Trombosis venosa profunda bilateral extensa asociada con tuberculosis / Bilateral extensive lower limb deep thrombosis: an unknow associaton with tuberculosis

El derrame pleural tuberculoso secundario a una reacción de hipersensibilidad a las proteínas tuberculosas suele tener una evolución no complicada. La tuberculosis pleural (TBC-PLE), así como la tuberculosis pulmonar (TBC-PUL), no se asocia en general con complicaciones hematológicas. Existen pocos informes de complicaciones hematológicas sistémicas, como la coagulación intravascular diseminada (CID)1 y la trombosis venosa profunda (TVP)2, en asociación con la TBC-PUL. Sin embargo, estas complicaciones no se han descrito para la TBC-PLE. Describimos 2 casos de TVP bilateral extensa de miembros inferiores relacionadas con tuberculosis, en un paciente con compromiso pleural y otro con afección del parénquima pulmonar, que sucedieron durante el tratamiento antituberculoso diario con isoniazida, rifampicina, pirazinamida y etambutol.

Simultaneous isolated bilateral facial palsy : A rare vincristine-associated toxicity.

We describe a case of a 15-year-old boy with vincristine-induced simultaneous isolated bilateral facial palsy. The boy presented with superior vena caval syndrome (SVC syndrome), right-sided pleural effusion and anterior mediastinal lymphadenopathy. Histopathological examination of left axillary lymph node was suggestive of lymphoblastic lymphoma. We started chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisolone. SVC syndrome disappeared completely after the 1st cycle, and he achieved remission after the 3rd cycle of chemotherapy. He noticed that he could not close his eyes. Neurological examination revealed bilateral lower motor neuron facial palsy. Findings from examination of other cranial nerves and peripheral nerves were normal. Results of MRI of brain and cerebrospinal fluid examination were normal. He received 6 mg vincristine before developing toxicity.

Immature teratoma with choriocarcinoma-like lesion of testis: case report of an unusual presentation.

An eighteen year old male presented with hemoptysis and superior vena caval syndrome. History and clinical examination revealed a testicular mass which was previously diagnosed as hematocele. Chest x-ray showed a four cm diameter shadow and several smaller shadows. Histological examination of the testicular mass established it as immature teratoma with choriocarcinoma-like lesion (CCLL)--a rare association in testicular tumours. Focal positivity for betaHCG was noted in the testicular tumour. Guided aspiration of the lung showed features of a metastatic non seminomatous germ cell tumour.

Lungs: victim of synchronous double malignancies.

A 20 year young man was referred to our institution with superior vena cava (SVC) syndrome, multiple lung opacities and a mass lesion in the right upper zone (RUZ). CT-guided FNAC from the mass lesion was consistent with the diagnosis of non-small cell lung carcinoma (NSCLC). A lump in his left testis was detected during clinical examination. Both FNAC and excisional biopsy of the testicular mass confirmed the diagnosis of immature teratoma with choriocarcinoma, a form of non-seminomatous germ cell tumour (NSGCT). With chemotherapy all metastatic lesions of lung and SVC syndrome disappeared, and the tumour-marker levels decreased. However, the opacity in RUZ progessed to involve right recurrent laryngeal nerve at thoracic inlet, metastasized to the brain, and the patient expired after 4th cycle of chemotherapy. This case of synchronous double primary malignancies (SDPM) is being reported for its rarity.