ABSTRACT
Objetivo: Los linfomas malignos constituyen la primera causa de fiebre de origen desconocido (FOD) dentro de la categoría de las neoplasias. Se realizó este estudio con el objetivo de determinar los hallazgos clínicos y aquellas investigaciones que contribuyeron al diagnóstico de dichos tumores. Método: Se realizó un estudio descriptivo-prospectivo de 18 pacientes hospitalizados para el estudio de una FOD clásica en los que se estableció el diagnóstico de linfoma maligno durante los años 2000 al 2005. Resultados: Más de la mitad de los casos (55%) se encontraba en estadio IV. Se detectó perdida de peso en 13 pacientes (72%) y adenopatías periféricas en la mitad de los casos. El ultrasonido abdominal evidenció alteraciones sugestivas de linfoma maligno en el 55% de los casos. La biopsia de adenopatías periféricas o profundas estableció el diagnóstico en 8 pacientes (44%) y la de médula ósea en 6 pacientes (33%). Hubo 4 pacientes fallecidos (22%) en los que el diagnóstico solo se pudo establecer en la necropsia. Conclusiones: La mayoría de los linfomas malignos que debutaron por FOD se encontraba en estadio avanzado. La perdida de peso y las adenopatías periféricas fueron las manifestaciones clínicas más frecuentes. El ultrasonido abdominal, la biopsia de adenopatías y la de médula ósea fueron los procederes de mayor utilidad diagnóstica
Objective: The main cause of fever of unknown origin (FUO) in the diagnostic category of neoplasms are malignant lymphomas. This study was done to describe the clinical features and the investigation results which diagnostic contribution. Method: Between 2000 and 2005 a prospective and descriptive study was conducted in 18 patients hospitalized for studying a classical FUO who were diagnosed as having a malignant lymphoma. Results: More than half of all patients (55%) were in stage IV. The weight loss and the peripheral lymphadenopathy were found in 13 (72%) and 9 patients (50%), respectively. Abdominal ultra sonography had a diagnostic contribution in 55% of the patients. The malignant lymphoma diagnostic was made by peripheral or deep lymphadenopathy biopsy in 8 patients (44%). The bone marrow biopsy established diagnostic in 6 patients (33%). In four patients (22%) the diagnosis was made at the autopsy. Conclusions: Most of patients with malignant lymphomas presenting as FUO had an advanced disease. The weight loss and the peripheral lymphadenopathy were the most frequent clinical features. Abdominal ultrasonography, lymphadenopathy biopsy and bone marrow biopsywere the procedures with more diagnostic utility
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Fever/etiology , Lymphoma, Non-Hodgkin/diagnosis , Hodgkin Disease/diagnosis , Lymphoma, Non-Hodgkin/pathology , Hodgkin Disease/pathology , Hospital Statistics , BiopsyABSTRACT
OBJECTIVE: The main cause of fever of unknown origin (FUO) in the diagnostic category of neoplasms are malignant lymphomas. This study was done to describe the clinical features and the investigation results which diagnostic contribution. METHOD: Between 2000 and 2005 a prospective and descriptive study was conducted in 18 patients hospitalized for studying a classical FUO who were diagnosed as having a malignant lymphoma. RESULTS: More than half of all patients (55%) were in stage IV. The weight loss and the peripheral lymphadenopathy were found in 13 (72%) and 9 patients (50%), respectively. Abdominal ultrasonography had a diagnostic contribution in 55% of the patients. The malignant lymphoma diagnostic was made by peripheral or deep lymphadenopathy biopsy in 8 patients (44%). The bone marrow biopsy established diagnostic in 6 patients (33%). In four patients (22%) the diagnosis was made at the autopsy. CONCLUSIONS: Most of patients with malignant lymphomas presenting as FUO had an advanced disease. The weight loss and the peripheral lymphadenopathy were the most frequent clinical features. Abdominal ultrasonography, lymphadenopathy biopsy and bone marrow biopsy were the procedures with more diagnostic utility.
Subject(s)
Fever of Unknown Origin/etiology , Hodgkin Disease/complications , Lymphoma, Non-Hodgkin/complications , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
It has been reported five cases of Castleman s disease. They were admitted at Hermanos Ameijeiras Surgical-Clinic Hospital. In four out of the five cases belonged to hyaline-vascular histological variety and one case to plasmacellular variety. All the cases which belonged hyaline-vascular variety were located and one of them was complicated with sarcoma of dendritic follicular cells. The plasmacellular variety was of the multicentric type. Of the four located cases two of them were retroperitoneals and they received surgical treatment only; the case of cervical location was treated with radiotherapy and steroids and the forth one of axillary location was treated with surgical removal followed of radiotherapy. The last one case, of plasma-cell and multicentric type, was only treated with prednisone. All the patients are still alive and only the one with plasmacellular variety has symptoms yet.
Subject(s)
Castleman Disease/diagnosis , Adult , Castleman Disease/therapy , Female , Humans , Male , Middle AgedABSTRACT
Se reportan cinco casos de enfermedad de Castleman (EC) ingresados en el Hospital Hermanos Ameijeiras. Cuatro casos correspondieron a la variedad histológica hialinovascular y uno a la plasmocelular. Todos los casos de la variedad hialinovascular fueron localizados y uno de ellos se complicó con un sarcoma de células foliculares dendríticas. La variedad plasmocelular fue del ltipo multicéntrico. De los cuatro casos localizados dos fueron retroperitoneales y recibieron sólo tratamiento quirúrgico; el otro de localización cervical recibió radioterapia y esteroides; y el cuarto de localización axilar, fue tratado con exéresis quirúrgica seguido de radioterapia. El último caso, de tipo multicéntrico y plasmocelular, recibió sólo tratamiento con prednisona. Todos los casos se mantienen vivos en la actualidad, y sólo el de la variedad plasmocelular continua con síntomas
It has been reported five cases of Castleman´s disease. They were admited at Hermanos Ameijeiras Surgical-Clinic Hospital. In four out of the five cases belonged to hyaline-vascular histological variety and one case to plamocelular variety. All the cases which belonged hyaline-vascular variety were located and one of them was complicated with sarcoma of dendritic follicular cells. The plasmacelular variety was of the multicentric type. Of the four located cases two of them were retroperitoneals and they received surgical treatment only; the case of cervical location was treated with radiotherapy and steroids and the forth one of axillary location was treated with surgical removal followed of radiotherapy. The last one case, of plasma-cell and multicentric type, was only treated with prednisone. All the patients are still alive and only the one with plasmacelular variety has symptoms yet
Subject(s)
Male , Female , Adult , Humans , Castleman Disease/diagnosis , Castleman Disease/therapyABSTRACT
INTRODUCTION: At the beginning of 1992 an epidemic neuropathy was seen in Cuba. MATERIAL AND METHODS: To determine the clinical characteristics we studied the clinical and neurological features, cerebrospinal fluid, and did neurophysiological investigations and sural nerve biopsies. RESULTS: Sixty patients were studied. Of these, 42 (70%) had polyneuropathy which was predominantly peripheral and 18 (30%) had combined forms. Most patients had asthenia and weight loss. The polyneuropathic effects were mainly in the legs. In 33.3% of the patients there were distal autonomic effects and sphincter disorders. Only 7 patients had hypoacusia. However, subclinical neurosensorial hypoacusia was seen in 33.3%. Optic neuropathy affected central vision bilaterally and symmetrically with temporal pallor of the papilla in half the cases. In 3 patients there was loss of ganglionar nerve fibres of the papillo-macula bundle. The contrast sensitivity visual test was abnormal in some patients with peripheral polyneuropathy, showing subclinical optic neuropathy in these cases. Sensory neuroconduction suggested axonal neuropathy in 30 patients, demyelinating neuropathy in 5 patients, while the remainder were normal. Motor neuroconduction was normal in most patients. Sural nerve biopsy of 27 patients showed axon damage in 96.2% of cases. CONCLUSIONS: The clinical picture is similar to that seen in nutritional deficiencies and toxic processes.
Subject(s)
Disease Outbreaks , Peripheral Nervous System Diseases/epidemiology , Adolescent , Adult , Axons/pathology , Biopsy , Cuba/epidemiology , Demyelinating Diseases/complications , Demyelinating Diseases/pathology , Female , Hearing Loss, Sensorineural/complications , Hearing Loss, Sensorineural/diagnosis , Humans , Incidence , Male , Middle Aged , Muscular Atrophy, Spinal/complications , Neural Conduction/physiology , Optic Neuritis/complications , Optic Neuritis/pathology , Peripheral Nervous System Diseases/complications , Peripheral Nervous System Diseases/pathology , Sural Nerve/pathology , Vision Disorders/complications , Vision Disorders/diagnosisABSTRACT
Se presenta una enfermera que ingresa en el hospital docente "General Calixto Garcia" con un sindrome osteoartricular y que se demuestra posteriormente se trataba de una manifestacion paraneoplasica de un tumor maligno del pulmon. Despues de la intervencion quirurgica regresaron todas estas manifestaciones. Se hace una breve revision de la osteoartropatia neumica hipertrofiante de Pierre Mari-Remberger; esta atiende fundamentalmente a las teorias que invocan en su patogenia
Subject(s)
Middle Aged , Humans , Female , Lung Neoplasms , Osteoarthropathy, Secondary HypertrophicABSTRACT
Se presenta una enfermera que ingresa en el hospital docente "General Calixto Garcia" con un sindrome osteoartricular y que se demuestra posteriormente se trataba de una manifestacion paraneoplasica de un tumor maligno del pulmon. Despues de la intervencion quirurgica regresaron todas estas manifestaciones. Se hace una breve revision de la osteoartropatia neumica hipertrofiante de Pierre Mari-Remberger; esta atiende fundamentalmente a las teorias que invocan en su patogenia
