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Article in English | WPRIM | ID: wpr-880304


BACKGROUND@#The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status.@*METHODS@#We conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40-74 years who participated in an annual health checkup in 2014.@*RESULTS@#In the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = - 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = - 0.03, p = 0.525).@*CONCLUSIONS@#TSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.

Aged , Cross-Sectional Studies , Cysts/etiology , Female , Humans , Hypertension/metabolism , Japan , Male , Middle Aged , Thyroid Diseases/etiology , Thyroid Gland/pathology , Thyrotropin/metabolism
Rev. Hosp. Clin. Univ. Chile ; 31(3): 223-230, 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1145386


The clinical approach to non-thyroid cervical masses in primary care has always been considered a diagnostic challenge. In the absence of specific diagnostic methods, the general practitioner must rely on clinic and general tests in order to achieve a suspected diagnosis and timely referral. On initial approach to cervical masses, one must first analyze each case according to patient age, associating an exhaustive anamnesis focused on the growth pattern and aggregate symptoms, along with a physical examination focused on signs of malignancy. Once completed, the etiology of the mass can be classified as probable congenital, inflammatory or tumoral origin. And also try to determine localization, temporality and discriminate between benign and malignant causes. Once the clinical interrogation has been completed, basic complementary tests and/or directed test according to suspicion can be requested. The foregoing allows the primary care physician a proper referral to specialist and/or initiation of appropriate treatment. (AU)

Humans , Male , Female , Cysts/etiology , Neck/physiopathology , Primary Health Care/trends , Cysts/diagnosis , Head and Neck Neoplasms/etiology
Autops. Case Rep ; 10(3): e2020144, 2020. graf
Article in English | LILACS | ID: biblio-1131832


Arteriovenous malformation (AVM) is a rare lesion in the uterus, which can lead to abnormal uterine bleeding. While AVM has been described in other organs in the literature, there is a paucity of pathology reports of the AVM in uterus. On gross examination, the uterus was markedly enlarged and partly distorted with a pedunculated solid mass, which on the cut surface showed multiple well-circumscribed hemorrhagic cysts ranging from 0.1 to 4.0 cm in size. Microscopically, they were malformed dilated vascular structures containing organized thrombi. We present this case of uterine AVM with gross and microscopic findings, which can serve as a crucial reminder for pathologists to keep in the differential diagnoses as a potential cause of abnormal uterine bleeding.

Humans , Female , Pregnancy , Middle Aged , Arteriovenous Malformations/pathology , Uterine Hemorrhage/etiology , Uterus/injuries , Cysts/etiology , Diagnosis, Differential
Rev. chil. enferm. respir ; 35(1): 58-62, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003647


Introducción: La linfangioleiomiomatosis Pulmonar (LAM) es una rara y progresiva enfermedad; caracterizada por proliferación excesiva de células musculares lisas a partir de vasos linfáticos, sanguíneos y vías aéreas. En conjunto al anormal crecimiento celular descrito, se aprecia degeneración quística difusa del parénquima pulmonar, lo que puede reflejarse desde cuadros completamente asintomáticos hasta el deterioro severo del intercambio gaseoso con insuficiencia respiratoria fulminante. Descripción del caso: Paciente femenino de 41 años de edad, con cuadro clínico consistente en tos seca ocasional, asociada a dolor leve de características pleuríticas en 'puntada de costado ' derecha. Ante la no mejoría clínica, se indica estudio imagenológico donde se demuestra neumotorax espontáneo derecho. En estudio tomográfico se aprecian además lesiones pulmonares quísticas. El estudio anátomo-patológico demuestra cambios estructurales que se reportan compatibles con LAM. Conclusión: Dada la simplicidad de los síntomas con que la LAM puede debutar, su confirmación diagnóstica se genera en fases avanzadas de la enfermedad, cuando el daño pulmonar importante conlleva a la aparición de factores clínicos con mayor repercusión sobre el estado general de los pacientes por lo que la realización de estudios imagenológicos tempranos gana vital importancia.

Introduction: Pulmonary lymphangioleiomyomatosis (LAM) is a rare and progressive disease; characterized by airway, lymphatic and blood vessels-smooth muscle cells excessive proliferation. Added to the abnormal cell growth, parenchymal cystic degeneration is present, which can be reflected initially as a asymptomatic course and can progress to severe gaseous exchange deterioration and fulminating respiratory insufficiency. Case description: A 41-year-old female patient with a clinical course consisting of occasional dry cough, associated with mild pleuritic pain on the right side of thorax. As no improvement was achieved, thoracic imaging study was performed, where a right pneumothorax was found. Tomography images showed multiple lung cystic lesions. Anatomopathological study reports structural changes compatible with LAM. Conclusion: Given the simplicity of the symptoms that LAM can debut with, its diagnostic confirmation is generated in advanced stages of the disease, when the important pulmonary damage leads to the appearance of clinical factors with greater impact on the general state of patients so early thoracic imaging studies gain vital importance.

Humans , Female , Adult , Lymphangioleiomyomatosis/diagnosis , Lymphangioleiomyomatosis/therapy , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Pneumothorax/etiology , Spirometry , Radiography, Thoracic , Tomography, X-Ray Computed , Lymphangioleiomyomatosis/complications , Sirolimus/therapeutic use , Cysts/etiology , Lung Neoplasms/complications
Autops. Case Rep ; 7(1): 37-41, Jan.-Mar. 2017. ilus
Article in English | LILACS | ID: biblio-905131


Small cell lung carcinoma (SCLC) is an uncommon tumor characterized by an aggressive behavior with early metastasis, usually to the contralateral lung, liver, brain, and bones. There are only five cases of this particular tumor metastasizing to the oral cavity described in the English literature. We present the case of metastatic SCLC in the mandible with radiographic findings resembling a residual cyst. A 66-year-old man with previous diagnosis and treatment for a SCLC was referred to the Stomatology Department with a history of persistent pain in the mandible 1 year after the inferior right pre-molar tooth extraction. The radiographic exam showed a well-delimited radiolucent area on that extracted tooth's region resembling a residual cyst. Biopsy was performed yielding the diagnosis of metastatic SCLC. The patient was referred to the clinical oncologist for chemotherapy. Although uncommon, this tumor should be included in the differential diagnosis of jawbone lesions, particularly when the patient presents a previous diagnosis of SCLC.

Humans , Male , Aged , Carcinoma, Small Cell/diagnostic imaging , Lung Neoplasms/drug therapy , Cysts/etiology , Diagnosis, Differential , Mandible/pathology , Pain/etiology
Rev. chil. pediatr ; 88(5): 629-634, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-900027


Las dilataciones quísticas de las vías biliares, conocidas como lagunas biliares, se han descrito en el seguimiento de los pacientes sometidos a portoenterostomía o cirugía de Kasai por atresia de las vías biliares (AVB). Su aparición se ha asociado con el desarrollo de colangitis y consecuentemente a un peor pronóstico. OBJETIVO: Describir las características clínicas y pronóstico de pacientes con AVB, sometidos a cirugía de Kasai, con énfasis en aquellos que desarrollaron lagunas biliares. PACIENTES Y MÉTODO: Estudio retrospectivo de pacientes sometidos a portoenterostomía de Kasai por AVB durante los años 2008 a 2016. Se tabuló la información demográfica y variables asociadas a la portoenterostomía de Kasai, trasplante hepático, lagunas o quistes biliares y episodios de colangitis. Se crearon curvas de Kaplan Meier y comparación mediante el test de Log Rank para evaluar sobrevida global, libre de colangitis y con hígado nativo, considerando un valor p como significativo. RESULTADOS: Se analizó el seguimiento de 13 pacientes. El tiempo promedio de realización del Kasai fue a los 85 meses (rango 42-193, DS 40,3), seis pacientes (46%) fueron sometidos a cirugía de Kasai después de los 90 días de vida por derivación tardía. Cuatro (31%) desarrollaron lagunas biliares múltiples, todos presentaron episodios de colangitis. La sobrevida libre de colangitis fue significativamente menor para los portadores de lagunas biliares. Nueve pacientes (69%) recibieron un trasplante hepático, en promedio a los 16 meses de edad (rango 6-40, DS 12,1), en 3 de ellos la causa fue colangitis recurrente. No se encontraron diferencias significativas en la sobrevida con hígado nativo ni en sobrevida global entre portadores y no portadores de lagunas biliares. CONCLUSIONES: En esta cohorte, la incidencia de lagunas biliares luego de la portoenterostomía es similar a la descrita en la literatura. Los resultados concuerdan con la relación propuesta entre ellas y el desarrollo de colangitis. En los pacientes de nuestra serie, el diagnóstico y derivación de AVB fue realizado tardíamente, determinando un peor pronóstico.

Since the introduction of Kasai’s hepatic portoenterostomy, the prognosis of patients with biliary atresia has improved. The presence of intrahepatic biliary cysts or bile lakes has been reported in some patients after the intervention. Bile lakes have been related to cholangitis and a poor outcome. OBJECTIVE: To describe the clinical features and prognosis of patients with biliary atresia after Kasai portoenterostomy, with special emphasis in those who developed biliary cysts. PATIENTS AND METHOD: Data from a retrospective cohort of 13 patients with biliary atresia with a Kasai portoenterostomy from 2008 to 2016 was analyzed. Demographic variables associated to Kasai portoenterostomy, hepatic transplant, biliary cysts and colangitis episodes were tabulated. Kaplan Meir and Log Rank test were used to evaluate colangitis-free and native liver survival. RESULTS: The mean age at Kasai was 85 months (SD 40.3, 42-193 months), six patients (46%) had a Kasai operation after 90 days of life. Four patients (31%) developed multiple biliary cysts; all of them had at least one episode of cholangitis. Cholangitis-free survival was significantly lower for those who developed bile lakes. Nine patients (69%) underwent liver transplant, 3 of them because of recurrent cholangitis. There were no differences in global survival or native liver survival between patients with or without biliary cysts. CONCLUSIONS: The incidence of biliary cysts after Kasai portoenterostomy in this series is similar to the reported. The results are consistent with the relationship proposed between the development of biliary cysts and cholangitis. Our patients, some already derived for evaluation and liver transplantation, underwent Kasai operation at an advanced age, which determines a poor prognosis.

Humans , Male , Female , Infant , Child, Preschool , Child , Postoperative Complications/surgery , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Biliary Atresia/surgery , Portoenterostomy, Hepatic , Cholangitis/etiology , Cysts/etiology , Bile Duct Diseases , Biliary Atresia/diagnosis , Cholangitis/surgery , Cholangitis/epidemiology , Retrospective Studies , Follow-Up Studies , Liver Transplantation , Treatment Outcome , Cysts/epidemiology
Rev. bras. ter. intensiva ; 27(4): 412-415, out.-dez. 2015. graf
Article in English | LILACS | ID: lil-770037


RESUMO Relatamos o caso de um uma criança de 2 anos de idade que sobreviveu após um episódio agudo de hemorragia intracraniana espontânea grave com sinais clínicos e radiológicos de hipertensão intracraniana e herniação transtentorial. O paciente foi para cirurgia de urgência para drenagem do hematoma, sendo inserido um cateter para monitorar a pressão intracraniana. Na análise da tomografia de crânio inicial, antes da drenagem do hematoma, constatou-se um cisto cerebral contralateral ao hematoma que, segundo análise do neurocirurgião e do neuroradiologista, possivelmente evitou um desfecho pior, visto que o cisto serviu de acomodação para o cérebro após a hemorragia maciça. Após investigação, constatou-se tratar de um caso de hemofilia tipo A sem diagnóstico prévio. O paciente foi tratado em terapia intensiva com controle da pressão intracraniana, reposição de fator VIII e obteve alta sem sequelas neurológicas evidentes.

ABSTRACT We report the case of a 2-year-old child who survived an acute episode of severe spontaneous intracranial hemorrhage with clinical and radiological signs of intracranial hypertension and transtentorial herniation. The patient underwent emergency surgery to drain the hematoma, and a catheter was inserted to monitor intracranial pressure. In the initial computed tomography analysis performed prior to hematoma drainage, a brain cyst was evident contralateral to the hematoma, which, based on the analysis by the care team, possibly helped to avoid a worse outcome because the cyst accommodated the brain after the massive hemorrhage. After the investigation, the patient was determined to have previously undiagnosed hemophilia A. The patient underwent treatment in intensive care, which included the control of intracranial pressure, factor VIII replacement and discharge without signs of neurological impairment.

Humans , Male , Child, Preschool , Intracranial Hypertension/etiology , Intracranial Hemorrhages/etiology , Hemophilia A/complications , Brain/pathology , Factor VIII/administration & dosage , Tomography, X-Ray Computed , Intracranial Hemorrhages/surgery , Intracranial Hemorrhages/pathology , Cysts/etiology , Cysts/pathology , Hematoma/etiology , Hematoma/pathology , Hemophilia A/diagnosis , Hemophilia A/drug therapy
Rev. argent. ultrason ; 11(3): 151-153, sept. 2012. ilus
Article in Spanish | LILACS | ID: lil-658578


Se presenta un caso infrecuente en un paciente de 55 años que consulta por aumento de tamaño del testículo derecho. En el examen ecográfico con transductor de 7,5 MHz se observan varias imágenes de aspecto quístico intraparenquimatosas. Por tratarse de un caso infrecuente se hace un recordatorio sobre las posibles etiologías.

Humans , Male , Middle Aged , Cysts/classification , Cysts/diagnosis , Cysts/etiology , Cysts , Testis/abnormalities , Testis
Article in English | IMSEAR | ID: sea-134640


This report describes an autopsy case pertaining to death due to traumatic rupture of aortic aneurysm. A 21 year old deaf and dumb male was assaulted with kicks over the chest. Autopsy revealed external injuries over the body. Internally, a fusiform aneurysmal dilatation of the lumen of the aortic root and tubular segment of the ascending aorta were observed, with tear of the anterior wall of the ascending aorta and resultant haemopericardium. Histologically, the wall of the aneurysm revealed cystic medial necrosis, which appears to idiopathic in nature. A Common complication of aortic aneurysms is dissection, with subsequent spontaneous rupture. In this case, there was no evidence of dissection and the rupture was traumatic in nature. Death was certified as due to cardiac tamponade. The extent of trauma to which the victim was subjected to, appears to be such as would have been insufficient to cause death in an otherwise normal individual. An account of the findings, along with a discussion of the pathology of aneurysms and cystic medial necrosis as also of the mechanism of rupture of aneurysms is provided.

Aneurysm, Ruptured/etiology , Aneurysm, Ruptured/mortality , Aortic Aneurysm, Thoracic/etiology , Aortic Aneurysm, Thoracic/mortality , Autopsy , Cysts/etiology , Cysts/mortality , Fatal Outcome , Humans , Male , Young Adult
Indian J Ophthalmol ; 2010 Sept; 58(5): 423-425
Article in English | IMSEAR | ID: sea-136102


The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS) in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

Aged , Cataract Extraction/adverse effects , Cataract Extraction/methods , Conjunctival Diseases/etiology , Conjunctival Diseases/pathology , Cysts/etiology , Cysts/pathology , Follow-Up Studies , Humans , Lens Implantation, Intraocular , Male , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/methods
Indian J Pediatr ; 2010 Feb; 77(2): 200-202
Article in English | IMSEAR | ID: sea-142502


The patients were 8 and 9 years old respectively. Both were passengers in a vehicle and suffered multisystem injuries. Case no.1 suffered a fractured occipital bone, lung contusions and a small pneumothorax in addition to the traumatic lung cysts in the left lung. Case 2 sustained contused and lacerated liver and right lung cysts. CT examination showed cystic areas in the lung which were diagnostic in case 2. In case 1 a traumatic rupture of diaphragm could not be ruled out and the patient underwent an exploratory laparotomy to deal with the same. The lung cysts in both the patients were treated conservatively and both showed resolution in repeat CT scans done at 6 months.

Child , Cysts/diagnosis , Cysts/etiology , Humans , Lung Diseases/diagnosis , Lung Diseases/etiology , Lung Injury/complications , Male , Pneumothorax/etiology , Prognosis , Tomography, X-Ray Computed
Indian J Pediatr ; 2009 Nov; 76(11): 1158-1160
Article in English | IMSEAR | ID: sea-142429


We describe the case of a child suffering from congenital cyanotic heart disease — double outlet right ventricle (DORV) with transposition of great vessels (TOGV). She underwent a left Blalock-Tausig (BT) shunt at one month of age followed by a Glen procedure with left pulmonary artery augmentation at six months. Following the second procedure she developed extensive cyst formation in the upper lobe of the left lung and pneumothorax. She was managed by intercostal drainage of the pneumothorax. The cysts were observed and on a CT scan X-rays taken at one month and six months no cysts were seen. This case illustrates the occurrence of pneumatoceles after pulmonary artery manipulation, their proclivity for causing pneumothoraces and involution on follow-up. Cysts noted in such a setting should be monitored carefully and followed up to resolution.

Cysts/diagnosis , Cysts/etiology , Cysts/therapy , Female , Humans , Infant, Newborn , Lung Diseases/diagnosis , Lung Diseases/etiology , Lung Diseases/therapy , Postoperative Complications , Pulmonary Artery/surgery , Tomography, X-Ray Computed , Transposition of Great Vessels/diagnostic imaging , Transposition of Great Vessels/surgery
Indian J Chest Dis Allied Sci ; 2008 Jul-Sep; 50(3): 293-4
Article in English | IMSEAR | ID: sea-30073


Traumatic pulmonary pseudocyst due to blunt chest trauma is rare. It is a clinical entity that manifests itself with minor clinical and major radiological signs. We report a case of a 16-year-old girl, who during an attack by a violent cow sustained a chest impact that resulted in a traumatic pulmonary pseudocyst, confirmed with a computed tomographic (CT) scan of the chest. The patient recovered with conservative management.

Adolescent , Cysts/etiology , Female , Humans , Lung Diseases/etiology , Thoracic Injuries/complications , Wounds, Nonpenetrating/complications
Rev. chil. pediatr ; 79(3): 295-300, jun. 2008. ilus
Article in Spanish | LILACS | ID: lil-517502


Introduction: Pneumatocele is an uncommon complication of pneumonia, most often asymptomatic with spontaneous resolution. Case-report: Female infant with an history of right upper lobe pneumonia, an air filled structure was noted in the chest X-ray. Asymptomatic until admitted for a wheezing episode, where an increase in the size of the structure was evidenced. She had clinical and radiological follow-up as recommended in a recent study, observing that 5 months later the cystic image was completely resolved. Discussion: According to criteria from published studies, this case is a non complicated pneumatocele because it was asymptomatic, compromised less than 50 percent of the hemithorax and no atelectasia, bronchopleural fistula or signs of infection were observed. Non complicated pneumatoceles can be followed up, and complicated can be treated by image guided catheter drainage or surgical resection. In this case, we confirmed spontaneous resolution after clinical and radiological follow-up.

Introducción: El neumatocele es una complicación poco frecuente de la neumonía, generalmente asintomático que se resuelve espontáneamente. Objetivo: Describir la presentación clínica e imageneológica de un neumatocele en un paciente pediátrico. Caso Clínico: Lactante mayor, género femenino, con antecedente de neumonía del lóbulo superior derecho a los 16 meses de vida. En controles radiográficos posteriores se evidenció una imagen aérea de paredes finas en ápex derecho en progresivo aumento. Asintomática hasta los 20 meses cuando fue hospitalizada por cuadro bronquial obstructivo por virus respiratorio sincicial y se constató crecimiento de la imagen. Se tomó conducta expectante manteniendo seguimiento clínico y radiológico. A la edad de 21 meses se evidenció resolución casi completa de imagen radiográfica. Conclusión: Este caso corresponde a un neumatocele simple, donde se recomienda mantener bajo observación. Los complicados pueden ser drenados por punción bajo imagen radiológica o resecados quirúrgicamente. En este caso se optó por seguimiento clínico y radiológico, pudiendo confirmar su resolución espontánea en el estudio posterior.

Humans , Female , Infant , Lung Diseases/etiology , Lung Diseases , Pneumonia/complications , Cysts/etiology , Cysts , Remission, Spontaneous
Indian J Ophthalmol ; 2008 Jan-Feb; 56(1): 70-2
Article in English | IMSEAR | ID: sea-72436


In this case report, we describe the rare occurrence of bilateral conjunctival retention cysts in a child with Stevens-Johnson syndrome. The case was managed conservatively as there were no functional or cosmetic problems.

Child , Conjunctival Diseases/etiology , Cysts/etiology , Humans , Male , Stevens-Johnson Syndrome/complications