ABSTRACT
Resumen La troponina cardiaca es el marcador bioquímico más sensible y específico de daño/necrosis miocárdica, de ahí que desempeñe un papel crucial en el diagnóstico del síndrome coronario agudo. Sin embargo, en ocasiones, como en el caso clínico que se describirá, la elevación anormal de troponina no siempre obedece a un síndrome coronario agudo trombótico, sino a causa cardiaca sin enfermedad coronaria significativa, causa extracardiaca o alteración analítica (verdaderos falsos positivos). El interés de este caso radica en que siempre debería tenerse en mente la posibilidad de que se produzca un falso positivo de troponina por causa analítica, en especial en situaciones clínicas sin una razón obvia de daño miocárdico y cuando no sea evidente la confirmación de daño miocárdico mediante pruebas complementarias.
Abstract Cardiac troponin is the most sensitive and specific biochemical marker for myocardial damage / necrosis, and thus has a crucial role in the diagnosis of acute coronary syndrome. However, occasionally, as in the clinical case that will be described, the abnormal elevation of troponin does not always obey that of an acute coronary syndrome, but also to a cardiac cause with no significant coronary disease, extra-cardiac cause, or analytical change (true false positives). The interest in this case lies in that it should always be borne in mind that a false positive troponin can be produced due to an analytical cause. This can be the case in clinical situations with no obvious reason for myocardial damage and when the confirmation of myocardial damage may not be evident using complementary tests.
Subject(s)
Humans , Male , Middle Aged , Troponin I , False Positive Reactions , Lifting , Coronary Disease , Acute Coronary SyndromeABSTRACT
Acinic cell carcinoma arising in salivary glands is a rare tumor, accounting for 2% to 5% of the primary neoplasms of the parotid gland. When these tumors are well-differentiated, the neoplasia has innocuous aspect, due to the similarity to normal parotid tissue. This makes the diagnosis difficult. Initially the malignancy of this tumor was uncertain; however, recent studies have declared it as malignant. The female / male ratio is 3:2. The nodule usually presents as solitary and well defined shape. Several authors have used different terms to describe histomorphological patterns of these tumors. Four descriptive categories (solid, microcystic, papillary-cystic and follicular) are useful for pathologists. Here we report a case of a 49 yr old man with a left parotid nodule of 5 cm. Parotidectomy was performed at the Hospital Universitario Miguel Servet, in Zaragoza (Spain). The microscopy showed a tumor with acinic semblance, having the four morphologic patterns previously described. The morphological and immunohistochemical study was consistent with the diagnosis of acinic cell carcinoma.
