ABSTRACT
OBJECTIVE: We report two new cases of inflammatory pseudotumor of the spleen and review the cases reported to date. We discuss the diagnostic value of the clinical manifestations, the modern image technics and the laboratory data and conclude that only pathological and immunohistochemical studies allow a reliable diagnosis of this disease. DATA SOURCES: We have obtained the cases for the review through a computer search with the system SilverPlatter 3.11 (SilverPlatter Software Copyright NU 1992). The new cases have been obtained from our files. DATA SYNTHESIS: 53% were random findings (47% in the workup of another disease and 5% at autopsy). In the remaining cases, the clinical signs were not specific and none of the image technics could establish diagnosis. Neither fine needle aspiration nor laboratory data rendered conclusive results. Only pathological and immunohistochemical study after splenectomy allowed diagnosis. The clinical signs disappeared in all the cases following splenectomy and none of the patients have had recurrences. CONCLUSIONS: Inflammatory pseudotumor is a benign disease of unknown etiology and pathogenesis. It consists of solitary or multiple tumors that can affect virtually any organ. Clinical signs are non-specific. This lesion can render diagnostic problems with neoplasms of the lymphoreticular system. Splenectomy is diagnostic and curative.
Subject(s)
Granuloma, Plasma Cell/pathology , Splenic Diseases/pathology , Aged , Biopsy, Needle , Female , Granuloma, Plasma Cell/surgery , Humans , Male , Middle Aged , Splenectomy , Splenic Diseases/surgeryABSTRACT
Rupture of the pericardium due to blunt thoracic trauma is a rare pathology with a range of mortality between 30 and 64% according to different authors. We review 40 cases which have been reported in the literature in the last decade and report a case of our own. We have found that 82% of the patients with traumatic rupture of the pericardium were men with a mean age of 45 years. In 80% of the cases the cause was a motor vehicle accident, 17% were due to falls and only 1 case was associated with a crush. The commonest location of the tear was the left pleuropericardium (62%) followed by the diaphragmatic portion of the pericardium (22%). In 80% of the cases the diagnosis was achieved in the course of a surgery performed for associated lesions. None of the cases was diagnosed in a post-mortem study. The traumatic rupture of the pericardium is a disease which often remains undiagnosed, especially when one does not have a high index of suspicion. Nevertheless, this is a disease which can threaten the life of the patient and we should keep it in mind to diagnose and treat it as soon as possible. It is known that an early and aggressive management of these patients implies a much better prognosis with a significant reduction of the mortality. In this article we want to give useful clues to allow a preoperative diagnosis and an early and adequate management.
Subject(s)
Heart Injuries/epidemiology , Accidental Falls , Accidents, Traffic , Heart Injuries/diagnosis , Heart Injuries/etiology , Heart Injuries/surgery , Humans , Male , Middle Aged , Pericardium/injuries , Thoracic Injuries/complications , Thoracic Injuries/etiology , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/etiologyABSTRACT
We report a case of MALT (Mucosa Associated Lymphocytic Tissue) gastric lymphoma which occurred in a 52-year-old woman, associated with Hodgkin's disease, Lymphocyte Predominant type, in epiploic nodes. Although many cases of composite lymphomas have been reported, we were not able to find cases of gastric MALT lymphoma associated with Hodgkin's disease. This is probably the first case reported in the literature.
Subject(s)
Hodgkin Disease/pathology , Lymphoid Tissue/pathology , Lymphoma/pathology , Neoplasms, Multiple Primary/pathology , Stomach Neoplasms/pathology , Female , Gastric Mucosa/pathology , Humans , Middle AgedABSTRACT
We report the experience of the General Surgery Service of Segovia General Hospital. In a 15-years-period (1976-1991), we have cared for 32 patients with muscular tumors of the gastrointestinal tract, including 22 leiomyomas and 11 leiomyosarcomas. These tumors were localized in stomach (46.8%), small intestine (40.6%), esophagus (9.3%) and colon-rectum (3.1%). A histologic study was developed on the basis of the mitosis number in 10 high power fields. Clinical manifestations, histological dates, treatment, and prognosis factors, outstanding the histological grade, size lesser than 10 cm, and tumor origin localization, are reviewed.
