Subject(s)
Abdominal Abscess , Splenic Diseases , Abdominal Abscess/diagnosis , Abdominal Abscess/therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Splenic Diseases/diagnosis , Splenic Diseases/therapyABSTRACT
Presentamos cinco casos de carcinoma suprarrenal, diagnosticados en nuestro hospital y describimos su presentación clínica, métodos diagnósticos y tratamiento empleados. Es un tumor poco frecuente, muy agresivo y con mal pronostico. Clínicamente se presentan como tumores caracterizados por efecto masa, síntomas debidos a invasión de vecindad o por una variedad de síndromes hormonales entre los que destacan el hipercortisolismo y la virilización. El diagnóstico se fundamenta en la caracterización bioquímica del síndrome hormonal y en las técnicas de imagen, especialmente la TAC y la RM. Anatomopatológicamente suelen ser tumores de gran tamaño con tendencia a invadir las estructuras vecinas Su tratamiento es fundamentalmente quirúrgico y de los distintos fármacos de quimioterapia, los más efectivos son los adrenolíticos (mitotane) solos o asociados a doxorubicina, cisplatino y etopósido
We present five cases of adrenal cortical carcinoma, diagnosed in our hospital and we describe the clinical presentation, diagnostic methods and treatement. It is a rare tumor, highly aggressive and prognosis is poor. The clinical presentation is characterized by a mass effect, symptoms caused by the invasion of the structures nearby or by a variety of hormonal changes, especially hypercortisolism and virilization. The diagnosis is based on the biochemical characterization of the hormonal profile and on imaging techniques, especially computed tomography and magnetic resonance. The treatment is generally surgical and the most effective chemotherapeutic agents are the adrenolytics (mitotane) alone or associated with doxorubicin, cisplatin and etoposide
Subject(s)
Male , Female , Middle Aged , Humans , Tomography, Emission-Computed/methods , Mitotane/therapeutic use , Angiography/methods , Adrenalectomy/methods , Nephrectomy/methods , Adrenocortical Carcinoma/complications , Adrenocortical Carcinoma/diagnosis , Adrenocortical Carcinoma/therapy , Retrospective Studies , Magnetic Resonance Imaging , Abdominal WallABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Glucocorticoids/therapeutic use , Immunocompromised Host , Opportunistic Infections/diagnosis , Pneumonia, Bacterial/diagnosis , Pneumonia, Staphylococcal/diagnosis , Pseudomonas Infections/diagnosis , Pulmonary Disease, Chronic Obstructive/drug therapyABSTRACT
We present five cases of adrenal cortical carcinoma, diagnosed in our hospital and we describe the clinical presentation, diagnostic methods and treatment. It is a rare tumor, highly aggressive and prognosis is poor. The clinical presentation is characterized by a mass effect, symptoms caused by the invasion of the structures nearby or by a variety of hormonal changes, especially hypercortisolism and virilization. The diagnosis is based on the biochemical characterization of the hormonal profile and on imaging techniques, especially computed tomography and magnetic resonance. The treatment is generally surgical and the most effective chemotherapeutic agents are the adrenolytics (mitotane) alone or associated with doxorubicin, cisplatin and etoposide.
Subject(s)
Adrenal Cortex Neoplasms/pathology , Adrenocortical Carcinoma/pathology , Adrenal Cortex Neoplasms/surgery , Adrenalectomy , Adrenocortical Carcinoma/surgery , Aged , Female , Humans , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Treatment OutcomeABSTRACT
Intravascular lymphomatosis (IVL) is a rare malignancy characterized by a proliferation of atypical lymphoid cells occluding small blood vessels (venules, capillaries and small arteries). The symptoms are caused by embolisms due to massive proliferation. Nervous system and skin are the most common sites of involvement but all organs may be involved, although it is typified by the absence of malignant cells in lymphoid tissues. We describe three cases of IVL: first patient was a 57 years old man with rapidly progressive dementia and neurological involvements and second case of a 69 years old man hospitalised with predominant symptoms in the lung (cough, dyspnea and fever), and a woman presenting as fever of unknown origin (FUO) with systemic inflammatory response syndrome. In all cases that we reported have been diagnosed post-mortem because of rapid progression of a multisystem disease and the absence of pathognomonic clinical manifestations. Diagnosis can be made using biopsy of one of the involved organs. In conclusion, we propose that IVL should be included in the differential diagnosis of acute confusional state, dementia or other unexplained neurological manifestations, fever of unknown origin, vasculitis, occult neoplasia or infections with signs of a systemic disease and marked elevation of serum lactate dehydrogenase (LDH).
Subject(s)
Lymphoma/pathology , Vascular Neoplasms/pathology , Aged , Autopsy , Diagnosis, Differential , Female , Humans , Male , Middle AgedABSTRACT
La linfomatosis intravascular (LIV) es una neoplasia poco frecuente caracterizada por la proliferación de células linfoides atípicas en la luz de pequeños vasos (vénulas, capilares y arteriolas). La sintomatología está causada por fénomenos trombóticos debido a la oclusión de los vasos por células tumorales. Los órganos más afectados son el sistema nervioso y la piel, aunque puede estar involucrado cualquier otro sistema, sin afectación de los tejidos linfoides. Presentamos tres casos de LIV: el primero se trata de un varón de 57 años que debuta con demencia y síntomas neurológicos; un segundo caso en un paciente de 69 años con manifestaciones predominantemente pulmonares (tos, disnea y fiebre) y una mujer con fiebre de origen desconocido (FOD) y síndrome inflamatorio sistémico. Dada la ausencia de signos específicos de esta entidad multiorgánica con evolución rápidamente progresiva, su diagnóstico es postmorten en todos nuestros casos. Para su confirmación se precisó de biopsia de uno de los órganos afectados. En conclusión, consideramos la necesidad de plantear el diagnóstico diferencial con el síndrome confusional agudo, demencia o síndromes neurológicos de etiología no filiada, vasculitis, neoplasias ocultas, fiebre de origen desconocido o infecciones con afectación multiorgánica y valores muy elevados de LDH
Intravascular lymphomatosis (IVL) is a rare malignancy characterized by a proliferation of atypical lymphoid cells occluding small blood vessels (venules, capillaries and small arteries). The symptoms are caused by embolims due to massive proliferation. Nervous system and skinare the most common sites of involvement but all organs may be involved, although it is typified by the absence of malignant cells in lymphoid tissues. We describe three cases of IVL: first patient was a 57 years old man with rapidly progressive dementia and neurological involvementsand second case of a 69 years old man hospitalised with predominant symptoms in the lung (cough, dyspnea and fever), and a woman presenting as fever of unknown origin (FUO) with systemic inflammatory response syndrome. In all cases that we reported have been diagnosed postmortenbecause of rapid progression of a multisystem disease and the absence of pathognomonic clinical manifestations. Diagnosis can be made using biopsy of one of the involved organs. In conclusion, we propose that IVL should be inclucled in the differential diagnosis of acute confusional state, dementia or other unexplained neurological manifestations, fever of unknown origin, vasculitis, occult neoplasia or infections with signs of a systemic disease and marked elevation of serum lactate dehydrogenase (LDH)
Subject(s)
Male , Female , Aged , Humans , Lymphoma/pathology , Vascular Neoplasms/pathology , Autopsy , Diagnosis, DifferentialSubject(s)
Leptospirosis/epidemiology , Adult , Aged , Female , Humans , Leptospirosis/diagnosis , Male , Middle Aged , Spain/epidemiologySubject(s)
Anticoagulants/adverse effects , Hemarthrosis/chemically induced , Aged , Aged, 80 and over , Humans , MaleSubject(s)
Arthritis/virology , Fever/virology , Parvoviridae Infections/complications , Parvovirus B19, Human/isolation & purification , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antibodies, Viral/blood , Arthritis/blood , Arthritis/drug therapy , Female , Fever/blood , Fever/drug therapy , Humans , Indomethacin/therapeutic use , Parvoviridae Infections/blood , Parvoviridae Infections/drug therapy , Parvovirus B19, Human/immunology , Treatment OutcomeSubject(s)
Acquired Immunodeficiency Syndrome/complications , Cerebral Infarction/microbiology , HIV-1 , Neurosyphilis/complications , Paresis/etiology , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Acquired Immunodeficiency Syndrome/diagnosis , Anti-Bacterial Agents/therapeutic use , Cerebral Infarction/diagnosis , Cerebral Infarction/drug therapy , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Neurosyphilis/diagnosis , Neurosyphilis/drug therapy , Paresis/diagnosis , Paresis/therapy , Penicillin G/therapeutic use , Treatment OutcomeABSTRACT
Listeria monocytogenes is still a very rare opportunist infection in immunosuppressive patients. The clinical-epidemiological and therapeutic characteristics in 10 patients with infection produced by LM are reported--four of them had primary bacteriemia, three patients had a meningeal involvement, there were two patients with spontaneous bacterial peritonitis and one suffered from abdominal access. All of the patients had underlying disorders favouring the infection. Sepsis and meningeal syndrome were the most common presenting forms. Ampicillin was the most used antibiotic. The overall mortality was 40%.
