo, onde os ovos do Schistosoma mansoni usualmente provocam reação granulomatosa comportando-se como lesão expansiva. Um paciente do sexo masculino, procedente de São Vicente de Ferrer, Baixada Ocidental Maranhense, área endêmica da doença, 27 anos de idade, apresentou tumor no cerebelo, o qual foi tratado cirurgicamente. O estudo histopatológico da lesão cerebelar, demonstrou extensa reação granulomatosa ao redor de ovos em desintegração de Schistosoma mansoni. Os granulomas exibiam diferentes estágios de evolução, desde necrótico exsudativo até produtivo. Este caso representa o primeiro de neuroesquistossomose relatado no estado do Maranhão. A evolução pós-operatória do paciente caracterizou-se por déficit e incoordenação motora dos membros superior e inferior direito associado a tremores.

Ferreira Luiz A.

1998-01-01

267

Intravascular radiation for restenosis prevention: could it be the holy grail?  

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This brief editorial discusses the use of intravascular radiation in preventing restenosis after angioplasty in coronary interventions. Results in porcine coronary arteries and clinical applications are briefly reported. (UK).

King, S.B. [Emory Univ., Atlanta, GA (United States)

1996-08-01

268

Intravascular radiation for restenosis prevention: could it be the holy grail?  

International Nuclear Information System (INIS)

This brief editorial discusses the use of intravascular radiation in preventing restenosis after angioplasty in coronary interventions. Results in porcine coronary arteries and clinical applications are briefly reported. (UK)

1996-08-01

269

Disseminated intravascular coagulation in a patient treated with strontium-89 for metastatic carcinoma of the prostate.  

Science.gov (United States)

Strontium-89 is effective in the palliation of bone pain caused by skeletal metastases. Its primary side effect is mild thrombocytopenia that typically recovers in 3 or 4 months. Subclinical disseminated intravascular coagulation is reported to be present in approximately 10% to 20% of patients with advanced prostate cancer. These patients may be at increased risk for severe marrow depression after radionuclide therapy for bone pain palliation. This report describes a patient with painful bony metastases resulting from prostate carcinoma. He had a normal platelet count and no clinical evidence of a coagulation disorder at the time of strontium-89 therapy, and a severe disseminated intravascular coagulation developed and lead to death after treatment. A normal platelet count before strontium-89 therapy does not preclude subsequent disseminated intravascular coagulation, and we support the Society of Nuclear Medicine's bone pain treatment procedure guideline that patients referred for bone palliation should be screened for disseminated intravascular coagulation before therapy. PMID:10551466

Paszkowski, A L; Hewitt, D J; Taylor, A

1999-11-01

270

Radionuclide assessment of peripheral intravascular capacity: a technique to measure intravascular volume changes in the capacitance circulation in man  

International Nuclear Information System (INIS)

Changes in the capacitance vasculature influence venous return and cardiac performance, so an understanding of the effects of pathophysiologic states on the human capacitance vasculature is necessary to understand integrated cardiovascular function in man. Techniques available to assess the capacitance vasculature in man, however, have limitations. We performed radionuclide imaging of the calf or forearm in 51 patients whose erythrocytes had been labeled in vivo with technetium-99m, basing our approach on the principle that counts from the radiolabeled intravascular space are proportional to blood volume. Two-minute or 15-second count acquisitions were obtained from the calf in 42 patients. Counts obtained at rest demonstrated little variation. With veno-occlusion at 15 and 30 mm Hg, counts increased 8 +- 1% (+- SEM) (p < 0.001) and 28 +- 2% (p < 0.001), respectively. After 0.4 mg of sublingual nitroglycerin, counts increased 9 +- 1% (p < 0.001). With leg elevation, counts decreased 34 +- 4% (p < 0.001). Response patterns were similar with 2-minute and 15-second acquisitions. In nine patients who underwent forearm imaging (2-minute acquisitions), counts increased 14 + 2% (p < 0.001) and 26 +- 4% (p < 0.001) at 15- and 30-mm Hg veno-occlusion and 15 +- 3% (p < 0.001) after nitroglycerin. Volume displacements, recorded simultaneously with a fluid-filled plethysmograph about the contralateral forearm, correlated linearly in all nine patients. Thus, gamma camera imaging of the radiolabeled peripheral intravascular space provides a quantitative and reliable assessment of peripheral vascular capacity in man. The technique could be used in conjunction with gated cardiac imaging in order to assess the interactions of peripheral vascular capacity and ventricular performance

1981-01-01

271

Radionuclide assessment of peripheral intravascular capacity: a technique to measure intravascular volume changes in the capacitance circulation in man  

Energy Technology Data Exchange (ETDEWEB)

Changes in the capacitance vasculature influence venous return and cardiac performance, so an understanding of the effects of pathophysiologic states on the human capacitance vasculature is necessary to understand integrated cardiovascular function in man. Techniques available to assess the capacitance vasculature in man, however, have limitations. We performed radionuclide imaging of the calf or forearm in 51 patients whose erythrocytes had been labeled in vivo with technetium-99m, basing our approach on the principle that counts from the radiolabeled intravascular space are proportional to blood volume. Two-minute or 15-second count acquisitions were obtained from the calf in 42 patients. Counts obtained at rest demonstrated little variation. With veno-occlusion at 15 and 30 mm Hg, counts increased 8 +- 1% (+- SEM) (p < 0.001) and 28 +- 2% (p < 0.001), respectively. After 0.4 mg of sublingual nitroglycerin, counts increased 9 +- 1% (p < 0.001). With leg elevation, counts decreased 34 +- 4% (p < 0.001). Response patterns were similar with 2-minute and 15-second acquisitions. In nine patients who underwent forearm imaging (2-minute acquisitions), counts increased 14 + 2% (p < 0.001) and 26 +- 4% (p < 0.001) at 15- and 30-mm Hg veno-occlusion and 15 +- 3% (p < 0.001) after nitroglycerin. Volume displacements, recorded simultaneously with a fluid-filled plethysmograph about the contralateral forearm, correlated linearly in all nine patients. Thus, gamma camera imaging of the radiolabeled peripheral intravascular space provides a quantitative and reliable assessment of peripheral vascular capacity in man. The technique could be used in conjunction with gated cardiac imaging in order to assess the interactions of peripheral vascular capacity and ventricular performance.

Rutlen, D.L.; Wackers, F.J.T.; Zaret, B.L.

1981-07-01

272

A basic study of electrical impedance spectroscopy for intravascular diagnosis and therapy monitoring of atherosclerosis  

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The thesis reports about the feasibility of electrical impedance spectroscopy with microsystems for the intravascular diagnosis of atherosclerosis. Based on a basic investigation on the cellular level, it describes how the impedance of vessel walls on the microscale is determined and how the cellular alteration related with atherosclerosis affects the measured impedance. For an intravascular impedance characterization of vessels, it shows the development of a balloon impedance catheter (BIC) ...

Cho, Sungbo

2008-01-01

273

Intravascular Thrombosis in Central Nervous System Malignancies: A Potential Role in Astrocytoma Progression to Glioblastoma  

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The presence of necrosis within a diffuse glioma is a powerful predictor of poor prognosis, yet little is known of its origins. Intravascular thrombosis is a frequent finding in glioblastoma [GBM; World Health Organization (WHO) grade IV] specimens and could potentially be involved in astrocytoma progression to GBM or represent a surrogate marker of GBM histology. We investigated whether intravascular thrombosis was more frequent or prominent in GBM than other central nervous system (CNS) mal...

Tehrani, Mahtab; Friedman, Theodore M.; Olson, Jeffrey J.; Brat, Daniel J.

2008-01-01

274

Comparison of external and intravascular cooling to induce hypothermia in patients after CPR  

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Objective: Hypothermia has been shown to reduce neurologic deficits in patients after cardiopulmonary resuscitation (CPR). It was not clear if intravascular cooling is superior to standard external cooling in inducing hypothermia. Goal of this study was to compare intravascular cooling with an automated cooling device with external cooling in everyday practice on a cardiac-care ICU (intensive care unit).Methods: Patients after successful CPR for unwitnessed cardiac arrest were subjected to ...

Flemming, K.; Simonis, G.; Ziegs, E.; Diewok, C.; Gildemeister, R.; Wunderlich, C.; Strasser, Rh

2006-01-01

275

The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection  

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Full Text Available

Background and aims. Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections.

Materials and methods. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test.

Results. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques (P = 0.127 and between right and left injection sites (P = 0.778.

Conclusion. According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance.

Sara Pourshahidi

2008-04-01

276

Gallium SPECT detection of neoplastic intravascular obstruction of the superior vena cava  

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A rare case of an intravascular neoplastic obstruction of the superior vena cava is discussed. The lesion was detected with gallium single photon emission computed tomography (SPECT) despite a normal appearance on a concurrent radiographic CT study. A computer-generated composite SPECT-CT image confirmed the intravascular localization of the radioisotope, and a subsequent CT-guided transthoracic needle biopsy revealed a poorly differentiated adenocarcinoma.

Swayne, L.C.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))

1989-11-01

277

Linfoma MALT de parótida, presentación de un caso clínico y revisión del tema / Parotid MALT lymphoma, presentation of a clinical case and review of subject  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5%. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH) y se consideran derivados del [...] tejido linfoide asociado a mucosas (MALT). Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada, de lento crecimiento, con varios años de evolución. Presentamos un caso clínico de linfoma tipo MALT de parótida de acuerdo a las características clínicas, histológicas e inmunohistoquímicas de este tumor. Además una revisión de la literatura de este caso. Abstract in english Lymphomas of the salivary glands are a rare entity, with an estimated incidence of 5%. The most frequent location is parotid gland, followed by the submandibular and sublingual. The majority of parotid lymphomas are non-Hodgkin's lymphoma NHL and are considered derived from mucosa-associated lymphoi [...] d tissue (MALT). Infrequently these cases have been reported and are often underdiagnosed for their presentation is relatively benign, localized behaving, slow growing, with several years of evolution. We report a case of parotid MALT lymphoma according to the clinical, histological and immunohistochemical characteristics of this tumor. In addition, a literature review of this case.

Fernández A, Francisca; Espinoza N, Carlos; Mercado M, Víctor; Vallejos A, Humberto.

278

Experimental evaluation of a model for oxygen exchange in a pulsating intravascular artificial lung.  

Science.gov (United States)

Intravascular oxygenation and carbon dioxide removal remains a potentially attractive means for respiratory support in patients with acute or chronic respiratory failure. Our group has been developing an intravascular hollow fiber artificial lung that uses a pulsating balloon located within the fiber bundle to augment gas transfer. We previously reported on a simple compartmental model for simulating O2 exchange in pulsating intravascular artificial lungs. In this study we evaluate the O2 exchange model with gas exchange and PO2 measurements performed on an idealized intravascular artificial lung (IIVAL) tested in a water perfusion loop. The IIVAL has well-defined bundle geometry and can be operated in balloon pulsation mode, or a steady perfusion mode for determining the mass transfer correlation required by the model. The O2 exchange rates and compartmental O2 tensions measured with balloon pulsation in the IIVAL are within 10% of model predictions for flow and pulsation conditions relevant to intravascular oxygenation. The experiments confirmed that a significant buildup of PO2 occurs within the fiber bundle, which reduces the O2 exchange rate. The agreement between experiments and predictions suggests that the model captures the cardinal processes dictating gas transfer in pulsating intravascular artificial lungs. PMID:10710187

Federspiel, W J; Hewitt, T J; Hattler, B G

2000-02-01

279

Linfomas no Hodgkin: Área metropolitana de Bucaramanga / Non-Hodgkin lymphomas from Bucaramanga metropolitan area  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción: Ninguna neoplasia ha generado tanta confusión en sus sistemas de clasificación como los linfomas no Hodgkin (LNH). Una correcta tipificación es necesaria para el diagnóstico, pronóstico y tratamiento. Objetivos: clasificar los LNH del registro poblacional de cáncer del área metropolita [...] na de Bucaramanga. Pacientes y métodos: SSe realizó un estudio observacional de corte transversal, utilizando como población los pacientes con LNH del área metropolitana de Bucaramanga de enero de 2000 a diciembre de 2006. La información se obtuvo de las historias clínicas y de inmunohistoquímica en bloques de parafina. Se utilizo la clasificación de linfomas de la OMS. Resultados: Se estudiaron 320 pacientes y se encontró predominio de la enfermedad en la 6ª y 7ª década. La distribución por género fue mayor en hombres con 61,26% y mujeres 45,6%. El sitio anatómico de compromiso más frecuente fue ganglios cervicales con 25,6%. La mayoría expresaron antígenos B, 86,8%, y T, 1,8%. El subtipo más frecuente fue difuso de célula grande en el 29,6%. Conclusiones: La mayoría los LNH del área metropolitana de Bucaramanga son de linajes B, nodales y de célula grande difuso. Fue evidente el uso limitado de otras técnicas para la clasificación de estas neoplasias en nuestra región. Salud UIS 2011; 43(1): 39-47 Abstract in english Introduction: There is not a neoplasm that has generated such confusion on its classification system such as the Non- Hodgkin's lymphoma. An adequate classification is necessary for diagnosis, prognostic and treatment. Objectives: To classify the NHL from the Bucaramanga metropolitan area poblat [...] ional cancer registry. Patients and methods: An observational cross-sectional study was made, using as population the patients with NHL from the Bucaramanga metropolitan area from January 2000 until December 2006. The information was obtained from the clinical records and inmunohistochemistry in paraffin blocks. The WHO lymphoma classification was used. Results: 320 patients were studied and a predominance of the disease was found on the 6th and 7th decade of life. Gender distribution was higher in men with 61.26% and women 45.6%. The anatomical site more frequently affected were the cervical lymph nodes with 25.6%. Most of them expressed B antigens, 86.8%, and T, 1.8%. The most frequent subtype was diffuse large B cell in 29.6%. Conclusions: Most of the NHL from the Bucaramanga metropolitan area are nodal, of B lineage, and diffuse large cell subtype. The limited use of other techniques for the classification of these neoplasms in our region was evident. Salud UIS 2011; 43(1): 39-47.

García Ramírez, Carlos Alberto; Uribe Pérez, Claudia Janeth; Niño Vargas, Paula Marina; Salazar Radi, Daniel Sebastián; Vásquez Pinto, Luis Enrique.

280

estatinas afectan la viabilidad de líneas celulares de leucemia y linfoma humanas in vitro  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Se ha propuesto que las estatinas inducen apoptosis sobre células tumorales. Para probar dicha hipótesis, se analizó el efecto de las estatinas atorvastatina, fluvastatina, lovastatina, mevastatina, pravastatina y simvastatina en el rango de concentraciones de 1 pM hasta 100 ?M, sobre la viabilidad [...] de las líneas celulares humanas Jurkat E6.1, Jurkat D1.1 (Linfoma T) , Daudi (Linfoma B), U937 (leucemia monocítica) y HL-60 (leucemia promielomonocítica) in vitro en cultivos de 48 horas, analizados por la técnica de hidrolización del compuesto bromuro de 3-(4,5-dimetiltiazol-2-il)-2,5-difenilltetrazolio (MTT). Lovastatina y mevastatina son los más potentes inductores de muerte celular independientemente del tipo celular (Ic 50 entre 12 y 50 ?M). Para las otras estatinas se observan diferencias en el Ic50 según la línea celular atorvastatina (38,1 y 48,6 ?M Jurkats, 55,3 ?M Daudi y 100 ?M para las otras líneas), pravastatina (25 ?M HL-60, 55,6 y 60,7 ?M Jurkats y ? 100 ?M Daudi y U937), simvastatina (25,1 ?M Jurkat D1.1, 50,2 ?M Jurkat E6.1, 45,2 ?M Daudi y 51,3 ?M HL-60, y > 100 ?M U937) y para fluvastatina en todos los casos > 100 ?M. La disminución de la viabilidad celular se revierte completamente cuando las células son incubadas con 10 ?M mevalonato. Se concluye que la lovastatina y mevastatina son las más potentes inductoras de muerte seguida por atorvastatina, pravastatina y simvastatina cuyo efecto depende del tipo de línea celular y la fluvastatina no tiene efectos importantes en la viabilidad de las líneas celulares estudiadas. Abstract in english Statins have been proposed to induce apoptosis of tumor cells. In order to test this hypothesis, the effect of atorvastatin, fluvastatin, lovastatin, mevastatin, pravastatin, simvastatin on cell viability was assessed by in vitro culture for 48 hr, at concentrations ranging from 1 pM to 100 ?M on hu [...] man cell lines Jurkat E6.1, Jurkat D1.1 (T cell lymphoma), Daudi (B cell lymphoma), U937 (monocitic leukemia) and HL-60 (pro mielomonocitic leukemia) and analyzed the oxidation of (3-(4.5-Dimethylthiazol-2-yl)-2.5- diphenyltetrazolium bromide (MTT). Lovastatin and mevastatin are the most potent inductors of cell death independently of the cell type (Ic 50 between 12 and 50 ?M). Differences in the Ic50 are observed depending on the cell line: atorvastatina (38.1 and 48.6 ?M Jurkats, 55.3 ?M Daudi y 100 ?M for the others lines), pravastatin (25 ?M HL-60, 55.6 y 60.7 ?M Jurkats and ? 100 ?M Daudi and U937), simvastatin (25.1 ?M Jurkat D1.1, 50.2 ?M Jurkat E6.1, 45.2 ?M Daudi and 51,3 ?M HL-60, and > 100 ?M U937) and for fluvastatin > 100 ?M in all cases. The decrease in cell viability is reverted completely when the cells were incubated with 10 ?M mevalonate. It is concluded that lovastatin and mevastatin are the most potent inductors of cell death followed by atorvastatin, pravastatin and simvastatin whose effect depends upon the cell type and fluvastatin does not have any important effects on cell viability on the cell lines studied.

Mery, Guerrero; Camilo, Di Giulio; Juan Bautista, De Sanctis.

 
 
 
 
281

Presentación clínica de los linfomas no hodgkinianos Clinical presentation of non-Hodgkin lymphomas  

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Full Text Available Se realizó un estudio retrospectivo en 644 pacientes con diagnóstico de linfoma no hodgkiniano atendidos en el Servicio de Hematología del Hospital "Hermanos Ameijeiras" con el objetivo de conocer las características clínicas y epidemiológicas de esta enfermedad al debut. La relación masculino femenino fue de 1,02 : 1; el 68,7 % eran de piel blanca; el grupo etáreo más afectado fue el de 55 - 74 años; la toma ganglionar predominó sobre la extraganglionar, con una mayor incidencia en la región cervical; la médula ósea fue la toma extraganglionar más común; la afectación extranodal primaria se presentó en el 15 % de los casos; los síntomas generales se detectaron en el 27,9 % de estos pacientes; la histología agresiva predominó sobre los indolentes y el tipo histológico más observado fue el difuso de células grandes. Al diagnóstico, el 66,1 % se encontraba en estadios avanzados. Se encontró significación estadística al relacionar el grado de agresividad con la presencia de síntomas generales y los estadiosA retrospective study was conducted in 644 patients with diagnosis of non-Kodgkin lymphoma that received attention at the service of Haematology of "Hermanos Ameijeiras" Hospital in order to know the clinical and epidemiological characteristics of this disease on its onset. The males females ratio was 1.02:1. 68.7 % were white and the age group 55-74 was the most affected. The ganglionar taking prevailed over the extraganglionar, with a higher incidence in the cervical region. The bone marrow was the most common extraganglionar taking. The primary extranodal affectation was present in 15 % of the cases. The general symptoms were detected in 27.9 % of these patients. Aggressive histology predominated among the indolents and the most observed histological site was the diffuse of large cells. On diagnosis, 66.1 % were in advanced stages. Statistical significance was found on relating the aggressiveness degree to the presence of general symptoms and stages

Calixto Hernández Cruz

2003-12-01

282

Tratamento do linfoma de Hodgkin após falha do transplante autólogo Treatment of Hodgkin's lymphoma after failure of autologous stem cell transplant  

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Full Text Available O linfoma de Hodgkin (LH é uma neoplasia do tecido linfóide de excelente prognóstico, porém, aproximadamente 15% dos pacientes em estádios precoces e 35% dos em estádios avançados progridem após o tratamento inicial. O transplante autólogo de medula óssea ou de células-tronco periféricas (ATMO é o tratamento de escolha nesses casos. Nosso estudo tem como objetivo avaliar o tipo de tratamento utilizado, a taxa de resposta e a sobrevida de pacientes recidivados ou refratários ao ATMO. De 38 pacientes com LH submetidos a ATMO entre abril de 1996 e novembro de 2005, foram avaliados 17 que apresentaram recidiva/refratariedade ao ATMO. Nesses casos, o tratamento de resgate foi individualizado, a depender das condições clínicas de cada um, sendo constituído usualmente de drogas citotóxicas não utilizadas previamente. Após o ATMO, dez (59% dos 17 pacientes obtiveram remissão completa, um (6% remissão parcial e seis (35% foram refratários. Em 14 dos 17 pacientes foi instituída quimioterapia de resgate com diversos esquemas no momento da recidiva/refratariedade após ATMO; um paciente foi tratado com radioterapia exclusiva e dois foram a óbito antes de qualquer terapia. Observamos uma taxa de resposta global de 57,4% (IC95%: 23,2 - 90,7%. A mediana da sobrevida livre de progressão foi de 19 meses e a mediana de sobrevida global foi de 32 meses. Apesar do LH recidivado/refratário ao ATMO não ser curável com os quimioterápicos atualmente disponíveis, os pacientes apresentaram longa sobrevida, com freqüentes exacerbações da doença.Hodgkin's lymphoma (HL is a lymphoid malignancy with excellent prognosis, however nearly 15% of the patients in early stages and 35% in advanced stages have progressive disease after initial treatment. Autologous bone marrow or hematopoietic stem cell transplantation (ABMT are the treatments of choice in these cases. This report presents the therapeutic approach and the outcome of HL patients who experience relapse after or are refractory to ABMT. Of 38 patients with LH who underwent ABMT between April 1996 and November 2005, 17 presented with relapsed/refractory disease and were included in this analysis. In these cases, the choice of rescue therapy varied upon the clinical conditions of each patient and was based on previously unused chemotherapy agents. After ABMT, 10 (59% of the 17 patients were in complete remission, one (6% in partial remission and six (35% were refractory. Fourteen of the 17 patients received different schemes of rescue therapy at the time of ABMT failure, one patient was treated exclusively with radiotherapy and two died before any treatment. We observed an overall response rate of 57.4% (95% CI: 23.2 - 90.7%. The median progression-free survival was 19 months and the median overall survival was 32 months. Despite ABTM, relapsed/refractory LH can not be cured with currently available chemotherapeutic agents, the patients had long survival times with frequent exacerbations of the diseas.

Fernanda M. Santos

2008-08-01

283

Tratamento do linfoma de Hodgkin após falha do transplante autólogo / Treatment of Hodgkin's lymphoma after failure of autologous stem cell transplant  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O linfoma de Hodgkin (LH) é uma neoplasia do tecido linfóide de excelente prognóstico, porém, aproximadamente 15% dos pacientes em estádios precoces e 35% dos em estádios avançados progridem após o tratamento inicial. O transplante autólogo de medula óssea ou de células-tronco periféricas (ATMO) é o [...] tratamento de escolha nesses casos. Nosso estudo tem como objetivo avaliar o tipo de tratamento utilizado, a taxa de resposta e a sobrevida de pacientes recidivados ou refratários ao ATMO. De 38 pacientes com LH submetidos a ATMO entre abril de 1996 e novembro de 2005, foram avaliados 17 que apresentaram recidiva/refratariedade ao ATMO. Nesses casos, o tratamento de resgate foi individualizado, a depender das condições clínicas de cada um, sendo constituído usualmente de drogas citotóxicas não utilizadas previamente. Após o ATMO, dez (59%) dos 17 pacientes obtiveram remissão completa, um (6%) remissão parcial e seis (35%) foram refratários. Em 14 dos 17 pacientes foi instituída quimioterapia de resgate com diversos esquemas no momento da recidiva/refratariedade após ATMO; um paciente foi tratado com radioterapia exclusiva e dois foram a óbito antes de qualquer terapia. Observamos uma taxa de resposta global de 57,4% (IC95%: 23,2 - 90,7%). A mediana da sobrevida livre de progressão foi de 19 meses e a mediana de sobrevida global foi de 32 meses. Apesar do LH recidivado/refratário ao ATMO não ser curável com os quimioterápicos atualmente disponíveis, os pacientes apresentaram longa sobrevida, com freqüentes exacerbações da doença. Abstract in english Hodgkin's lymphoma (HL) is a lymphoid malignancy with excellent prognosis, however nearly 15% of the patients in early stages and 35% in advanced stages have progressive disease after initial treatment. Autologous bone marrow or hematopoietic stem cell transplantation (ABMT) are the treatments of ch [...] oice in these cases. This report presents the therapeutic approach and the outcome of HL patients who experience relapse after or are refractory to ABMT. Of 38 patients with LH who underwent ABMT between April 1996 and November 2005, 17 presented with relapsed/refractory disease and were included in this analysis. In these cases, the choice of rescue therapy varied upon the clinical conditions of each patient and was based on previously unused chemotherapy agents. After ABMT, 10 (59%) of the 17 patients were in complete remission, one (6%) in partial remission and six (35%) were refractory. Fourteen of the 17 patients received different schemes of rescue therapy at the time of ABMT failure, one patient was treated exclusively with radiotherapy and two died before any treatment. We observed an overall response rate of 57.4% (95% CI: 23.2 - 90.7%). The median progression-free survival was 19 months and the median overall survival was 32 months. Despite ABTM, relapsed/refractory LH can not be cured with currently available chemotherapeutic agents, the patients had long survival times with frequent exacerbations of the diseas.

Fernanda M., Santos; Luís F., Pracchia; Camila G. C., Linardi; Valeria, Buccheri.

284

Linfoma de células en anillo de sello que simula carcinoma mucosecretante Signet ing cell lymphoma mimicking mucin-producing carcinoma  

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Full Text Available El linfoma de células en anillo de sello es una neoplasia poco frecuente, caracterizada por la presensencia de grandes células de citoplasma vacuolado, claro, similar a los encontrados en adeno-carcinomas mucosecretantes. Se ha descripto en ganglios linfáticos y tejidos extralinfáticos. Se presenta el caso de un paciente varón de 59 años con linfoma de células en anillo de sello localizado en pared lateral de orofaringe. Esta localización creemos que no ha sido descripta anteriormente. La histología mostró células en anillo de sello y el inmunofenotipo tumoral fue: vimentina, CD45, CD20, Ig M y cadenas kappa positivos, siendo la fracción de crecimiento tumoral alta (Ki 67:70%. El paciente evolucionó desfavorablemente y falleció a los dos meses del diagnóstico sin recibir tratamiento.Signet ring cell lymphoma is a rare neoplasm caracterized by large, vacuolated and clear cells mimicking mucin-producing adenocarcinoma. It is localized in nodal and extranodal sites. A case of a 59 years old male, with a diffuse lymphoma signet ring cell type localized on oropharingeal mucosa is reported. The histopathology study showed signet ring cells and the immunophenotype was: vimentine(+, CD45(+, CD20(+, Ig M(+, Kappa chain(+ and high index proliferative activity of neoplastic cells (Ki 67:70%. After a review of the literature and previous reports, we could not find a similar case in this anatomic site. The patient had a unfavourable clinical course and died two months after the diagnosis without receiving any treatment.

Ana María Saenz de Chirife

2004-12-01

285

Linfoma não-Hodgkin em crianças com imunodeficiência: relato de cinco casos / Non-Hodgkin's lymphoma in children with immunodeficiency: report of five cases  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Neste estudo é relatado o quadro clínico de cinco crianças com linfoma não-Hodgkin secundário a imunodeficiência ou imunossupressão: três portadoras do vírus da imunodeficiência humana, uma com imunodeficiência primária e uma após transplante hepático. De acordo com a classificação atual, os tipos h [...] istológicos foram: linfoma linfoblástico de células B precursoras (2), linfoma cutâneo de grandes células anaplásico (1), linfoma de células B periféricas, sugestivo de Burkitt (1), e linfoma linfoblástico de células T precursoras (1). Todos os pacientes foram submetidos a quimioterapia, sendo que dois estão em remissão clínica, dois morreram e um continua em tratamento. Após a introdução da terapia anti-retroviral combinada e o aumento dos transplantes de órgãos sólidos ocorre maior risco de neoplasia nesses pacientes. Desse modo, é importante o seguimento desses pacientes para determinar os fatores de risco para o desenvolvimento de neoplasias e definir adequada estratégia de tratamento. Abstract in english The outcomes of five children with non-Hodgkin's lymphomas associated with immunodeficiency or immunosuppression is reported: three children with HIV, one with primary immunodeficiency and one after liver transplantation. According to the REAL classification, two patients had precursor B-lymphoblast [...] ic lymphomas, one had an anaplastic large cell lymphoma, one had a peripheral B-cell neoplasm suggestive of Burkitt's lymphoma, and one had precursor T-lymphoblastic lymphoma. All patients received chemotherapy. Two are in complete remission, two died and one remains under treatment. There has been an increasing awareness of the risk of non-Hodgkin's lymphoma and lymphoproliferative disorders after active antiretroviral therapy and with the expansion of solid organ transplant programs in the pediatric setting. Thus, for these patients it is important to establish risk factors for hematological disorders and determine the optimal and safest treatment.

Maria Christina L. A., Oliveira; Adriana R., Rodrigues; Keyla C., Sampaio; Ana Cecília S. C., Gomes; Marcos B., Viana.

286

Linfoma não-Hodgkin em crianças com imunodeficiência: relato de cinco casos Non-Hodgkin's lymphoma in children with immunodeficiency: report of five cases  

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Full Text Available Neste estudo é relatado o quadro clínico de cinco crianças com linfoma não-Hodgkin secundário a imunodeficiência ou imunossupressão: três portadoras do vírus da imunodeficiência humana, uma com imunodeficiência primária e uma após transplante hepático. De acordo com a classificação atual, os tipos histológicos foram: linfoma linfoblástico de células B precursoras (2, linfoma cutâneo de grandes células anaplásico (1, linfoma de células B periféricas, sugestivo de Burkitt (1, e linfoma linfoblástico de células T precursoras (1. Todos os pacientes foram submetidos a quimioterapia, sendo que dois estão em remissão clínica, dois morreram e um continua em tratamento. Após a introdução da terapia anti-retroviral combinada e o aumento dos transplantes de órgãos sólidos ocorre maior risco de neoplasia nesses pacientes. Desse modo, é importante o seguimento desses pacientes para determinar os fatores de risco para o desenvolvimento de neoplasias e definir adequada estratégia de tratamento.The outcomes of five children with non-Hodgkin's lymphomas associated with immunodeficiency or immunosuppression is reported: three children with HIV, one with primary immunodeficiency and one after liver transplantation. According to the REAL classification, two patients had precursor B-lymphoblastic lymphomas, one had an anaplastic large cell lymphoma, one had a peripheral B-cell neoplasm suggestive of Burkitt's lymphoma, and one had precursor T-lymphoblastic lymphoma. All patients received chemotherapy. Two are in complete remission, two died and one remains under treatment. There has been an increasing awareness of the risk of non-Hodgkin's lymphoma and lymphoproliferative disorders after active antiretroviral therapy and with the expansion of solid organ transplant programs in the pediatric setting. Thus, for these patients it is important to establish risk factors for hematological disorders and determine the optimal and safest treatment.

Maria Christina L. A. Oliveira

2008-01-01

287

Linfoma primario del sistema nervioso central: serie de casos / Primary lymphoma of the central nervous system: case series  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish INTRODUCCIÓN: el linfoma primario del sistema nervioso central (LPSNC) corresponde a una causa de importante mortalidad dentro de los tumores primarios del sistema nervioso central, además existen pocos datos epidemiológicos actualmente, razón por la cual se decide hacer un reporte de casos en el gr [...] upo de neuropatología de la Universidad de Antioquia. OBJETIVO: describir el comportamiento de esta patología en un grupo de pacientes. MATERIALES Y MéTODOS: se revisaros los estudios patológicos e historias clínicas de 12 pacientes con diagnóstico de LPSNC en el servicio de neuropatología de la Universidad de Antioquia 2004 el 2011. RESUTADOS: se encontraron 12 pacientes que cumplían el criterio de inclusión. De estos pacientes el 61.5% fueron hombres y el 38.5% mujeres. La edad promedio al momento del diagnóstico fue de 42.6 años (1- 77 años). El Linfoma B no hodking de células gigantes con patrón difuso fue el tumor más frecuente con un 83.3 %, 8.35% corresponde a linfoma de células T, 8.35% a Linfoma de Burkitt; 33.3 % corresponden a pacientes inmunode-ficientes. CONCLUSIóN: en esta serie de pacientes con linfoma del sistema nervioso central se encontraron características clínicas similares a las encontradas en la literatura, quizás el único hallazgo disímil fue la mayor cantidad de pacientes sin aparente alteración en el sistema inmune. Abstract in english INTRODUCTION: primary lymphoma of the central nervous system (PCNSL) is a major cause of mortality in primary tumors of the central nervous system, plus there are only a few epidemiological data today, these are the reasons why it was decided to make a report of cases in the group of neuropathology [...] at the University of Antioquia. OBJETIVES: to describe the behavior of this disease in group of patients. MATERIALS AND METHODS: we reviewed the pathological studies and clinical records of 12 patients diagnosed with PCNSL in the service of neuropathology at the University of Antioquia from the years of 2004 to 2011. RESULTS: there were 12 patients who met the inclusion criteria. Of these patients, 61.5% were male and 38.5% women. The average age at diagnosis was 42.6 years (1 - 77 years). The giant cell, diffuse pattern B non-Hodgkin lymphoma was the most frequent tumor with 83.3%,T- cell lymphoma with 8.35%, Burkitt lymphoma 8.35%; 33.3% of the patients were immunodeficient. CONCLUSION: in this series of patients with central nervous system lymphoma similar clinical characteristics were found to those in the medical literature, perhaps the only different finding was a higher rate of patients without an apparent alteration in the immune system.

Jorge Andrés, Jiménez Arango; Salomé, Martínez López; Juan Pablo, Gómez Escobar; Carlos Santiago, Uribe Uribe; Juan Carlos, Arango Viana.

288

Aplicação do índice prognóstico internacional em pacientes com linfoma difuso de grandes células B em uma instituição brasileira The use of the international prognostic index in a Brazilian institution for patients suffering from diffuse large B-cell lymphoma  

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O linfoma difuso de grandes células B (LDGCB) corresponde a 50% dos casos de linfoma não-Hodgkin (LNH). A partir de 1993, o tratamento destes pacientes passou a ser direcionado pelo Índice Internacional de Prognóstico (IPI) validado em vários estudos. Entretanto a aplicação do IPI ainda não foi avaliada em nossa população e em nossas condições socioeconômicas. Neste estudo avaliamos o impacto do IPI ajustado para a idade (IPIa) na remissão completa (RC), sobrevida global (SG) e ...

2005-01-01

289

Optimization of intravascular brachytherapy treatment planning in peripheral arteries.  

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This work deals with the treatment planning optimization for intravascular brachytherapy (IVB) in peripheral arteries. The objective is both to quantitatively study the validity of different hypotheses required for a reliable application of the treatment with current techniques, and to contribute to the definition and the specification of a new optimized procedure taking into account the actual patient's vessel geometry. The detection of vascular luminal surface was performed by an image analysis process, i.e., virtual active navigation, applied to standard CT data. Dose distribution was calculated according to the formalism proposed and recommended by the AAPM in TG43 and TG60. A method combining simulated annealing and BFGS algorithms was applied to optimize the parameters associated with the dwell points such as their number, positions, and dwell times. Dose-surface histogram (DSH) was used to evaluate the dose distribution results. Four levels of accuracy in target surface description were tested. The application of this optimization method to four different CT data sets including patient data, phantom and animal models showed that the treatment plan can be improved when the actual vessel geometry has been taken into account. PMID:17574815

Zhou, Zhengdong; Haigron, Pascal; Shu, Huazhong; Yu, Wenxue; Moisan, Cécile; Manens, Jean-Pierre; Lucas, Antoine; Luo, Limin

2007-09-01

290

Segmentation method of intravascular ultrasound images of human coronary arteries.  

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The goal of this study was to show the feasibility of a 2D segmentation fast-marching method (FMM) in the context of intravascular ultrasound (IVUS) imaging of coronary arteries. The original FMM speed function combines gradient-based contour information and region information, that is the gray level probability density functions of the vessel structures, that takes into account the variability in appearance of the tissues and the lumen in IVUS images acquired at 40 MHz. Experimental results on 38 in vivo IVUS sequences yielded mean point-to-point distances between detected vessel wall boundaries and manual validation contours below 0.11 mm, and Hausdorff distances below 0.33 mm, as evaluated on 3207 images. The proposed method proved to be robust in taking into account various artifacts in ultrasound images: partial shadowing due to calcium inclusions within the plaque, side branches adjacent to the main artery to segment, the presence of a stent, injection of contrast agent or dissection, as tested on 209 images presenting such artifacts. PMID:24119335

Destrempes, François; Roy Cardinal, Marie-Hélène; Allard, Louise; Tardif, Jean-Claude; Cloutier, Guy

2014-03-01

291

Intra-Vascular Neural Interface with Nano-Wire Electrode  

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A less-invasive recording technique capable of simultaneously monitoring the activity of significant number (103 ? 104) of neurons is a vital step in developing an effective brain-machine interface. Although there are many excellent techniques for recording activities of a single neuron or a group of neurons, there is no methodology for accessing large number of cells in a behaving experimental animal or human individual. Brain vascular parenchyma offers the promising candidate to solve this problem. We have proposed the use of myriad of nano-wire-electrodes that are introduced into the Central Nervous System through the vascular system to address any brain area. In this study we design a microcatheter for ex vivo experiments. Using a Wollaston platinum wire we design a submicron-scale electrode, and develop the fabrication method. We then evaluate the mechanical property of the electrode to flow into the intricacies of the capillary bed in ex vivo Xenopus laevis. Furthermore, we demonstrate the feasibility of intravascular recording in the spinal cord of Xenopus laevis.

Watanabe, Hirobumi; Takahashi, Hirokazu; Nakao, Masayuki; Walton, Kerry; Llinás, Rodolfo R.

292

Monolithic CMUT on CMOS Integration for Intravascular Ultrasound Applications  

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One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter based volumetric imaging arrays where the elements need to be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom designed CMOS receiver electronics from a commercial IC foundry. The CMUT on CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT to CMOS interconnection. This CMUT to CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire bonding method. Characterization experiments indicate that the CMUT on CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Experiments on a 1.6 mm diameter dual-ring CMUT array with a 15 MHz center frequency show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging CTOs located 1 cm away from the CMUT array.

Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F. Levent

2012-01-01

293

Filament support spindle for an intravascular cavopulmonary assist device.  

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We are developing an intravascular axial flow blood pump to support adolescent and adult Fontan patients. To protect the blood vessel, this pump has an outer cage with radially arranged filaments and a newly designed spindle at the pump outlet. The outlet spindle is included to limit the axial movement of the rotor and to house bearings that support the rotor. This study evaluates the impact of the outlet spindle on pump performance using computational fluid dynamics (CFD) and experimental testing of a prototype configuration. We measured the pressure-flow performance of the prototype with a protective cage using a blood analog fluid. The pump with the cage filaments and spindle generated 1 to 16mmHg of pressure rise for flow rates of 1 to 4L/min at 4000 to 7000rpm. The difference between the CFD predictions and experimental results was found to be approximately 9.8%. Scalar stress levels remained below 570Pa with exposure times on the order of 1.5s. These results are acceptable and support the continued development of this cavopulmonary assist device with an outlet spindle to reinforce the protective cage filament design. PMID:21092047

Throckmorton, Amy L; Kapadia, Jugal Y; Wittenschlaeger, Thomas M; Medina, Tanisha J; Hoang, Hien Q; Bhavsar, Sonya S

2010-11-01

294

El Tratado De Dilectione Dei de Balduino de Ford  

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Full Text Available Figura relevante de la Orden del Císter, Balduino de Ford es un autor que se distingue por la originalidad de su espiritualidad. Su tratado De dilectione Dei es una meditación sobre el Primer Mandamiento, que nos invita a amar a Dios "con todo el corazón en sus beneficios, con toda el alma en sus promesas, con todas las fuerzas en sus juicios y con toda la mente en sus preceptos". Su reflexión, nutrida de la Biblia y expresada en un lenguaje marcado por la retórica latina, insiste en que el amor perfecto exige del creyente amar lo que a Dios le agrada porque a Él le agrada. Termina identificando prácticamente amor con obedienciaFamous figure of the cistercian order, Baldwin of Ford is an author who stands out for the originality of his spirituality. His treatise "De dilectione Dei" is a meditation about the First Comandment, which is an invitation to love God "with all the heart in His benefits, with all the soul in His promises, with all the forces in His judgements and with all the mind in His precepts". According to his reflection, fed with the Bible and expressed in a language marked by the latin rhetoric, the perfect love requires to love what is pleasing to God because it pleases Him. Baldwin practically identifies love with obedience

Carlos Hallet

2004-01-01

295

El Tratado De Dilectione Dei de Balduino de Ford  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Figura relevante de la Orden del Císter, Balduino de Ford es un autor que se distingue por la originalidad de su espiritualidad. Su tratado De dilectione Dei es una meditación sobre el Primer Mandamiento, que nos invita a amar a Dios "con todo el corazón en sus beneficios, con toda el alma en sus pr [...] omesas, con todas las fuerzas en sus juicios y con toda la mente en sus preceptos". Su reflexión, nutrida de la Biblia y expresada en un lenguaje marcado por la retórica latina, insiste en que el amor perfecto exige del creyente amar lo que a Dios le agrada porque a Él le agrada. Termina identificando prácticamente amor con obediencia Abstract in english Famous figure of the cistercian order, Baldwin of Ford is an author who stands out for the originality of his spirituality. His treatise "De dilectione Dei" is a meditation about the First Comandment, which is an invitation to love God "with all the heart in His benefits, with all the soul in His pr [...] omises, with all the forces in His judgements and with all the mind in His precepts". According to his reflection, fed with the Bible and expressed in a language marked by the latin rhetoric, the perfect love requires to love what is pleasing to God because it pleases Him. Baldwin practically identifies love with obedience

Carlos, Hallet.

296

Neumonías, reporte de dos casos tratados por homeopatía*  

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Full Text Available Las neumonías son entidades que afectan al aparato respiratorio, especialmente al pulmón. Su tratamiento habitual es el uso de antibióticos y en ocasiones en cantidades abusivas. En el presente trabajo se describen dos casos que fueron tratados por homeopatía y en los cuales no fue necesario el uso de los antibióticos. Ambas pacientes habían padecido de bronconeumonía en 3 ocasiones anteriores. A las 2 pacientes se les indicó tratamiento con Phosphoro 6 CH durante 1 mes consecutivo a razón de 5 gotas 3 veces al día, y su respuesta fue favorable al tratamiento, al concluir éste se le dio el medicamento de fondo. Hace 6 meses que padecieron la neumonía y se mantienen asintomáticas.Pneumonias are diseases affecting the respiratory system, specially the lungs. Its habitual treatment consists in the use of antibiotics, which are sometimes excessively used. In this paper we describe 2 cases that are treated by homeopathy with no need of antibiotics. Both patients had suffered from bronchopneumonia 3 times before. They were treated with 5 drops of Phosphorus 6 CH 3 times a day during a month and the response was favorable. On concluding the treatment, they continued taking drugs. These subjects suffered from pneumonia 6 months ago and they are still asymptomatic.

Jorge Luis Campistrous Lavaut

1997-06-01

297

Alterações vasculares na coróide de ratos diabéticos tratados e não tratados / Choroidal vessels alterations in treated and untreated diabetic rats  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Conhecer os efeitos do diabetes e o impacto de seu tratamento medicamentoso em curto e longo prazo sobre os vasos da coróide e membrana de Bruch. MÉTODOS: Foram estudados 30 ratos Wistar, divididos em 3 grupos experimentais: grupo controle (GC), grupo diabético (GD) e grupo diabético trata [...] do (GT), estudados 1 mês (momento M1) e 12 meses (momento M2) após o início do experimento. O diabetes foi induzido por aloxana endovenosa, na dose de 42 mg/kg. O GT foi tratado com hipoglicemiante oral (acarbose) e insulina subcutânea. Após o sacrifício, os olhos foram preparados para exame ao microscópio eletrônico de transmissão, interessando a ultra-estrutura da membrana de Bruch e os vasos da coróide. RESULTADOS: O exame ultra-estrutural da coróide dos ratos diabéticos mostrou depósitos na membrana de Bruch, acúmulo de vesículas, glicogênio e corpos densos no citoplasma das células endoteliais. O grupo mais afetado foi de ratos diabéticos de 12 meses (GDM2). Os animais com menor intensidade de alterações foram os ratos tratados por 12 meses (GTM2). CONCLUSÃO: Os ratos diabéticos desenvolveram alterações degenerativas na membrana de Bruch e vasos da coróide. Estas alterações foram mais evidentes nos animais submetidos à doença crônica, mas também ocorreram agudamente. O tratamento a curto prazo não foi capaz de evitar os processos degenerativos. A longo prazo, o tratamento inibiu a progressão destes processos. Abstract in english PURPOSE: To evaluate the diabetic alterations and the impact of short and long-term medical treatment on them. METHODS: Thirty Wistar rats were divided into 3 groups: control (GC), diabetic (DG), and treated diabetic (TG) and the observations were made 1 month (M1) and 12 months (M2) after diabetes [...] induction. Diabetes was induced by intravenous alloxan (42 mg/kg). The treated group received acarbose orally and insulin by subcutaneous injection. Eyes were prepared for transmission electron microscopy, specifically for ultrastructure of the Bruch membrane and choroidal vessels. RESULTS: Ultrastructural examination of the diabetic rat coroid showed deposits in the Bruch membrane and accumulation of vesicles, glycogen and dense bodies in endothelial cell cytoplasm. The most affected group was that of the diabetics on month 12 (GDM2). The treated diabetics showed the least alterations on month 12 (GTM2). CONCLUSION: Diabetic rats develop degenerative alterations in the Bruch membrane and choroidal vessels. These alterations are more evident in animals submitted to chronic disease, but they are also present in acute disease. Degenerative processes were not avoided with short-term treatment. Long-term treatment inhibited the progress of these processes.

Antonio Carlos Lottelli, Rodrigues; Silvana Artioli, Schellini; César Tadeu, Spadela; Elisa Aparecida, Gregório; Carlos Roberto, Padovani.

298

Concomitant thyroid Malt lymphoma and papillary thyroid carcinoma / Concomitância de linfoma MALT de tireoide e carcinoma papilífero de tireoide  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O objetivo deste trabalho foi descrever um raro linfoma MALT primário de tireoide concomitante com carcinoma papilífero em paciente masculino submetido à tireoidectomia total. O tratamento e o seguimento são discutidos no texto. Paciente masculino com rápido aumento da tireoide sem linfonodomegalias [...] com exames normais. A tireoidectomia total foi indicada e realizada sem complicações. O anatomopatológico mostrou carcinoma papilífero multicêntrico concomitante com linfoma MALT e tireoidite de Hashimoto. A imuno-histoquímica foi positiva para CD 20, CD 43, CD 79, AE1/AE3. O estadiamento clínico não demonstrou evidência de metástases de ambos, Ann Harbor estádio IE, sem sintomas B. Realizado RIT sem radioterapia ou quimioterapia. Atualmente se encontra com tireoglobulina indetectável, sem recidivas ao seguimento de dois anos. Concluiu-se que o linfoma MALT primário de tireoide é raro e o carcinoma papilífero é o mais frequente com boa evolução. A concomitância de ambos é muito rara e o tratamento deve priorizar a neoplasia que apresenta o pior prognóstico no momento da descoberta. Abstract in english The objective of this study was to describe the rare thyroid MALT lymphoma concomitant with papillary thyroid carcinoma in a male patient who was submitted to total thyroidectomy. Treatment and follow-up issues are addressed. Male patient complains of fast thyroid enlargement without lymphadenophaty [...] and normal clinical exams. Total thyroidectomy was indicated and performed without any complications. The pathology showed multicentric papillary thyroid carcinoma, concomitant thyroid MALT lymphoma and Hashimoto's thyroiditis. The immunohistochemistry assay was positive for CD 20, CD 43, CD 79, AE1/AE3. The staging studies showed no evidence of both metastasis, Ann Harbor stage IE, without B symptoms. After RIT no further radiotherapy or chemotherapy was indicated. Nowadays the thyroglobulin is undetectable, without recurrences at two years of follow-up. It was concluded that primary thyroid MALT lymphoma is uncommon being the papillary thyroid carcinoma more frequent. Both occurring concomitantly is very rare and the treatment has to prioritize the tumor of worst prognosis at the discovery moment.

Giulianno Molina de, Melo; Danilo Anunciatto, Sguilar; Cyntia Moniz Figueira, Petiti; André Gustavo Gumz, Eichstaedt; Rogério Ramos, Caiado; Ricardo Antenor de Souza e, Souza.

299

Concomitant thyroid Malt lymphoma and papillary thyroid carcinoma Concomitância de linfoma MALT de tireoide e carcinoma papilífero de tireoide  

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Full Text Available The objective of this study was to describe the rare thyroid MALT lymphoma concomitant with papillary thyroid carcinoma in a male patient who was submitted to total thyroidectomy. Treatment and follow-up issues are addressed. Male patient complains of fast thyroid enlargement without lymphadenophaty and normal clinical exams. Total thyroidectomy was indicated and performed without any complications. The pathology showed multicentric papillary thyroid carcinoma, concomitant thyroid MALT lymphoma and Hashimoto's thyroiditis. The immunohistochemistry assay was positive for CD 20, CD 43, CD 79, AE1/AE3. The staging studies showed no evidence of both metastasis, Ann Harbor stage IE, without B symptoms. After RIT no further radiotherapy or chemotherapy was indicated. Nowadays the thyroglobulin is undetectable, without recurrences at two years of follow-up. It was concluded that primary thyroid MALT lymphoma is uncommon being the papillary thyroid carcinoma more frequent. Both occurring concomitantly is very rare and the treatment has to prioritize the tumor of worst prognosis at the discovery moment.O objetivo deste trabalho foi descrever um raro linfoma MALT primário de tireoide concomitante com carcinoma papilífero em paciente masculino submetido à tireoidectomia total. O tratamento e o seguimento são discutidos no texto. Paciente masculino com rápido aumento da tireoide sem linfonodomegalias com exames normais. A tireoidectomia total foi indicada e realizada sem complicações. O anatomopatológico mostrou carcinoma papilífero multicêntrico concomitante com linfoma MALT e tireoidite de Hashimoto. A imuno-histoquímica foi positiva para CD 20, CD 43, CD 79, AE1/AE3. O estadiamento clínico não demonstrou evidência de metástases de ambos, Ann Harbor estádio IE, sem sintomas B. Realizado RIT sem radioterapia ou quimioterapia. Atualmente se encontra com tireoglobulina indetectável, sem recidivas ao seguimento de dois anos. Concluiu-se que o linfoma MALT primário de tireoide é raro e o carcinoma papilífero é o mais frequente com boa evolução. A concomitância de ambos é muito rara e o tratamento deve priorizar a neoplasia que apresenta o pior prognóstico no momento da descoberta.

Giulianno Molina de Melo

2010-06-01

300

Linfoma primario del sistema nervioso central en un paciente inmunocompetente / Primary central nervous system lymphoma in an immunocompetent patient  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El linfoma primario del sistema nervioso central (LPSNC) constituye el 2% de los linfomas extranodales y entre 0,3% y 1,5% de todas las neoplasias intracraneales en pacientes inmunocompetentes, siendo más frecuente a partir de los 60 años. Reportamos el caso de un paciente varón de 76 años, sin ante [...] cedentes médicos de importancia, que inició su enfermedad con inestabilidad en la marcha, dificultad para mover el hemicuerpo izquierdo, a predominio braquial, cefalea holocraneal y mareos. Ingresó a emergencia despierto, parcialmente desorientado, Glasgow 14 y ptosis palpebral derecha; además, hemiparesia e hipoestesia izquierda, a predominio crural. Por tomografía computarizada cerebral se evidenció imagen captadora de contraste en región frontoparietal derecha, intra y extra craneal, edema cerebral y desplazamiento de la línea media. Se realizó craneotomía y biopsia del tumor, diagnosticándose linfoma difuso de células grandes B del sistema nervioso central. Fue VIH negativo. Se descartó otro tumor primario y metástasis. Recibió esquema CHOD/BVAM y radioterapia. Evolucionó favorablemente. Según resonancia magnética cerebral postratamiento, desapareció el tumor. Abstract in english Primary central nervous system lymphoma (PCNSL) constitutes 2% of extranodal lymphomas and 0,3%-1,5% of all intracranial neoplasms in immunocompetent patients, being more frequent after the sixth decade of life. We report a case of a 76 year-old man with no antecedents who started his disease with m [...] arch instability, difficulty to move left side of his body with brachial predominance, holocraneal headache and dizziness. He arrived at emergency with Glasgow 14 and right eyelid ptosis. He had left sided hemiparesis and hypoesthesia with crural predominance and occasional disorientation. Brain computed tomography (CT) showed a contrast-enhanced image in the right frontoparietal region with both extra- and intra-cranial components, cerebral edema and middle line deviation. Craniotomy and biopsy of the tumor resulted in diffuse large B cell lymphoma of the central nervous system. The patient was HIV negative. Other primary tumor and metastasis were discarded. He was treated with ?CHOD/BVAM? regimen and radiotherapy. He evolved favorably. No tumor was found in the post treatment brain MRI.

Málaga-Zenteno, José; Mamani-Quispe, Jersson Alonso; Fuentes Fuentes, Mariela; Suclla-Velásquez, José Alonso; Meza Aragón, Julio.

 
 
 
 
301

Intravascular natural killer cell lymphoma mimicking mycosis fungoides: a case report and review of the literature.  

Science.gov (United States)

: Intravascular lymphoma is a rare entity. Most cases constitute a variant of extranodal diffuse large B-cell lymphoma, and only 10% of the published cases are of T-cell or histiocytic origin. Even fewer cases of intravascular natural killer (NK) cell lymphoma have been reported. To date, only the intravascular lymphoma of B-cell linage is recognized as a distinct entity by the WHO Classification. Here, we report the clinical, morphological, immunohistochemical, and molecular findings of a 72-year-old male patient with intravascular NK-cell lymphoma of the skin who initially presented with red skin efflorescences suspicious of mycosis fungoides. A skin biopsy revealed large cell infiltrates of NK/T-cell phenotype (CD3?, CD4, CD8, CD56, and TIA-1), which were localized strictly intravascularly and which were positive for Epstein-Barr virus nucleic acid EBER (Epstein-Barr virus-encoded small RNA). Molecular studies revealed a germline configuration for the T-cell receptor consistent with the possibility of an NK-cell origin. At the beginning, the disease appeared to be limited to the skin with no sign of bone marrow involvement or leukemic dissemination. Chemotherapy was initiated; however, the patient subsequently developed meningiosis lymphomatosa with recurrent epileptic episodes and bone marrow infiltration with pancytopenia 7 months after primary admission. Finally, the patient passed away in a septic shock. PMID:24803068

Gebauer, Niklas; Nissen, Ebba J; Driesch, Peter von den; Feller, Alfred C; Merz, Hartmut

2014-05-01

302

Leishmaniosis laríngea recidivante: un caso inusual en un paciente inmunocompetente tratado con corticoides Recidivant laryngeal leishmaniosis: an unusual case in an immunocompetent patient treated with corticosteroids  

Directory of Open Access Journals (Sweden)

Full Text Available La leishmaniosis es una parasitosis de evolución crónica; en Argentina, sus agentes etiológicos principales pertenecen al complejo Leishmania (Viannia braziliensis, habitualmente asociado a lesiones cutáneas y mucocutáneas. Informamos en este trabajo un caso de leishmaniosis laríngea en un hombre de 29 años procedente de Jujuy, quien a raíz de múltiples subdiagnósticos portaba esta parasitosis desde hacía 20 años. En el año 2008 este paciente consulta por disfonía crónica y trastornos en las vías aéreas superiores, refiere que fue sometido a terapias con tuberculostáticos, antifúngicos y corticoides desde 2002. Diferentes biopsias y fibroscopías revelaron los siguientes diagnósticos: laringitis granulomatosa inespecífica, laringitis compatible con tuberculosis, laringitis compatible con histoplasmosis, linfoma Natural Killer extraganglionar a células pequeñas. Finalmente, estudios realizados en nuestro hospital demostraron la presencia de una laringe granulomatosa en toda su extensión, amastigotes intra y extracelulares de Leishmania spp., ausencia de formas compatibles con Micobacterias e Histoplasma, y laringitis crónica vinculable a Leishmania spp. El paciente realizó tratamiento con antimoniato de N-metil-glucamina y demostró una muy buena evolución clínica tras ser examinado 2 meses después. Si bien la leishmaniosis laríngea como lesión única no es la presentación prevalente de esta zoonosis, su estudio amerita especial atención en pacientes tratados con corticoides, pues esto evitará un diagnóstico tardío y las mayores consecuencias asociadas a la morbimortalidad propia de esta parasitosis.Leishmaniosis is a chronic parasitic disease, which in Argentina is mainly caused by protozoa belonging to the Leishmania (Viannia braziliensis complex, leading to cutaneous and mucosal pathologies. We report a rare case of laryngeal leishmaniosis in a 29 year-old man from Jujuy province, Argentina, who had been misdiagnosed with other pathologies, carrying this infectious disease for about 20 years. During 2008, the patient was admitted with complaints of progressive hoarseness of the voice and dyspnea. He also reported having received tuberculostatics, antifungal and corticosteroids treatments since 2002. Different biopsies and direct laryngoscopic exams revealed inespecific granulomatous larynx, TBC-related laryngitis, laryngitis related to Histoplasma infection, extra-nodal Natural Killer-cell lymphoma. Finally, the patient was evaluated at the University Hospital and the final diagnosis was: granulomatous larynx, intra and extra-cytoplasmic Leishmania spp amastigotes, negative for TBC and Histoplasma cultures, and chronic laryngitis related to Leishmania infection, according to the laryngeal endoscopy, microbiological and histopathological exams, respectively. The patient received pentavalent antimonial treatment and his condition improved after 2 months of follow-up. Primary laryngeal leishmaniosis is rare and this localization does not belong to the most prevalent mucosal leishmaniosis. However, this parasitic disease warrants special concern, especially in patients who received prolonged corticosteroid treatments, in order to avoid a misdiagnosis of this disease.

R. Casero

2010-06-01

303

Linfoma de células B de la zona marginal extranodal del tejido linfoide asociado a mucosas (malt) primario de esófago: Presentación de un caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish El tracto gastrointestinal es la localización mas frecuente de los linfomas no Hodgkin extranodales, sin embargo, el compromiso del esófago es extremadamente raro, con una incidencia menor del 1% de todos los pacientes con linfoma. Se ha descrito con mayor frecuencia afectación secundaria del esófag [...] o como parte de un compromiso extenso de un linfoma gástrico o mediastinal. Se presenta el caso de paciente femenina, de 59 años de edad, con síntomas dispépticos de 2 meses de evolución. En la Endoscopia Digestiva Superior (EDS) se evidencia en tercio distal de esófago, lesión elevada, de 1cm de diámetro, con características similares al resto de la mucosa, móvil. La biopsia Endoscópica revela la presencia de un linfoma MALT de bajo grado confirmado por inmunohistoquímica. Se indicó tratamiento de erradicación para H pylori, y los estudios de extensión fueron normales. Posteriormente se realizó resección mucosal endoscópica, donde se observaron grupos aislados de linfocitos neoplásicos, con bordes de resección libres. Paciente con seguimiento endoscópico normal. Pocos casos han sido reportados en la literatura acerca de linfomas MALT de esófago, por lo tanto las características clínicas y biológicas de estos linfomas no están claramente establecidas. Es necesario el estudio y seguimiento de estos casos, para determinar los posibles factores de riesgo y así aplicar las medidas preventivas. Abstract in english The gastrointestinal tract is the most common extra nodal site involved in Non- Hodgkin's lymphoma. However, esophageal involvement is extremely rare, accounting for less than 1% of patients with lymphoma. It has been described that esophageal involvement in lymphoma is more often a result of contig [...] uous spread from mediastinal lymph nodes or from an extended gastric lymphoma. A 59 year old female consulted for dyspeptic symptoms. Endoscopic examination revealed a small submucosal mass, that measured 1 cm located at the lower thoracic esophagus. The biopsy reported a Malt lymphoma that was confirmed by immunohistochemistry. She received therapy for H. pylori eradication. Endoscopic mucosal resection was performed, and isolated groups of atypical lymphocytes were found, with free resection margins. Endoscopic follow up has been normal. Few cases have been reported in literature, therefore biological and clinical characteristics of MALT lymphoma of the esophagus are currently unknown, further study is needed to establish risk factors in order to be able to take preventive measures.

L, Zambrano; M, Calderón; S, Romero; S, Peraza; L, Fuenmayor; K, Bustamante; N, Zambrano; D, Parlapiano; D, Castro; A, Morales; J, García.

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Incidência e aspectos de imagem do linfoma pós-transplante hepático em crianças Incidence and imaging findings of lymphoma after liver transplantation in children  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Avaliar a incidência e os aspectos de imagem do linfoma pós-transplante hepático em crianças. MATERIAIS E MÉTODOS: Foram revisados os prontuários e exames de imagem de crianças submetidas a transplante hepático entre 2000 e 2008 em uma única instituição. RESULTADOS: De 241 crianças submetidas a transplante hepático, com seguimento médio de 41,4 ± 26,4 meses, 16 (6,6% tiveram linfoma. A média de idade no transplante hepático das crianças que desenvolveram linfoma foi inferior à das crianças que não desenvolveram (23,9 ± 18,9 vs. 38,0 ± 48,9 meses; p = 0,02. O tempo entre o transplante e o desenvolvimento do linfoma variou de 6 a 103 meses. A apresentação clínica e radiológica foi variável e a localização mais comum do tumor foi no abdome (n = 13; 81,3%, seguida de tórax e cabeça e pescoço (n = 4; 25,0% cada. Os achados de imagem incluíram: linfonodomegalias, massas mediastinais, pulmonares e mesentéricas, espessamento parietal de alças intestinais e nódulos hepáticos e renais. Quatro crianças (25,0% faleceram devido a complicações do linfoma. CONCLUSÃO: Linfomas são complicações relativamente incomuns e potencialmente fatais que podem acontecer a qualquer momento após o transplante hepático em crianças, e que têm diversas apresentações clínicas e de imagem.OBJECTIVE: To evaluate the incidence and imaging findings of lymphoma after liver transplantation in children. MATERIALS AND METHODS: The authors reviewed records and imaging studies of children submitted to liver transplantation in the period between 2000 and 2008 in a single institution. RESULTS: Among 241 children submitted to liver transplantation, with a mean follow-up period of 41.4 ± 26.4 months, 16 (6.6% had lymphoma. The mean age of the patients who developed lymphoma at the moment of transplantation was lower than in children who did not develop malignancy (23.9 ± 18.9 versus 38.0 ± 48.9 months; p = 0.02. The time interval between liver transplantation and the diagnosis of lymphoma ranged from 6 to 103 months. Clinical and radiological presentation was variable and the abdomen was the most common location of the tumor (n = 13; 81.3%, followed by chest and head and neck (n = 4; 25.0% each. Imaging findings included adenopathy, mediastinal, pulmonary and mesenteric masses, bowel wall thickening and hepatic and renal nodules. Four children (25.0% died because of complications of lymphoma. CONCLUSION: Lymphomas are relatively uncommon and potentially fatal complications that may occur any time after pediatric liver transplantation, presenting different clinical and imaging findings.

Almir Galvão Vieira Bitencourt

2012-02-01

305

El Tratado Antártico, vehículo de paz en un campo minado  

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Full Text Available El 99% de la superficie de la Antártica, esto es 14 millones de Km², está cubierta por hielos de unos 2 Km de profundidad. Además de ser el continente más frío, la Antártica es también el más seco, ventoso y alto del mundo, con una elevación media de 2.500 Mt. Tales características físicas explican la ausencia de población humana indígena en el área, así como lo tardío de su exploración y explotación por parte de estados europeos y americanos entre otros. Sólo a partir del siglo XVIII comienzan las expediciones al territorio antártico, con finalidades que van desde la investigación científica, pasando por la pesca de ballenas, hasta intentos de anexión territorial por parte de alguna nación. Conforme avanza el siglo XX, continúa la penetración del continente y los reclamos de soberanía sobre distintas áreas de la zona. Esto dio pie a disputas y choques entre estados. Durante la II Guerra Mundial amenazaba con transformarse en un nuevo escenario de enfrentamiento bélico entre las fuerzas enemigas. A lo largo de la Guerra Fría, se ve con temor que la Antártica podría ser tomada como centro de pruebas de armamento convencional y nuclear. A fin de evitar estos males y regularizar la explotación y exploración del continente, nació el Sistema del Tratado Antártico o STA. El régimen fue creado en 1958-1959 y pretendió detener las demandas de soberanía territorial además de salvaguardar el área de cualquier amenaza nuclear y militar. Aunque las partes signatarias tienen un evidente interés de futura anexión territorial, y el STA no ha logrado dar solución al problema de la soberanía sobre el continente, al menos ha congelado una peligrosa fuente de discordia e inestabilidad regional y mundial. Especialmente interesantes son los casos de Chile, Argentina y el Reino Unido, cuyas demandas territoriales sobrepuestas constituyen un buen ejemplo del choque de los títulos de soberanía esgrimidos por diversas naciones, con frecuencia basados en diferentes sistemas jurídicos. Finalmente, el establecimiento del Tratado Antártico ha dado tiempo a la evolución del derecho internacional, con la esperanza de que futuras regulaciones territoriales puedan traer una solución no violenta respecto a la posesión del continente.The history of human activity in Antarctic is largely explained by its remoteness and its unique physical characteristics. 99% of its surface, i.e. 14 million Km², is covered by ice with an average depth of 2 km, constituting over 90% of the globe's ice. Besides being the coldest continent, it is also the driest, the windiest and the highest, with an average elevation of 2,500 m. The harshness of its environment explains the lack of indigenous human population of the area and the late dates of its recognition. As the legal, political and economic interest in the region took shape, different countries started to assert their right to territorial sovereignty over various parts of the continent. The strong emphasis on sovereignty, particularly in the context of overlapping claims by various nations, resulted in clashes -verbal and physical - which threatened the peaceful relations in Antarctic. Within this context the Antarctic Treaty and its supporting agreements and arrangements -collectively, the Antarctic Treaty System or ATS- emerged. The regime was created in 1958-1959 aiming to halt the potentially explosive nature of the sovereignty claims and trying to safeguard the area from any nuclear and military threat. In regards to the claims, those put forward by Chile, Argentina and the United Kingdom, are a good example of overlapping territorial demands based on diverse legal systems. Although the ATS has been a remarkable agreement, it has also has several problems. In fact, the management of the sovereignty issue has been both its principle problem and its most brilliant achievement. ATS has simultaneously frozen a very difficult issue and given time to the evolution of international law, with the hope that the future might bring a non-violent solutio

M. Cristina Prieto Larrain

2004-01-01

306

Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis  

Energy Technology Data Exchange (ETDEWEB)

Heart disease is by far the biggest killer in the United States, and type II diabetes, which affects 8% of the U.S. population, is on the rise. In many cases, the acute coronary syndrome and/or sudden cardiac death occurs without warning. Atherosclerosis has known behavioral, genetic and dietary risk factors. However, our laboratory studies with animal models and human post-mortem tissue using FT-IR microspectroscopy reveal the chemical microstructure within arteries and in the arterial walls themselves. These include spectra obtained from the aortas of ApoE-/- knockout mice on sucrose and normal diets showing lipid deposition in the former case. Also pre-aneurysm chemical images of knockout mouse aorta walls, and spectra of plaque excised from a living human patient are shown for comparison. In keeping with the theme of the SPEC 2008 conference Spectroscopic Diagnosis of Disease this paper describes the background and potential value of a new catheter-based system to provide in vivo biochemical analysis of plaque in human coronary arteries. We report the following: (1) results of FT-IR microspectroscopy on animal models of vascular disease to illustrate the localized chemical distinctions between pathological and normal tissue, (2) current diagnostic techniques used for risk assessment of patients with potential unstable coronary syndromes, and (3) the advantages and limitations of each of these techniques illustrated with patent care histories, related in the first person, by the physician coauthors. Note that the physician comments clarify the contribution of each diagnostic technique to imminent cardiac risk assessment in a clinical setting, leading to the appreciation of what localized intravascular chemical analysis can contribute as an add-on diagnostic tool. The quality of medical imaging has improved dramatically since the turn of the century. Among clinical non-invasive diagnostic tools, laboratory tests of body fluids, EKG, and physical examination are still the first line of defense. However, with the fidelity of 64-slice CT imaging, this technique has recently become an option when the patient presents with symptoms of reduced arterial flow. Single photon emission computerized tomography (SPECT) treadmill exercise testing is a standard non-invasive test for decreased perfusion of heart muscle, but is time consuming and not suited for emergent evaluation. Once the invasive clinical option of catherization is chosen, this provides the opportunity for intravascular ultrasound (IVUS) imaging. As the probe is pulled through the artery, the diameter at different parts is measurable, and monochrome contrast in the constricted area reveals the presence of tissue with a different ultrasonic response. Also, via an optical catheter with a fiber-optic conductor, the possibly of spectroscopic analysis of arterial walls is now a reality. In this case, the optical transducer is coupled to a near-infrared spectrometer. Revealing the arterial chemical health means that plaque vulnerability and imminent risk could be assessed by the physician. The classical emergency use of catherization involves a contrast agent and dynamic X-ray imaging to locate the constriction, determine its severity, and possibly perform angioplasty, and stent placement.

Wetzel, D.; Wetzel, L; Wetzel, M; Lodder, R

2009-01-01

307

Fibronectin: blood turnover in normal animals and during intravascular coagulation  

Energy Technology Data Exchange (ETDEWEB)

Plasma fibronectin (FN) binds fibrin in vitro by both noncovalent and covalent bonds and is decreased in DIC. In rabbits, conventionally purified /sup 125/I-FN had a complex blood clearance with a late t1/2 of 71 hr. A large portion was apparently altered, as evinced by rapid clearance and an intravascular/total body ratio (C1) of 0.28-0.51. /sup 3/H-labeled FN, made in vivo by injection of /sup 3/H amino acids, had a t1/2 of 73 hr. Crosstransfusion of /sup 131/I-FN and /sup 3/H-FN into a second set of animals gave similar t1/2s and C1s of 0.74-0.82, indicating the altered /sup 125/-FN was biologically screened in the first animals. Other animals were given /sup 125/I-fibrinogen and screened /sup 131/I-FN. Intravenous thrombin (50-60 U/kg/1 hr) caused a 25%-50% decrease in both /sup 125/I-fibrinogen and /sup 131/I-FN. Ancrod injection reduced fibrinogen by greater than 90% but had no effect on /sup 131/I-FN. /sup 131/I-FN levels did not change when thrombin was given after ancrod. No cross-linked FN-fibrinogen alpha-chain was found in the plasma, nor was the thrombin-induced fall in FN affected by spermidine blockade. These experiments demonstrate that FN and fibrin bind in vivo during defibrination and are rapidly cleared from the blood. The abnormal fibrin resulting from ancrod either does not bind FN in vivo or does so reversibly.

Sherman, L.A.; Lee, J.

1982-09-01

308

Fast treatment planning with IVUS imaging in intravascular brachytherapy  

Science.gov (United States)

The planned target volume in intracoronary brachytherapy is the vessel wall. The success of the treatment is based on the need of delivering doses possibly not lower than 8 and not higher than 30 Gy. An automatic procedure in order to acquire intravascular ultrasound images of the whole volume to be irradiated is pointed out; a motor driven pullback device, with velocity of the catheter of 0.5 and 1 mm/s allows to acquire the entire target volume of the vessel with a number of slices normally ranging from 400 to 1600. A semiautomatic segmentation and classification of the different structures in each slice of the vessel is proposed. The segmentation and the classification of the structures allows the calculation of their volume; this is very useful in particular for plaque volume assessment in the follow-up of the patients. A 3D analyser tool was developed in order to visualize the walls and the lumen of the vessel. The knowledge, for each axial slice, of the position of the source (in the centre of the catheter) and the position of the target (vessel walls) allows the calculation of a set of source-target distances. Given a time of irradiation, and a type of source a dose volume histogram (DVH) describing the distribution of the doses in the whole target can be obtained. The whole procedure takes few minutes and then is compatible with a safe treatment of the patient, giving an important indication about the quality of the radiation treatment selected.

Novario, Raffaele; Bianchi, Carla; Lorusso, Rita; Sampietro, Chiara; Tanzi, Fabio; Conte, Leopoldo; Vescovi, Mario; Caccia, Massimo; Alemi, Mario; Cappellini, Chiara

2004-05-01

309

Protection against high intravascular pressure in giraffe legs  

DEFF Research Database (Denmark)

The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure.

Petersen, Karin K; Hørlyck, Arne

2013-01-01

310

Protection against high intravascular pressure in giraffe legs.  

Science.gov (United States)

The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure. PMID:24005251

Petersen, Karin K; Hørlyck, Arne; Ostergaard, Kristine H; Andresen, Joergen; Broegger, Torbjoern; Skovgaard, Nini; Telinius, Niklas; Laher, Ismael; Bertelsen, Mads F; Grøndahl, Carsten; Smerup, Morten; Secher, Niels H; Brøndum, Emil; Hasenkam, John M; Wang, Tobias; Baandrup, Ulrik; Aalkjaer, Christian

2013-11-01

311

Thromboelastometry in patients with severe sepsis and disseminated intravascular coagulation.  

Science.gov (United States)

Severe sepsis induces coagulopathy, which may lead to disseminated intravascular coagulation (DIC). Thromboelastometry is a point-of-care whole blood coagulation monitor, which has been validated in human endotoxemia model. We assessed thromboelastometry in severe sepsis and overt DIC and investigated its applicability in differentiating sepsis-related coagulation disturbances. Thromboelastometry (EXTEM and FIBTEM tests) and traditional coagulation assays were analyzed in 28 patients with severe sepsis, 12 of who fulfilled the criteria of overt DIC on admission. Ten healthy persons served as controls. Coagulation parameters, clotting time, clot formation time (CFT), alpha angle, maximal clot firmness (MCF) and lysis index at 60 min, were registered. In patients with overt DIC, EXTEM MCF, CFT and alpha angle differed from that in both healthy controls and patients without DIC, indicating hypocoagulation (MCF 52, 63 and 68 mm; CFT 184, 88 and 73 s; and alpha angle 58, 72 and 76 degrees , respectively, P < 0.01 for all). In patients without DIC, the trend was toward hypercoagulation in EXTEM and FIBTEM MCF (68 vs. 63 mm, P = 0.042 and 23 vs. 15 mm, P = 0.034, respectively). Receiver operating characteristic curves showed that MCF, CFT and alpha angle discriminated patients with overt DIC moderately (area under curve 0.891, 0.815 and 0.828, respectively, P < 0.001 for all). Traditional coagulation assays showed progressively worsening coagulopathy from controls to septic patients without DIC and further to those with overt DIC. We conclude that thromboelastometry may be a valuable tool in assessing whole blood coagulation capacity in patients with severe sepsis with and without overt DIC. PMID:19581801

Sivula, Mirka; Pettilä, Ville; Niemi, Tomi T; Varpula, Marjut; Kuitunen, Anne H

2009-09-01

312

Monolithic CMUT-on-CMOS integration for intravascular ultrasound applications.  

Science.gov (United States)

One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter-based volumetric imaging arrays, for which the elements must be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom-designed CMOS receiver electronics from a commercial IC foundry. The CMUT-on-CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low-temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT-to-CMOS interconnection. This CMUT-to-CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire-bonding method. Characterization experiments indicate that the CMUT-on-CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Ex- periments on a 1.6-mm-diameter dual-ring CMUT array with a center frequency of 15 MHz show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging chronic total occlusions located 1 cm from the CMUT array. PMID:23443701

Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F Levent

2011-12-01

313

Linfoma Burkitt del seno esfenoidal en pediatría: Reporte de caso / Burkitt Lymphoma of the Sphenoid Sinus in Children: Case Report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se reporta un caso de linfoma Burkitt del seno esfenoidal en un paciente de sexo masculino, de 3 años de edad, de raza caucásica. Presentaba un cuadro clínico de 10 días de evolución con deterioro del sensorio, vómitos y amaurosis bilateral y, por tomografía computada y resonancia magnética, se iden [...] tificó una masa que comprometía el seno esfenoidal. Se arribó al diagnóstico por anatomía patológica e inmunomarcación. Abstract in english We report a case of Burkitt lymphoma of the sphenoid sinus in a 3 year-old caucasian male patient. He presented a clinical condition of 10 days of improvement with a sensory deterioration, vomiting and bilateral amaurosis. A mass which compromised the sphenoid sinus was identified by computed tomogr [...] aphy and magnetic resonance imaging. The diagnosis could be reached by pathology and immunohistochemical studies.

Jorge, Docampo; Carolina, Mariluis; Gustavo, Civitarese; Carlos, Castillo; Carlos, Morales; Claudio, Bruno.

314

Linfoma No Hodgkin, manifestaciones oftalmológicas: Presentación de 1 caso / Non-Hodgkin's lymphoma, ophthalmological manifestations: A case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta un paciente con Linfoma no Hodgkin linfocítico estadio IV y Retinosis Pigmentaria de base diagnosticado en el Centro de Referencia Nacional de Retinosis Pigmentaria, con manifestaciones oftalmológicas de esta neoplasia, remitido, además, al Instituto Nacional de Oncología y Radiobiología [...] . Se ilustra con imágenes estas lesiones infrecuentes. Abstract in english A patient with lymphocytic stage IV non-Hodgkin's lymphoma and base Retinitis Pigmentosa diagnosed at the National Reference Center of Retinitis Pigmentosa is presented. The patient, who showed ophthalmological manifestations of this neoplasia was also referred to the National Institute of Oncology [...] and Radiobiology. These uncommon injuries are illustrated with images.

Ramírez Castro, Tomás; Lorenzo González, María E..

315

Accumulation of /sup 99m/Tc-sulfur colloid by the lung and kidney following disseminated intravascular coagulation  

International Nuclear Information System (INIS)

A patient is described who demonstrated accumulation of /sup 99m/Tc-sulfur colloid in both the lung and kidney following treatment for disseminated intravascular coagulation. This phenomenon has been demonstrated experimentally in animals following the induction of disseminated intravascular coagulation, but to our knowledge has not been previously described in humans

1980-01-01

316

Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: A systematic review and meta-analysis  

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Abstract Background Contrast-induced nephropathy is an important cause of acute renal failure. We assess the efficacy of acetylcysteine for prevention of contrast-induced nephropathy among patients undergoing intravascular angiography. Methods We conducted a systematic review and meta-analysis of randomized controlled trials comparing prophylactic acetylcysteine plus hydration versus hydration alone in patients undergoing intravascular angiography. Studies were ...

2004-01-01

317

Characteristics of intravascular large B-cell lymphoma on cerebral MR imaging.  

Science.gov (United States)

IVL is characterized by a propensity for intravascular tumor cell proliferation. Premortem diagnosis of IVL is difficult because of its nonspecific clinical, laboratory, and imaging manifestations. This study examined cerebral MR imaging patterns of IVL and their changes with and without chemotherapy. Nine of 11 patients studied presented with abnormal findings. We define 5 patterns of abnormal MR imaging findings: 1) infarctlike lesions, 2) nonspecific white matter lesions, 3) meningeal enhancement, 4) masslike lesions, and 5) hyperintense lesions in the pons on T2WI. Seven patients presented with only 1 pattern, while 2 patients presented with multiple patterns. Lesions in 7 treated patients responded to chemotherapy. Pathologic specimens revealed intravascular tumor cell infiltration with associated infarctions, necrosis, congestion, demyelination, vasculitis, and tumor cell extravasation. We conclude that MR imaging patterns can be possible manifestations of intravascular-dominant infiltration by tumor cells with associated occlusion or inflammation, depending on the level of affected vessels. PMID:22173763

Yamamoto, A; Kikuchi, Y; Homma, K; O'uchi, T; Furui, S

2012-02-01

318

A case of giant cavernous hemangioma of the liver complicated by intravascular coagulopathy.  

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Full Text Available A case of liver hemangioma complicated by intravascular coagulopathy is presented because of the rarity of the association. Hemangioma of the liver was suspected by palpation of the liver tumor, scintigraphy and x-ray examination, and confirmed by selective hepatic arteriography in combination with exploratory laparotomy. Intravascular coagulopathy was established by demonstrating secondary fibrinolysis and consumption of platelets and coagulation factors. Unconjugated hyperbilirubinemia due to micro-angiopathic hemolytic anemia was also present. The clinical course of the clotting abnormalities was basically a chronic one with an occasional acute or subacute defibrination process associated with further enlargement of the hepatic tumor. These provide sufficient evidence that the intravascular coagulopathy was closely related with the hemangioma in the liver. Neither ligation of a presumed nutritional artery of the hemangioma nor radiation therapy caused any demonstrable reduction in the tumor size.

Watanabe,Makoto

1978-04-01

319

Imaging findings of acute intravascular thrombus on non-enhanced computed tomography.  

Science.gov (United States)

Intravascular thrombosis and thromboembolism are critical diagnoses which are frequently made on contrast-enhanced computed tomography (CECT) or Doppler ultrasound. For a variety of reasons, some patients with acute intravascular pathology are imaged using CT without intravenous contrast. In the acute setting, the increased Hounsfield unit (HU) density of the thrombus compared to the blood pool allows the diagnosis to be made, or at least suggested, on non-enhanced computed tomography (NECT). The increased density of the clot is commonly referred to as the "hyperdense vessel sign." This is a well-known finding in the setting of stroke, but hyperdense vessels can also signal arterial or venous thrombosis in the chest, abdomen, pelvis, and extremities. Once a hyperdense vessel sign is noted on NECT, further exploration with CECT, angiography, or ultrasound may then be performed. Here, we present a pictorial review of the appearance of acute intravascular thrombosis as seen on non-enhanced computed tomography. PMID:24652034

Whitesell, Ryan T; Steenburg, Scott D

2014-06-01

320

Currently available methodologies for the processing of intravascular ultrasound and optical coherence tomography images.  

Science.gov (United States)

Optical coherence tomography and intravascular ultrasound are the most widely used methodologies in clinical practice as they provide high resolution cross-sectional images that allow comprehensive visualization of the lumen and plaque morphology. Several methods have been developed in recent years to process the output of these imaging modalities, which allow fast, reliable and reproducible detection of the luminal borders and characterization of plaque composition. These methods have proven useful in the study of the atherosclerotic process as they have facilitated analysis of a vast amount of data. This review presents currently available intravascular ultrasound and optical coherence tomography processing methodologies for segmenting and characterizing the plaque area, highlighting their advantages and disadvantages, and discusses the future trends in intravascular imaging. PMID:24949801

Athanasiou, Lambros; Sakellarios, Antonis I; Bourantas, Christos V; Tsirka, Georgia; Siogkas, Panagiotis; Exarchos, Themis P; Naka, Katerina K; Michalis, Lampros K; Fotiadis, Dimitrios I

2014-07-01

 
 
 
 
321

Linfoma de Hodgkin em baixa faixa etária: relato de dois casos Hodgkin's lymphoma in young children: two cases report  

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Full Text Available Relato de dois casos de pacientes do sexo masculino com linfoma de Hodgkin (LH e idades inferiores a 5 anos apresentando linfonodomegalias com evolução de alguns meses e seguimento em nosso serviço. Os estudos imuno-histopatológicos do tumor confirmaram linfoma de Hodgkin, esclerose nodular e positividade para o vírus Epstein-Barr (EBV em material tumoral, em ambos os casos. Após período de 13 meses em remissão completa houve recidiva em um dos pacientes, mostrando doença agressiva. A análise laboratorial do tumor mostrou as mesmas características da doença inicial, e mantendo a positividade ao EBV. Uma exposição mais precoce e intensa ao EBV poderia aumentar o risco para formas muito precoces da doença e a inesperada evolução poderia estar ligada à associação do subtipo histológico e positividade ao EBV.The cases of two male under five-year-olds diagnosed with Hodgkin's lymphoma presenting as lymphadenopathy in evolution for some months and treated in our hospital are reported. Immunohistopathological findings of the tumors proved the existence of Hodgkin's lymphoma nodular sclerosis and positive Epstein-Barr virus in tumoral material in both cases. After 13 months of complete remission one of the patients relapsed and presented aggressive disease. Laboratorial analyses of the tumor showed the same characteristics as the initial disease including positive Epstein-Barr virus. Early and intense exposure to Epstein-Barr virus may increase the risk related to the very early development of the disease and the unexpected evolution may be connected to the association of the histological subtype and the positive Epstein-Barr virus.

Silvia M. Luporini

2006-12-01

322

Linfoma folicular primario duodenal: Informe de un caso y revisión de la literatura / Primary follicular lymphoma of the duodenum: Case report and literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Mujer de 80 años con síntomas dispépticos a quien se le realizó endoscopia de vías digestivas altas que mostró lesiones polipoides confluentes en la segunda porción del duodeno, cuyo estudio histológico indicó un linfoma no Hodgkin B folicular primario, neoplasia duodenal infrecuente de bajo grado, [...] la cual debe diferenciarse de hiperplasia linfoide folicular reactiva y de otros linfomas Abstract in english Patient was an 80 year old woman with dyspepsia. An upper endoscopy showed confluent polypoid lesions in the second portion of the duodenum. A histological study showed a follicular B-cell lymphoma. This is a rare low grade neoplasm of duodenum which must be differentiated from follicular reactive h [...] yperplasia and other lymphomas

Hiromi López T, Juan Carlos; Casasbuenas D, María del Pilar; Acosta F, Jinneth; Ricaurte G, Orlando.

323

Linfoma folicular primario duodenal: Informe de un caso y revisión de la literatura Primary follicular lymphoma of the duodenum: Case report and literature review  

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Full Text Available Mujer de 80 años con síntomas dispépticos a quien se le realizó endoscopia de vías digestivas altas que mostró lesiones polipoides confluentes en la segunda porción del duodeno, cuyo estudio histológico indicó un linfoma no Hodgkin B folicular primario, neoplasia duodenal infrecuente de bajo grado, la cual debe diferenciarse de hiperplasia linfoide folicular reactiva y de otros linfomasPatient was an 80 year old woman with dyspepsia. An upper endoscopy showed confluent polypoid lesions in the second portion of the duodenum. A histological study showed a follicular B-cell lymphoma. This is a rare low grade neoplasm of duodenum which must be differentiated from follicular reactive hyperplasia and other lymphomas

Juan Carlos Hiromi López T

324

Intravascular brachytherapy in prevention of the secondary restenosis angioplasty transluminal coronaries  

International Nuclear Information System (INIS)

The radiotherapy coronary intravascular has demonstrated in a convincing way in clinical and experimental studies that produces a favorable decrease of the restenosis process. There is enough evidence to define this technique as the main current therapeutic option in the handling of the reestenosis intra stent. Accumulated experience exists of up to 3 years in patient's treaties with radiation gamma and multiple studies in several centers that demonstrate similar benefits with issuing beta. The present articulates it revises a series of radiotherapy systems and makes a setting a day on the employment of the brachytherapy intravascular in cardiologic patient

2001-01-01

325

Evolutive behavior towards cardiomyopathy of treated (nifurtimox or benznidazole) and untreated chronic chagasic patients / Evolução à miocardiopatia dos infectados chagásicos crônicos tratados (nifurtimox ou benzonidazol) e não tratados  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Para comparar a evolução dos infectados chagásicos crônicos não tratados (UTPs) e tratados (TPs) com nifurtimox ou benznidazol, fez-se um estudo longitudinal numa área de baixa endemicidade (cidade de Santa Fe, Argentina), com média de seguimento de 14 anos. Em cada controle foram feitas análises so [...] rológicas e parasitológicas, exames clínicos, eletrocardiográficos e radiológicos. No inicio, 19/198 infectados apresentaram miocardiopatia chagásica crônica (MChCr), enquanto 179 eram assintomáticos. A frequência de MChCr no seguimento destes últimos foi 3,2% para os tratados e 7% para os não tratados. Dos pacientes com MChCr no início, 2/5 dos tratados e 9/14 dos não tratados agravaram sua miocardiopatia. Comparando a evolução clínica dos infectados, 5,9% dos tratados e 13% dos não tratados tiveram evolução desfavorável, mas esta diferença não é estatisticamente significativa. Na avaliação sorológica por IFI, 86% dos TPs e só 38% dos UTPs apresentaram títulos menores ou iguais a 1/64. As diferenças são estatisticamente significativas (média geométrica: 49,36 vs 98,2). Os xenodiagnósticos seriados realizados, demonstraram efetividade das drogas (considerar a baixa sensibilidade deste método na etapa crônica). Os pacientes tratados mostraram melhor evolução clínica e mais baixos níveis de anticorpos do que os não tratados. É preciso continuar as investigações para estabelecer pautas terapêuticas mais claras sobre a relação risco-benefício, sustentadas nos princípios científicos e éticos. Abstract in english The aim of this work was to compare the evolution of chronic chagasic untreated patients (UTPs) with that of benznidazole or nifurtimox-treated patients (TPs). A longitudinal study from a low endemic area (Santa Fe city, Argentina) was performed during an average period of 14 years. Serological and [...] parasitological analyses with clinical exams, ECG and X-chest ray were carried out. At the onset, 19/198 infected patients showed chagasic cardiomyopathy (CrChM) while 179 were asymptomatic. In this latter group the frequency of CrChM during the follow-up was lower in TPs compared with UTPs (3.2% vs 7%). Within the CrChM group, 2/5 TPs showed aggravated myopathy whereas this happened in 9/14 UTPs. Comparing the clinical evolution of all patients, 5.9% of TPs and 13% of UTPs had unfavourable evolution, but the difference is not statistically relevant. Serological titers were assessed by IIF. Titers equal to or lower than 1/64 were obtained in 86% of the TPs, but only in 38% of UTPs. The differences were statistically significant (geometric mean: 49.36 vs. 98.2). Antiparasitic assessment of the drugs (xenodiagnosis) proved to be effective. The low sensitivity in chronic chagasic patients must be born in mind. Despite treated patients showed a better clinical evolution and lower antibody levels than untreated ones, it is necessary to carry on doing research in order to improve therapeutic guidelines, according to the risk/benefit equation and based on scientific and ethical principles.

Diana, FABBRO de SUASNÁBAR; Enrique, ARIAS; Mirtha, STREIGER; María, PIACENZA; Mónica, INGARAMO; Mónica, DEL BARCO; Norberto, AMICONE.

326

Evolutive behavior towards cardiomyopathy of treated (nifurtimox or benznidazole and untreated chronic chagasic patients Evolução à miocardiopatia dos infectados chagásicos crônicos tratados (nifurtimox ou benzonidazol e não tratados  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this work was to compare the evolution of chronic chagasic untreated patients (UTPs with that of benznidazole or nifurtimox-treated patients (TPs. A longitudinal study from a low endemic area (Santa Fe city, Argentina was performed during an average period of 14 years. Serological and parasitological analyses with clinical exams, ECG and X-chest ray were carried out. At the onset, 19/198 infected patients showed chagasic cardiomyopathy (CrChM while 179 were asymptomatic. In this latter group the frequency of CrChM during the follow-up was lower in TPs compared with UTPs (3.2% vs 7%. Within the CrChM group, 2/5 TPs showed aggravated myopathy whereas this happened in 9/14 UTPs. Comparing the clinical evolution of all patients, 5.9% of TPs and 13% of UTPs had unfavourable evolution, but the difference is not statistically relevant. Serological titers were assessed by IIF. Titers equal to or lower than 1/64 were obtained in 86% of the TPs, but only in 38% of UTPs. The differences were statistically significant (geometric mean: 49.36 vs. 98.2. Antiparasitic assessment of the drugs (xenodiagnosis proved to be effective. The low sensitivity in chronic chagasic patients must be born in mind. Despite treated patients showed a better clinical evolution and lower antibody levels than untreated ones, it is necessary to carry on doing research in order to improve therapeutic guidelines, according to the risk/benefit equation and based on scientific and ethical principles.Para comparar a evolução dos infectados chagásicos crônicos não tratados (UTPs e tratados (TPs com nifurtimox ou benznidazol, fez-se um estudo longitudinal numa área de baixa endemicidade (cidade de Santa Fe, Argentina, com média de seguimento de 14 anos. Em cada controle foram feitas análises sorológicas e parasitológicas, exames clínicos, eletrocardiográficos e radiológicos. No inicio, 19/198 infectados apresentaram miocardiopatia chagásica crônica (MChCr, enquanto 179 eram assintomáticos. A frequência de MChCr no seguimento destes últimos foi 3,2% para os tratados e 7% para os não tratados. Dos pacientes com MChCr no início, 2/5 dos tratados e 9/14 dos não tratados agravaram sua miocardiopatia. Comparando a evolução clínica dos infectados, 5,9% dos tratados e 13% dos não tratados tiveram evolução desfavorável, mas esta diferença não é estatisticamente significativa. Na avaliação sorológica por IFI, 86% dos TPs e só 38% dos UTPs apresentaram títulos menores ou iguais a 1/64. As diferenças são estatisticamente significativas (média geométrica: 49,36 vs 98,2. Os xenodiagnósticos seriados realizados, demonstraram efetividade das drogas (considerar a baixa sensibilidade deste método na etapa crônica. Os pacientes tratados mostraram melhor evolução clínica e mais baixos níveis de anticorpos do que os não tratados. É preciso continuar as investigações para estabelecer pautas terapêuticas mais claras sobre a relação risco-benefício, sustentadas nos princípios científicos e éticos.

Diana FABBRO de SUASNÁBAR

2000-04-01

327

Multicentric lymphoma with metastasis in the central nervous system in a dog Linfoma multicêntrico com metástase no sistema nervoso central em cão  

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Multicentric lymphoma was diagnosed in a two-year-old dog with respiratory distress, dysorexia, abdominal enlargement and generalized lymphadenopathy. Immunohistochemical examination showed T-cell origin with CD3+ e CD79- expression. After five weeks, progressive neurological deficits and neoplastic lymphocytes were identified in the cerebrospinal fluid. Histopathological examination showed neoplastic cell invasion in the spleen, lymph nodes, cerebrum and cerebellum.Linfoma multicêntrico...

Aptekmann, K. P.; Okamoto, C. E.; Campos, K. C. H.; Takahira, R. K.

2005-01-01

328

Infiltração do sistema nervoso central e das meninges nos linfomas com representação leucemica Meningeal and central nervous system infiltration in lymphomas with leukemic conversion: report of four cases  

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Os autores fazem referência a 4 pacientes com representação leucêmica no decurso de linfomas malignos que apresentaram infiltração de células neoplasicas no sistema nervoso central e meninges. É feito o estudo anatomopatoló-gico, encontrando-se em 2 deles a formação de nódulos leucêmicos no parênquima nervoso. Nos outros dois, houve regressão total de sintomatologia neurológica com o uso do metotrexate por via intratecal.The cases of four patients with lymphoma with leucem...

1981-01-01

329

Síndrome de lisis tumoral espontáneo en una paciente con linfoma no Hodgkin Spontaneous tumor lysis syndrome in a patient with non-Hodking' s lymphoma  

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Presentamos el caso de una mujer de 77 años sin antecedentes de proceso neoplásico que ingresa por la aparición en pocas semanas de múltiples adenopatías cervicales y que fallece a las pocas horas presentado hiperuricemia, hipocalcemia, hiperpotasemia, hiperfosfatemia e hiperazotemia. La citología y estudio molecular de una muestra de una adenopatía cervical fueron compatibles con de linfoma no Hodgkin de estirpe B de alto grado. Se trataría por tanto de un síndrome de lisis tumoral ...

2005-01-01

330

Linfoma de células da zona do manto em anexos oculares: relato de caso Mantle-cell lymphoma of the ocular adnexa: a case report  

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Full Text Available Os tumores linfóides dos anexos oculares são neoplasias de crescimento lento que acometem principalmente idosos. O objetivo deste trabalho é relatar um caso de linfoma não-Hodgkin de células da zona do manto, um subtipo raro de linfoma de células B nos anexos oculares. RELATO DO CASO: Paciente masculino de 62 anos com tumoração em pálpebras superiores, região maxilar e cavidade oral, tendo o diagnóstico inicial de doença de Mikulics, evoluiu com acentuado aumento das lesões, apesar da terapêutica imunossupressora. Biopsias da pálpebra superior esquerda e medula óssea revelaram linfoma não-Hodgkin de células B da zona do manto. Apesar da disseminação (estadiamento grau IV, quimioterapia e transplante de medula óssea conduziram à remissão da doença. COMENTÁRIOS CONCLUSIVOS: Apesar da disponibilidade de avançados métodos diagnósticos complementares como a imunofenotipagem e a análise genética molecular, o linfoma representa, para clínicos e patologistas, um desafio quanto ao diagnóstico e ao prognóstico.Ocular adnexal lymphoid tumors are slow-growing neoplasms that affect predominantly the elderly. The purpose of this study is to report a non-Hodgkin lymphoma from mantle zone cells, a rare ocular annexal B-cell lymphoma subtype. CASE REPORT: A 62-year-old male patient with superior eyelid, maxillary and oral tumours, had an initial diagnosis of Mikulics disease, developed lesion enlargement, despite immunosuppressant therapy. Left superior eyelid and bone marrow biopsy revealed non-Hodgkin lymphoma the mantle zone. In spite of dissemination (stage IV, chemotherapy and bone marrow transplant led to disease remission. CONCLUSIVE COMMENTARIES: Despite the availability of advanced complementary diagnostic methods, like immunophenotyping and molecular genetic analysis, lymphoma represents, for physicians and pathologists, a challenge regarding diagnosis and prognosis.

Anna Paula Lemos de Albuquerque

2006-06-01

331

Insuficiência renal aguda como manifestação inicial de linfoma de Burkitt renal Acute renal failure as first clinical presentation of Burkitt’s renal lymphoma  

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Full Text Available Relatamos o caso de um jovem de 14 anos que procurou atendimento médico por edema e hipertensão, sendo insuficiência renal aguda secundária a linfoma de Burkitt renal diagnosticada após avaliação laboratorial, de imagem e biópsia de massa tumoral renal.This case report is from a 14-year-old boy who had edema and hypertension due to a primary renal Burkitt's lymphoma, diagnosed through laboratory and image evaluation and kidney tumor biopsy.

José Gastão Rocha de Carvalho

2006-06-01

332

Intravascular Ultrasound in Percutaneous Coronary Intervention for Chronic Total Occlusion  

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Full Text Available Background: Percutaneous coronary intervention (PCI of chronic total occlusion (CTO is one of the most challenging procedures in interventional cardiology. New techniques and devices have made possible to face these complex procedures. Intravascular ultrasound (IVUS reveals special features and contributes greatly to procedural success.Method: We analysed retrospectively IVUS contribution and findings in 23 cases of a total 46 CTOs PCI from February 2009 to August 2010 in our cath lab. Both true and functional CTO were included in this study. The procedure was considered successful when a TIMI III flow was reached in the occluded vessel after stent implantation with a residual stenosis less than 30%. IVUS features and contribution in CTO-PCI were analysed. All data were introduced in SPSS version 15 (SPSS Inc. Chicago, Illinois, USA. Continuous variables were described by mean ± SD and categorical variables were expressed as percentage. A P<0.05 was considered statistically significant.Results: 46 PCIs in 34 patients were performed during 19 months in our centre. The procedure was successful in 28 cases (60.9%.. IVUS was performed in 23 (82.1% of successful procedures. IVUS revealed calcium somewhere in 17 (73.9%. Despite wire angiographic verification in true lumen distally IVUS showed subintimal wire position in part of CTO segment in 6(26.1%. In 22(95.7% of cases IVUS allowed both the wire position verification in true lumen and the vessel measurement before stent implantation. In 1(4.3% case a second wire was introduced into true lumen guided by IVUS after realising that the first wire was in false lumen. We could not find significant relation between calcium presence and subintimal wire penetration in CTO segment (p: 0.14 Conclusions: IVUS showed calcium in CTO segment in a high percentage of cases. It is not unusual to find wire penetration in subintimal space in part of CTO segment. IVUS has a key contribution in the step by step interpretation during PCIs of CTO. Wire position verification and more precise vessel measurement can be easily done by IVUS.

M Mohandes

2010-09-01

333

Linfoma do colo uterino: relato de dois casos e revisão da literatura Lymphoma of the uterine cervix: report of two cases and review of the literature  

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Full Text Available A ocorrência de linfomas primários do trato genital feminino é rara. O diagnóstico normalmente não é possível pelo exame citológico, sendo necessária a biópsia do colo. Neste artigo, descrevemos duas pacientes encaminhadas ao nosso serviço por linfoma de colo uterino. Em uma delas, é claramente demonstrada a dificuldade diagnóstica que pode ocorrer nessa patologia. As duas pacientes foram tratadas com quimioterapia, apresentando evolução pós-operatória satisfatória. Não há um tratamento padrão para os linfomas de colo uterino. O tratamento local exclusivo é advogado por alguns estudos na literatura em estádio clínico IE, enquanto outros serviços optam pelo tratamento sistêmico em todos os estádios.The occurrence of primary lymphomas of the female genital tract is rare. The diagnosis is usually not possible by the cytological examination; a tissue biopsy is necessary. The present paper reports two patients referred to our service with a diagnosis of cervical lymphoma. In one of them, the diagnostic difficulties are demonstrated. Both patients were submitted to chemotherapy with satisfactory post-operatory period. There is no standard treatment for uterine lymphomas. Exclusive local treatment is supported by some reports in the literature in clinical stage IE, while others prefer systemic treatment irrespective of clinical stage.

Hugo Fontan Köhler

2008-12-01

334

Linfoma do colo uterino: relato de dois casos e revisão da literatura / Lymphoma of the uterine cervix: report of two cases and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A ocorrência de linfomas primários do trato genital feminino é rara. O diagnóstico normalmente não é possível pelo exame citológico, sendo necessária a biópsia do colo. Neste artigo, descrevemos duas pacientes encaminhadas ao nosso serviço por linfoma de colo uterino. Em uma delas, é claramente demo [...] nstrada a dificuldade diagnóstica que pode ocorrer nessa patologia. As duas pacientes foram tratadas com quimioterapia, apresentando evolução pós-operatória satisfatória. Não há um tratamento padrão para os linfomas de colo uterino. O tratamento local exclusivo é advogado por alguns estudos na literatura em estádio clínico IE, enquanto outros serviços optam pelo tratamento sistêmico em todos os estádios. Abstract in english The occurrence of primary lymphomas of the female genital tract is rare. The diagnosis is usually not possible by the cytological examination; a tissue biopsy is necessary. The present paper reports two patients referred to our service with a diagnosis of cervical lymphoma. In one of them, the diagn [...] ostic difficulties are demonstrated. Both patients were submitted to chemotherapy with satisfactory post-operatory period. There is no standard treatment for uterine lymphomas. Exclusive local treatment is supported by some reports in the literature in clinical stage IE, while others prefer systemic treatment irrespective of clinical stage.

Hugo Fontan, Köhler; Pablo Roberto, Novik; Antônio Hugo José Fróes Marques, Campos.

335

Environmental risk factors related to the development of canine non-Hodgkin's lymphoma Fatores de risco ambientais relacionados ao desenvolvimento do linfoma não Hodgkin canino  

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Full Text Available This research aimed to investigate the possible risk factors associated with the development of canine non-Hodgkin's lymphoma. Owners of 83 dogs with non-Hodgkin's lymphoma and of 84 healthy dogs answered an epidemiological questionnaire. Dogs who lived outside of the house and within 100 meters of busy streets or avenues (defined as more than 50 vehicles per minute had a higher risk for developing the disease (OR: 3.1, 95% CI: 1.4-6.9, P=0.005. These results suggest that air pollution derived from vehicle traffic may be associated with the development of canine non-Hodgkin's lymphoma.Este trabalho teve como objetivo investigar os possíveis fatores de risco ambientais, associados com o desenvolvimento de linfoma não-Hodgkin nos cães. Um questionário epidemiológico foi aplicado aos proprietários de 83 cães com linfoma não-Hodgkin e 84 proprietários de cães saudáveis. Os cães que viviam permanentemente no lado de fora da casa e em torno de 100 metros de ruas movimentadas ou avenidas (mais de 50 veículos por minuto tiveram um maior risco de desenvolvimento da doença (OR: 3,1, IC 95%: 1,4-6,9, P=0,005. Esses resultados sugerem que a poluição do ar oriunda do tráfego veicular pode estar associada com o desenvolvimento de linfomas não-Hodgkin canino.

Danielle Almeida Zanini

2013-01-01

336

Environmental risk factors related to the development of canine non-Hodgkin's lymphoma / Fatores de risco ambientais relacionados ao desenvolvimento do linfoma não Hodgkin canino  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Este trabalho teve como objetivo investigar os possíveis fatores de risco ambientais, associados com o desenvolvimento de linfoma não-Hodgkin nos cães. Um questionário epidemiológico foi aplicado aos proprietários de 83 cães com linfoma não-Hodgkin e 8