Idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is the most common fibrosing lung disease. It is associated with a very poor prognosis. Treatments can delay the progression of IPF, so early diagnosis is fundamental. Radiologists play a fundamental role in the evaluation and accurate diagnosis of IPF. Identifying the characteristic patterns of IPF on high-resolution computed tomography (HRCT) is key in the process of multidisciplinary diagnosis, often obviating the need for surgical lung biopsies. This review describes and illustrates the clinical and imaging findings in IPF in the context of the most recent international guidelines, as well as the differential diagnosis and the role of HRCT in follow-up and assessment of complications.

Quiste entérico mediastínico: presentación clínica e histopatología inusuales / Mediastinal enteric cyst: unusual clinical presentation and histopathology

El quiste entérico mediastínico es una entidad inusual. Es poco frecuente en adultos y es habitual que sea un hallazgo casual. La lesión en la mayoría de ocasiones presenta un revestimiento interno mucoso del tracto gastrointestinal, y existen diversas teorías para explicar el origen de estas lesiones. Presentamos un caso de quiste entérico torácico en adulto que comenzó con taponamiento cardíaco y que en el estudio histopatológico mostró presencia de tejido pancreático. En la bibliografía médica revisada, únicamente se ha encontrado un caso de quiste entérico mediastínico con tejido pancreático (AU)

[Mediastinal enteric cyst: unusual clinical presentation and histopathology]. / Quiste entérico mediastínico: presentación clínica e histopatología inusuales.

A mediastinal enteric cyst is an uncommon entity which is rare in adults and usually found incidentally. In most cases the lesion is lined by gastrointestinal mucosa, and theories as to the origin of such lesions are diverse. We report an adult case of thoracic enteric cyst that presented with cardiac tamponade and for which histopathological examination revealed the presence of pancreatic tissue. Review of the literature yielded only 1 case of mediastinal enteric cyst with pancreatic tissue.

[Severe neonatal encephalopathy, secondary to a prolonged vasovagal episode in a woman 31 weeks pregnant]. / Encefalopatía neonatal grave, secundaria a episodio vasovagal prolongado en una gestante de 31 semanas.

INTRODUCTION: Vasovagal syncope is not frequent during the second half of pregnancy, although the supine hypotension syndrome is common during this period. During these episodes, the marked hypotension may impede uteroplacental blood flow. CASE REPORT: A woman who was 31.5 weeks pregnant lost consciousness for 15 minutes on standing up. 24 hours later, when it was observed that foetal movement had diminished, a cardiotocographic recording was done. This showed a pathological pattern and foetal biophysical profile on echography showed a marked foetal hypotonia and absence of movement. Emergency caesarean section was carried out and a male foetus delivered, weighing 1.810 g, with an Apgar score of 5/6 and requiring intubation and mechanical ventilation for respiratory difficulties and generalized hyptonia with absent reflexes. During the following days he developed generalized hypertonia and died aged 18 days. At necropsy there was severe brain damage, of ischaemic type. Complementary tests on the mother were normal. CONCLUSIONS: Severe prenatal encephalopathy secondary to maternal vasovagal syncope is uncommon, and we have found no report of it in the literature. The prolonged duration of the hypotensive episode, together with prematurity, which implies poor regulation of cerebral blood flow, may have contributed to the severe damage to the central nervous system

Encefalopatía neonatal grave, secundaria a episodio vasovagal prolongado en una gestante de 31 semanas / Severe neonatal encephalopathy, secondary to a prolonged vasovagal episode in a woman 31 weeks pregnant

Introducción. El síncope vasovagal es poco frecuente en la segunda mitad de la gestación, aunque en este período resulta frecuente el síndrome de hipotensión supina. En estos episodios, la hipotensión marcada puede dificultar el flujo uteroplacentario. Caso clínico. Gestante de 31,5 semanas que presenta pérdida de conciencia de 15 minutos al adoptar la bipedestación. A las 24 horas, al percibir disminución de movimientos fetales, se practica registro cardiotocográfico, que evidencia patrón patológico y perfil biofísico fetal, mediante ecografía, en el cual se observa hipotonía fetal marcada y ausencia de movimientos. Se practica cesárea urgente y se produce nacimiento de feto, varón de 1.810 g, Apgar 5/6 que requiere intubación y ventilación por dificultad respiratoria y con hipotonía generalizada con ausencia de reflejos. En los días siguientes desarrolla hipertonía de base y fallece a los 18 días de vida. En la necropsia se observa lesión encefálica grave de tipo isquémico. Exploraciones complementarias maternas, negativas. Conclusión. La encefalopatía prenatal grave secundaria a síncope vasovagal materno es una entidad muy poco frecuente, de la cual no hemos encontrado otros casos en la literatura. La prolongada duración del episodio hipotensivo, junto con la prematuridad que comporta escasa regulación del flujo cerebral, pudieron contribuir a la gran afectación del sistema nervioso central (AU)

[Bladder leiomyoma. Review of the literature and report of a new case]. / Leiomioma vesical. Revisión de la literatura y presentación de un nuevo caso.

OBJECTIVE: To report an additional case of leiomyoma of the bladder and review the literature. METHODS: A case of leiomyoma of the bladder is presented. Its etiopathogenesis is described and the literature briefly reviewed, with special reference to the differential diagnosis. RESULTS/CONCLUSIONS: Leiomyoma of the bladder is an uncommon benign tumor that must be distinguished from other lesions. Treatment is by surgery, which generally achieves good results.

[Leiomyosarcoma originating in the renal vein. A special case]. / Leiomiosarcoma originado en vena renal. Un caso especial.

OBJECTIVES: An additional case of leiomyosarcoma of the renal vein is presented and the literature reviewed. METHODS/RESULTS: The patient had a history of hypertension. He and his brother were the first case of twins with bilateral retinoblastoma reported in the literature. The pathological findings were diagnostic of leiomyosarcoma of the renal vein. The clinical features, diagnosis and treatment are discussed. CONCLUSIONS: Leiomyosarcoma of the renal vein is an uncommon tumor which presents difficulties in making the preoperative diagnosis. A possible relationship may exist between this tumor type and the radiotherapy administered during childhood due to retinoblastoma.

[Tumors of the gonadal stroma. Report on a Sertoli cell tumor]. / Tumores del estroma gonadal. A propósito de un tumor de células de Sertoli.

OBJECTIVES: A rare case of Sertoli cell tumor of the testis is described. The problems associated with this tumor type and the importance of the differential diagnosis are discussed. METHODS/RESULTS: The clinical features of a patient with Sertoli cell tumor in a cryptorchid testis are presented. CONCLUSIONS: It is recognized that there is a higher incidence of tumors in undescended testis and among these are Sertoli cell tumors.

[Ureteral endometriosis. Review of the literature]. / Endometriosis ureteral. Revisión de la literatura.

Ureteral endometriosis is an uncommon process. It should be suspected, however, in patients with known pelvian disease presenting urological sings and symptoms. It is important to establish early diagnosis which does not delay a conservative therapeutical approach, so as to avoid the progressive decline of renal function and, eventually, nephrectomy. Contribution of one case of extraluminar ureteral endometriosis fitting this hypothesis and review of the most appropriate etiology, sings and symptoms, diagnosis and therapeutical approach.

[Bronchiolitis obliterans with secondary pneumoconiosis]. / Bronquiolitis obliterante con neumoconiosis secundaria.

A seven year old girl developed recurrent bronchitis since three month of life. Chronic wheezing remain between exacerbations. Pathological examination of her lung biopsy disclosed bronchiolar obstruction due to peribronchiolar fibroses. Storage of anthracoid material, compatible with pneumoconiosis in relation to impairment on mucociliary function, was present. This is an unusual picture in childhood.

[Massive pulmonary embolism due to hydatid vesicles. Report of a case (author's transl)]. / Tromboembolismo pulmonar masivo por vesículas hidatídicas. A propósito de un caso.

A patient with hepatic and peritoneal hydatidosis suffered acute episodes of restrictive bronchial disease for the last 2 years. The patient was admitted during the course of one of this acute episodes with clinical symptoms of pulmonary embolism. Supportive therapeutic measures were prescribed, but the patient died 12 hours latter. Autopsy revealed hepatic, peritoneal and pulmonary hidatidosis as well as multiple pulmonary thromboembolisms due to hydatid vesicles. Literature on this subject is reviewed, and different clinical forms and therapeutic possibilities are discussed. The importance of small therapeutic possibilities are discussed. The importance of small recurrent hydatid embolisms in the pathogenesis of acute or subacute cor pulmonale in patients with liver hydatidosis is stressed.