ABSTRACT
A new case of hepatic inflammatory pseudotumor (HIP) is reported. A 66-year-old woman presented with fever and toxic syndrome. Analysis demonstrated an elevation in erythrocyte sedimentation, CRP, leukocytosis and normocytic anemia. A lesion was observed on ultrasonography in the right hypoechoic hepatic lobe with echos within (mosaic pattern). The lesion was hypodense on CT scan and was hypervascularized on angiography. NMR was hypointense on T1 and hyperintense on T2. The patient underwent surgery with intraoperative biopsy being performed. Hepatectomy was not carried out given negativity of malignancy. Following surgery the patient remained asymptomatic and the analytical alterations normalized. After a asymptomatic 5-year period the clinical-analytical alterations reappeared following erysipelas. Fever showed partial response to non steroid antiinflammatory drugs and a satisfactory response to corticoids. Studies are required to evaluate the role of corticoid treatment in this disease.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Granuloma, Plasma Cell/drug therapy , Liver Diseases/drug therapy , Prednisone/therapeutic use , Aged , Biopsy , Combined Modality Therapy , Female , Granuloma, Plasma Cell/diagnosis , Humans , Liver/diagnostic imaging , Liver/pathology , Liver Diseases/diagnosis , Magnetic Resonance Imaging , Recurrence , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Two patients with gastric tuberculosis are described. The first presented toxic syndrome, multiple abdominal adenopathies, microcytic anemia and a subcardial ulcer with malignant characteristics at endoscopy. Diagnosis was based on the positivity of Ziehl-Neelsen staining and on the growth of Mycobacterium tuberculosis in the culture of the gastric mucosa. The second patient presented toxic syndrome, fever and a miliary pattern on thoracic radiography. Endoscopy demonstrated an ulcerated nodular lesion with granulomas with acid alcohol resistant bacillus being observed on biopsy. Mycobacterium tuberculosis was found in both the sputum and bronchoaspirate. The evolution of both cases was favorable with specific treatment.
Subject(s)
Stomach Diseases/diagnosis , Tuberculosis, Gastrointestinal/diagnosis , Aged , Anemia/etiology , Biopsy , Cardia , Humans , Male , Middle Aged , Mycobacterium tuberculosis/isolation & purification , Sputum/microbiology , Stomach/pathology , Stomach Diseases/complications , Stomach Diseases/pathology , Tuberculosis, Gastrointestinal/complications , Tuberculosis, Gastrointestinal/pathology , Tuberculosis, Miliary/complicationsABSTRACT
Validity of visual reading of a reactive strip is measured, in comparison with automatized reading and the exam of the urinary sediment, in 562 school pupils with ages between 6 and 16 years. Using urine culture as standard reference, sensibility of the leukocyte-esterase (L-E) test, nitrites and red cells was 66.7%, 33.3% and 66.7% respectively, for the visual reading; 66.7%, 33.3% and 33.3% for automatized reading, respectively; and 66.7% for leukocyturia, and 33.3% for hematuria in the urine sediment. Specificity of tests was 84.9%, 99% and 42.7% for L-E, nitrites and red cells, in visual reading; 92.5%, 100% and 80.8% for the same tests in automatized reading, and 94.5% (leukocyturia) and 86.3% (red cells) in the urinary sediment. Validity of these diagnostic methods results different depending on the population they are applied to. Even though the multi-urine test is still the most effective test in a symptomatic population and the less expensive, it would be not recommendable its use as a screening test in a school population with hidden urinary infection.
