[Solitary hepatic mass as initial manifestation of non-hodgkin lymphoma]. / Masa hepática única como forma de presentación de un linfoma no Hodgkin.

A 55 years-old woman was admitted to the hospital because fifteen days of malaise, right upper quadrant pain and fever. Physical exam revealed hepato-splenomaly and radiologic evaluation (abdominal ultrasonography and CT) showed a solid hepatic mass with several retroperitoneal lymphadenopathies. Through an hepatic fine needle aspiration biopsy and a bone marrow biopsy, the diagnosis of a high grade non-Hodgkin lymphoma was made. The histopathological study of a retroperitoneal lymphadenopathy surgical biopsy got the definitive diagnosis. This form of liver involvement (big solid hepatic mass) by lymphoma is not usual and when it is found, it's necessary to make a differential diagnosis with primary hepatic tumors, hepatic metastases and primary lymphoma of the liver.

Masa hepática única como forma de presentación de un linfoma no Hodgkin / Solitary hepatic mass as initial manifestation of a non-Hodgkin lymphoma

Una mujer de 55 años acudió por un cuadro constitucional de 15 días de evolución junto con dolor en hipocondrio derecho a lo que se añadió el día previo al ingreso fiebre. En la exploración física destacaba hepatoesplenomegalia y en las pruebas de imagen se constató la existencia de una masa hepática sólida y adenopatías retroperitoneales. La realización de una punción-aspiración con aguja fina de la masa hepática y una biopsia de médula ósea demostró la existencia de un linfoma no Hodgkin de alto grado que se confirmó posteriomente con el estudio histopatológico de una adenopatía resecada. Esta forma de afectación hepática (masa única de gran tamaño) en los linfomas es poco frecuente y puede plantear el diagnóstico diferencial con tumores primarios hepáticos, metastásicos o incluso con el linfoma hepático primario (AU)

[Axillary-subclavian thrombosis: review of its etiology and features in recent years]. / Trombosis axilosubclavia: revisión de la etiología y características en los últimos años.

OBJECTIVES: To describe etiology and clinical characteristics of all patients diagnosed with axillary-subclavian vein thrombosis (ASVT) in our center. METHODS: Retrospective study during last 4 years (January 1991 to December 1994). Only those patients with a typical phlebography were included. RESULTS: 42 patients were diagnosed with ASVT. 10 in 1991, 6 in 1992, 10 in 1993 and 16 in 1994. The average age was 56.3 years. About sex, 20 were in men and 22 in women. The right upper extremity was affected in 16 patients, left side was in 24 and 2 were bilateral. Respect the incriminating agent, a central venous line was the most common, finding in 24 patients (57.14%). A local external compression was detected in 9 patients (21.4%), in 5 the ASVT was associated to a hypercoagulability state and finally only 2 patients were diagnosed with spontaneous o effort ASVT (4.76%). In those associated to a central catheter, 8 patients had a subclavian venous line and 6 had a drum catheter. Lung, colon and breast malignancies were the types of tumours more diagnosed. Treatment basically consisted on intravenous heparin, dicumarinics and subcutaneous heparin. Long term results are not valid because most patients haven't post-treatment phlebography. CONCLUSIONS: The possession of a catheter in the subclavian vein and the existence of a malignancy; especially a lung, colon or breast cancer, are the factors more associated with the development of an axillary-subclavian vein thrombosis in our area. The long of the average life span, the development and use of new oncologic treatment, besides the increasing use of the subclavian veins could do that ASVT would be a more frequent disease. In patients with several associated factors, could be used profilactics treatments.