Pseudodiverticulosis esofágica intramural: una causa poco frecuente de disfagia / Esophageal intramural pseudodiverticulosis: a rare cause of dysphagia

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Plasmablastic lymphoma associated to Crohn's disease and hepatitis C virus chronic infection.

Plasmablastic lymphoma is a very rare and recently-described subtype of diffuse large B-cell lymphoma. It has a poor prognosis despite intensive chemotherapy treatment. A 57-year old woman with perianal Crohn's disease receiving azathioprine and infliximab developed this type of lymphoma after a short period of time on the treatment. She also had a hepatitis C virus chronic infection which had not been diagnosed or treated before. There is no solid scientific evidence that either immunomodulators or anti-TNF drugs have a definitive role in the appearance of malignancies, and therefore there are no clear recommendations to limit their use. In these patients, there are some other factors we have to take into account, like the inflammatory bowel disease in itself and its behaviour over time, or the comorbidities of the patient, with special attention to virus infections. In this case report, we will analyse the role of these factors in the development of lymphoproliferative disorders and the recommendations given by experts to avoid their appearance.

Tumor esofágico de células granulares: descripción de un tumor benigno poco frecuente / Granular cell tumor of the esophagus: description of an infrequent benign tumor

ResumenEl tumor de células granulares (TCG) es un tumor infrecuente descrito en 1926 por Abrikossoff. El 6% de estos tumores se encuentran en el tracto gastrointestinal siendo el esófago el lugar de mayor incidencia. El comportamiento suele ser benigno por lo que la mayoría de los TCG esofágicos son asintomáticos descubriéndose de forma casual en la realización de una gastroscopia. En el examen endoscópico aparece como una lesión polipoide o sésil, de aspecto submucoso, bien delimitada, recubierta de mucosa normal de color amarillento y con un aumento de su consistencia. La ecoendoscopia ha mejorado notablemente la evaluación de estas lesiones siendo actualmente la mucosectomía endoscópica el tratamiento de elección con una baja tasa de complicaciones. El estudio histológico de la pieza de resección evidencia características propias como la positividad para la proteína S-100. Presentamos 2 nuevos casos de TCG en esófago recientemente diagnosticados y se comentan los aspectos más relevantes de esta infrecuente enfermedad (AU)

Granular cell tumors (GCT) are infrequent tumors first described by Abrikossoff in 1926. Gastrointestinal involvement occurs in about 6% of GCT, the esophagus being the most frequent location. These tumors are usually benign and asymptomatic and are usually found incidentally when an upper gastrointestinal endoscopy is carried out for another reason, showing an isolated polyp or sessile submucosal nodule, covered by intact yellowish mucosa and with firm consistency. Endoscopic ultrasonography has significantly improved the diagnosis of these lesions. Nowadays endoscopic mucosectomy is the treatment of choice of esophageal GCT with a low frequency of complications. Histologic analysis of the surgical specimen shows specific characteristics such as positivity for S-100 protein. We present two new cases of esophageal GCT that were diagnosed recently and discuss the most relevant features of this infrequent disease (AU)

[Granular cell tumor of the esophagus: description of an infrequent benign tumor]. / Tumor esofágico de células granulares: descripción de un tumor benigno poco frecuente.

Granular cell tumors (GCT) are infrequent tumors first described by Abrikossoff in 1926. Gastrointestinal involvement occurs in about 6% of GCT, the esophagus being the most frequent location. These tumors are usually benign and asymptomatic and are usually found incidentally when an upper gastrointestinal endoscopy is carried out for another reason, showing an isolated polyp or sessile submucosal nodule, covered by intact yellowish mucosa and with firm consistency. Endoscopic ultrasonography has significantly improved the diagnosis of these lesions. Nowadays endoscopic mucosectomy is the treatment of choice of esophageal GCT with a low frequency of complications. Histologic analysis of the surgical specimen shows specific characteristics such as positivity for S-100 protein. We present two new cases of esophageal GCT that were diagnosed recently and discuss the most relevant features of this infrequent disease.

[Colorectal melanoma: review of two distinct forms of presentation]. / Melanoma colorrectal: revisión de dos formas diferentes de presentación.

Malignant melanoma of the colon and rectum is an infrequent disease. Primary anorectal melanoma accounts for 0.1-4.6% of all malignant neoplasms of the anal canal. Melanoma metastatic to the colon is symptomatic only in 4.4% of patients with a primary melanoma at another site and most of these tumors are diagnosed postmortem. We report two cases of colorrectal malignant melanoma. The first case concerned a patient with rectal bleeding who was diagnosed with a rectal lesion compatible with melanoma. Abdominoperineal resection was performed due to positivity of the sentinel lymph node. We discuss the utility of sentinel lymph node detection in this kind of tumor. In the second case, we discovered a polyp compatible with metastatic melanoma in the transverse colon in a patient with a previous diagnosis of melanoma. In both surgical specimens, the diagnosis of melanoma was confirmed by positivity for protein S-100, Melan-A and HMB-45.

Melanoma colorrectal: revisión de dos formas diferentes de presentación / Colorectal melanoma: review of two distinct forms of presentation

El melanoma maligno colorrectal es una enfermedad infrecuente. El melanoma primario anorrectal se observa en el 0,1-4,6% de todos los tumores malignos anales. Por otro lado el melanoma metastásico en esta localización solo produce síntomas en el 4,4% de los pacientes con melanoma a otros niveles, siendo diagnosticado la mayoría de las veces post mórtem. Presentamos los casos de 2 pacientes con melanoma colorrectal. El primero de ellos muestra un paciente atendido por rectorragia en el que se diagnosticó una masa endoanal correspondiente a un melanoma y en el cual se practicó una resección abdominoperineal tras observar la positividad del ganglio centinela, discutiéndose su utilidad en este tipo de tumores. En el paciente del segundo caso se encontró una lesión polipoide en colon transverso correspondiente a una metástasis de un melanoma previamente diagnosticado. En ambas piezas histológicas la anatomía patológica fue característica con positividad para S-100, Melan-A y HMB-45 (AU)

Malignant melanoma of the colon and rectum is an infrequent disease. Primary anorectal melanoma accounts for 0.1-4.6% of all malignant neoplasms of the anal canal. Melanoma metastatic to the colon is symptomatic only in 4.4% of patients with a primary melanoma at another site and most of these tumors are diagnosed postmortem. We report two cases of colorrectal malignant melanoma. The first case concerned a patient with rectal bleeding who was diagnosed with a rectal lesion compatible with melanoma. Abdominoperineal resection was performed due to positivity of the sentinel lymph node. We discuss the utility of sentinel lymph node detection in this kind of tumor. In the second case, we discovered a polyp compatible with metastatic melanoma in the transverse colon in a patient with a previous diagnosis of melanoma. In both surgical specimens, the diagnosis of melanoma was confirmed by positivity for protein S-100, Melan-A and HMB-45 (AU)