ABSTRACT
A esquistossomose é uma doença que, no Brasil, é causada pelo Schistosoma mansoni e transmitida através da água por moluscos do gênero Biomphalaria. Essa espécie ocorre na África, nas Antilhas e na América do Sul. O parasita, ao atingir a fase adulta de seu ciclo biológico no sistema vascular do homem, alcança as veias mesentéricas. Cada fêmea põe cerca de 400 ovos por dia, e estes, a partir da submucosa, chegam à luz intestinal. Há relatos de casos a respeito de ovos de S. mansoni nos pulmões de pacientes sem evidência de fibrose hepática. Relatamos um caso dessa forma atípica de apresentação da doença. O paciente apresentava dor torácica não-ventilatóriodependente, perda ponderal significativa e tosse seca. A TC de tórax mostrou uma tumoração irregular no lobo inferior esquerdo, mas somente a biópsia pulmonar evidenciou ovos de S. mansoni degenerados. O paciente não apresentava sinais clínicos de hipertensão pulmonar ou portal, as quais tampouco foram diagnosticadas através de exames.
Schistosomiasis is a disease that, in Brazil, is caused by Schistosoma mansoni and is transmitted by snails of the genus Biomphalaria. This species occurs in Africa, the Antilles and South America. The parasite, developing to the adult stage in the vascular system of the host, migrates to the mesenteric veins. Each female lays approximately 400 eggs per day, and these travel from the submucosa to the intestinal lumen. There have been reported cases in which S. mansoni eggs were identified in the lungs of patients with no evidence of liver fibrosis. We report a case with this atypical presentation of the disease. The patient presented nonpleuritic chest pain, significant weight loss and dry cough. A CT scan revealed an irregular tumor in the left lower lobe. However, a lung biopsy revealed non-viable S. mansoni eggs. The patient presented no clinical signs of pulmonary or portal hypertension; nor was either identified through diagnostic tests.
Subject(s)
Animals , Humans , Male , Middle Aged , Hypertension, Pulmonary/diagnosis , Lung Diseases, Parasitic/pathology , Plasma Cell Granuloma, Pulmonary , Schistosomiasis mansoni/pathology , Diagnosis, Differential , Lung Diseases, Parasitic/parasitology , Parasite Egg Count , Plasma Cell Granuloma, Pulmonary/parasitology , Plasma Cell Granuloma, Pulmonary/pathologyABSTRACT
O pseudotumor inflamatório de pulmão é uma neoplasia benigna rara que geralmente se manifesta como um nódulo pulmonar solitário. A apresentação endobrônquica é infreqüente. O tratamento de escolha continua sendo a cirurgia conservadora e deve-se sempre procurar obter margens livres devido à possibilidade de recidiva local. Esse artigo relata o caso de um paciente de 36 anos, com crises de sibilância e tosse, que foi submetido, com sucesso, à broncoplastia para ressecção de um pseudotumor inflamatório endobrônquico.
Inflammatory pseudotumor of the lung is a rare form of benign neoplasia and is generally characterized by a solitary pulmonary nodule. The endobronchial presentation is uncommon. Conservative surgery remains the treatment of choice, and surgeons should always strive to achieve tumor-free margins due to the possibility of local recidivism. This article reports the case of a 36-year-old male patient with recurrent attacks of wheezing and cough. The patient underwent successful bronchoplasty for the resection of an endobronchial inflammatory pseudotumor.
Subject(s)
Adult , Humans , Male , Bronchial Diseases/diagnosis , Plasma Cell Granuloma, Pulmonary/diagnosis , Biopsy , Bronchoscopy , Bronchial Diseases/pathology , Bronchial Diseases/surgery , Cough , Plasma Cell Granuloma, Pulmonary/pathology , Plasma Cell Granuloma, Pulmonary/surgery , Tomography, X-Ray ComputedABSTRACT
El pseudotumor inflamatorio es una lesión benigna inflamatoria caracterizada en el aspecto histológico por una mezcla de fibroblastos, histiocitos, linfocitos y células plasmáticas. Relativamente rara, con localización tamaño, y sintomatología variable, que puede simular la presencia de un tumor maligno. En la infancia se presenta como una masa intrapulmonar. Se describe caso de paciente preescolar femenina de 3 años de edad, quien consultó a nuestro centro por presentar fiebre, disfagia y tos de 3 meses de evolución. Se evidenció en estudios imaginológicos de tórax, imagen densa en base de hemitórax izquierdo que impresionó como empiema tabicado. Se le realizó toracotomía izquierda evidenciándose tumoración intercisural, adherida fuertemente a pared torácica, diafragma y proyectada a mediastino posterior. Además lesiones satélites en pleura parietal. Se toma muestra de lesión principal y resección de las satélites para estudio histopatológico, la cual reportó pseudotumor inflamatorio. El pseudotumor inflamatorio es una patología tumoral benigna, que se sospecha en niños con infecciones respiratorias a repetición, refractaria a tratamiento convencional y con hallazgos imaginológicos compatibles con lesión ocupante de espacio a nivel pulmonar. Se puede observar su relación con el virus de Epstein-Baar. El diagnóstico es sólo posible por biopsia, y el tratamiento de elección es resección quirúrgica. Sin embargo, en este caso se evidenció aparente mejoría dada por la disminución de la masa tumoral con el tratamiento con antiinflamatorios no esteroideos.
The pseudo inflammatory tumor is a benign lesion characterized in the histological aspect by a mixture of fibroblasts, histiocytes, lymphocytes and plasmatic cells. Relatively rare, with location, size and variable simptomatology that it can simulate the presence of a malignant tumor. In the childhood it appears like an intrapulmonary mass. A case of female infant patient of 3 years old is described, that consult to our center to display fever, dysphagia and cough of 3 months of evolution. In radiological images of thorax were viewed a dense image in the left thorax base that impresses septate emphyema. A left thoracotomy was made viewed an intercysural tumor like, adhered strongly to thoracic wall, diaphragm and projected to later mediastinum, and in addition, satellites injuries in parietal pleural. An incisional sample of main lesion was taking and complete resection of the satellites to histopathology study, which reported pseudo inflammatory tumor. Pseudo inflammatory tumor is a benign tumoral pathology that is suspected in children with repetition respiratory infection refracted to conventional treatment and with image findings compatible with tumor at pulmonary level. Its relation with the virus of Epstein-Baar can be observed. The diagnosis is only possible by biopsy, and the election treatment is the surgical resection. Although in this case the improvement was viewed by diminution of tumor mass with use of non steroidal anti inflammatory drugs.
Subject(s)
Humans , Female , Child, Preschool , Anti-Inflammatory Agents, Non-Steroidal , Plasma Cell Granuloma, Pulmonary/diagnosis , Plasma Cell Granuloma, Pulmonary/pathology , Pneumonia/pathology , Pneumonia/therapy , Medical OncologyABSTRACT
O pseudotumor inflamatório de pulmão é uma afecção rara, e representa um dilema pela semelhança com processo maligno nos aspectos radiológicos, macroscópicos e patológicos. Relata-se o caso de um paciente com queixas respiratórias, que após propedêutica adequada foi submetido à toracotomia exploradora, com diagnóstico de pseudotumor confirmado pela imunohistoquímica. São discutidos dados referentes à história clínica, aspectos radiológicos, histopatológicos e cirúrgicos, além de formas de tratamento da condição.
Subject(s)
Humans , Male , Adult , Plasma Cell Granuloma, Pulmonary/diagnosis , Plasma Cell Granuloma, Pulmonary/pathology , Follow-Up StudiesABSTRACT
Descreve-se o caso de um menino de cinco anos, no qual, durante o controle de tratamento de pneumonia adquirida na comunidade, foi evidenciada uma massa circunscrita, heterogênea, no lobo superior esquerdo. Foi realizada lobectomia superior esquerda, com diagnóstico histológico pós-operatório de pseudotumor inflamatório histiocítico. Não se detectou recorrência nos quatro anos de pós-operatório. De etiologia ignorada, essas lesões podem ter comportamento local semelhante ao de sarcomas, razões que fazem da exérese com amplas margens cirúrgicas o método de eleição para diagnóstico e tratamento simultâneos
Subject(s)
Humans , Male , Child, Preschool , Plasma Cell Granuloma, Pulmonary/diagnosis , Follow-Up Studies , Plasma Cell Granuloma, Pulmonary/surgery , Plasma Cell Granuloma, Pulmonary/pathology , ThoracotomyABSTRACT
Inflammatory pseudotumour of lung is a rare benign lung tumour of uncertain aetiology. It is difficult to distinguish clinically as well as histologically from inflammatory lesions, hamartomas and neoplasms. Only two such cases have been reported from India earlier. We report one such case, that was clinically misdiagnosed as neuroblastoma.
Subject(s)
Biopsy , Child, Preschool , Diagnosis, Differential , Humans , Lung Neoplasms/diagnostic imaging , Male , Neuroblastoma/diagnostic imaging , Plasma Cell Granuloma, Pulmonary/pathology , Pneumonectomy , Tomography, X-Ray ComputedABSTRACT
Inflammatory pseudotumor [also called plasma cell granuloma, histiocytoma and x-anthofibroma] is a benign, slow growing lesion which may present with cough, dyspnea, hemoptysis and unresolving pneumonia or can be discovered radiographically as a localised lesion. It has been reported in individuals up to 70 years old, but approximately two-thirds have developed in individuals under 30 years of age. The sex incidence is approximately equal. Inflammatory pseudotumors of the lung are usually peripheral lesions but may occasionally be endobronchial. We report the case of an endobronchial inflammatory pseudotumor in a 17-year-old girl who presented with unresolving right-sided pneumonia. Appropriate radiological, bronchoscopic and histopathological investigations lead to accurate pre-operative diagnosis and early complete surgical resection through a limited right main bronchus incision [bronchotomy]. The patient made good postoperative recovery and an excellent prognosis is anticipated
Subject(s)
Humans , Female , Plasma Cell Granuloma, Pulmonary/pathology , Plasma Cell Granuloma, Pulmonary/surgeryABSTRACT
Os pseudotumores inflamatórios do pulmäo säo raros. Caracterizam-se pela presença de massas pulmonares benignas, de etiologia desconhecida, compostas por uma variedade de células mesenquimais e inflamatórias. Radiologicamente assemelham-se aos carcinomas do pulmäo. Os autores relatam dois casos de pseudotumor inflamatório do pulmäo tratados no Instituto Nacional do Câncer e fazem breve revisäo do tema.