Linfoma intravascular, un desafio diagnóstico: Caso clínico / Intravascular lymphoma: Report of one case

Intravascular lymphoma is a rare subtype of extranodal diffuse large B-cell lymphoma characterized by clonal proliferation of lymphocytes inside of small and medium caliber vessels. Its incidence is estimated at one case per million. The clinical picture is very variable, but frequently has skin and central nervous system involvement. It is diagnosed by demonstrating pathological blood vessel infiltration by lymphoma cells. We report a 44 years old male presenting with fever, malaise and erythematous lesions in the abdominal wall. An abdominal wall biopsy showed dilated vascular vessels with atypical cells in their lumen, compatible with large B-cell intravascular lymphoma. He was treated with rituximab, cyclophosphamide, adriamycin, vincristine and prednisone and an autologous hematopoietic stem cell transplantation, achieving a complete remission that has lasted two years.

Anomalías vasculares / Vascular anomalies

Las anomalías vasculares incluyen un amplio número de enfermedades de la red vascular que tiene similitudes en su manifestación clínica, esto ha llevado por años a una confusión en la nomenclatura, diagnóstico y tratamiento. A continuación se presenta una revisión del tema que pretende describir la nomenclatura y clasificación vigente así como revisar la sintomatología, complicaciones y manejo actualizado.

Vascular tumors of the retina and choroid: diagnosis and treatment

The vascular tumors of the retina and choroids comprise a diverse group of congenital and acquired lesions. The major vascular tumors of the retina include retinal capillary hemangioma, cavernous hemangioma of the retina, retinal vasoproliferative tumor, and racemose hemangiomatosis of the retina or Wyburn-Mason syndrome. Choroidal vascular tumors include circumscribed choroidal hemangioma and diffuse choroidal hemangioma. While classified as benign, visual symptoms secondary to exudative retinal detachment and a variety of other mechanisms are common and are a major source of long-term visual disability. While many therapeutic modalities exist, treatment of symptomatic cases can be challenging. Of particular importance, many of the vascular tumors of the retina and choroids have significant associations with systemic disease. As ocular symptoms are often the most common presenting disease manifestation, the ophthalmologist plays an important role in accurate and early diagnosis. The ability to initiate prompt screening and treatment in appropriate cases is critical. In the following article, the key clinical and diagnostic features of the major retinal and choroidal vascular tumors, their systemic associations, and the literature pertaining to the most currently available treatment strategies are reviewed

Embolización arterial supra-selectiva en otorrinolaringología: indicaciones y complicaciones en 12 años / Superselective arterial embolization in otorhinolaryngology: indications and complications in a 12-year experience

Introducción: La embolización arterial es un procedimiento invasivo cuya aplicación resulta beneficiosa en numerosas patologías otorrinolaringologías. Se indica como terapia primaria o como adyuvante preoperatorio principalmente en tumores vasculares de cabeza y cuello. Sus complicaciones no son infrecuentes y requieren de evaluación precoz para manejo oportuno. Objetivo: Analizar la experiencia de nuestro servicio en el uso de embolización arterial supraselectiva en otorrinolaringología. Material y método: Estudio retrospectivo. Se analizan los procedimientos realizados entre 1995 y 2007, se caracteriza el grupo de estudio, destacando diagnóstico, indicaciones y complicaciones del procedimiento. Resultados: Se obtuvo un total de 23 procedimientos realizados en 18 pacientes. El 95,6% (n=22) como terapia adyuvante prequirúrgica de tumores vasculares y el 4,4% (n=1) como terapia primaria de epistaxis intratable. Se encontró la presencia de complicaciones en 21,7% de los pacientes, con una Incidencia general de 17,4% (n=4) en complicaciones menores y 4,3% (n=1) en complicaciones mayores. Conclusiones: Es indiscutible su indicación preoperatoria en tumores vascularizados de cabeza y cuello por los beneficios quirúrgicos intraoperatorios. Las complicaciones son en su mayoría menores, las complicaciones mayores son infrecuentes, pero de un gran impacto para el paciente. En pacientes seleccionados, radiólogos preparados y materiales adecuados es una herramienta útil y segura.

Introduction. Arterial embolization is an invasive procedure that results beneficial in numerous otorhinolaryngological pathologies. It is mainly indicated as the primary therapy or as a presurgical adjuvant in vascular head and neck tumors . Its complications are not infrequent and require early assessment. Aim. Jo analyze the otorhinolaryngology superselective arterial embolization experience in our clinical department. Material and Method. This is a retrospective study. Procedures performed between 1995 and 2007 were analyzed. The group was characterized considering diagnosis, indications and complications derived from the procedure. Results. A total of 23 procedures performed in 18 patients was studied. 95.6% (n=22) were carried out as presurgical adjuvant therapy in the treatment of vascular tumors, and 4.4% (n=1) as primary treatment for intractable epistaxis. Complications were found in 21.7% of patients, with a general incidence of 17.4% (n=4) due to minor complications and 4.3% (n=1) due to major complications. Conclusion. Presurgical arterial embolization is recommended in highly vascular head and neck tumors because of the surgical benefits it reports. Complications are mostly minor; major complications being infrequent, but with high impact on the patient. It is thus a useful and safe tool in selected patients, when trained radiologists and adequate materials are available.