Hallazgos radiológicos en tomografía computarizada de los tumores carcinoides bronquiales típicos y atípicos / Multidetector computed tomography assessment of the degree of differentiation of bronchial carcinoid tumors

Objetivo. Definir los hallazgos radiológicos en tomografía computarizada (TC) de los tumores carcinoides bronquiales y determinar si estos hallazgos permiten clasificarlos en típicos o atípicos. Material y métodos. Se revisaron retrospectivamente los TC de tórax de pacientes con diagnóstico histológico de tumor carcinoide bronquial realizados en nuestro hospital entre el 1 de enero de 2001 y el 31 de diciembre de 2009. La muestra estaba formada por 52 pacientes (23 mujeres y 29 varones) con una edad media de 47 años (rango de edad11-77 años). Se catalogaron los 52 casos como típicos o atípicos en función del tamaño, localización, focalidad, tipo de crecimiento, calcificaciones, signos secundarios a obstrucción bronquial y presencia de adenopatías de tamaño significativo o de metástasis. Posteriormente se compararon los resultados con la anatomía patológica. Resultados. Los tumores carcinoides típicos fueron los más prevalentes (46 casos). Las variables asociadas a los atípicos fueron el sexo masculino, edad tardía de presentación y tamaño> 3 cm. Cuantas más variables atípicas reúnen los tumores carcinoides, mayor es la sensibilidad de la TC para diagnosticarlos correctamente. La ausencia de variables atípicas permite excluir el diagnóstico de tumor carcinoide atípico hasta en un 95% de los casos. Conclusión. La TC es una técnica que ayuda a definir y caracterizar radiológicamente los tumores carcinoides como típicos o atípicos, aunque por ahora no existe una fórmula precisa para diferenciarlos (AU)

Objective. To define the CT findings for bronchial carcinoid tumors and to determine whether these findings enable these tumors to be classified as typical or atypical. Material and methods. We reviewed the chest CT studies performed between 1 January 2001 and 31 December 2009 in patients at our hospital diagnosed with bronchial carcinoid tumors. The sample consisted of 52 patients (23 women and 29 men) with a mean age of 47 years (range 11-77 years). The 52 cases were classified as typical or atypical on the basis of the following radiological findings: size, location, focality, type of growth, calcifications, signs secondary to bronchial obstruction, and the presence of significant lymph node enlargement or metastases. These findings were then compared with the histological findings. Results. Typical carcinoid tumors were the most prevalent (46 cases). The variables associated with atypical tumors were: male sex, advanced age at onset, and size > 3 cm. The accuracy of CT in classifying atypical tumors correctly increased with the number of variables indicative of atypical carcinoid tumors. A negative result for atypical nature made it possible to rule out an atypical carcinoid tumor in 95% of the cases. Conclusion. CT is useful for defining and characterizing carcinoid tumors into typical or atypical, although a precise formula for differentiating between the two types remains to be defined (AU)

[Appendectomy and Crohn's disease]. / Apendicectomía y enfermedad de Crohn.

UNLABELLED: We analyzed the relationship between Crohn's disease and appendectomy in paediatric age. METHOD AND MATERIAL: We studied the patients diagnosed with Crohn's disease and appendectomy (under 20) between 1999 and 2011. We retrieved their previous medical histories and carried out an histological re evaluation of those appendix. RESULTS: 11 patients out of 137 (8,02%) had an appendectomy before the development of Crohn's disease. An average age in which the appendectomy took place and the development of Crohn's disease was diagnosed 14 (5-20 years), having 90% of the patients diagnosed in the early post-surgical stages. A patient did not develop any symptoms until a year later. There were no more appendectomies carried out in comparison with the adult population. The initial anatomopathologic diagnosis and the histological re evaluation agreed in just one case, compatible with Crohn's disease. CONCLUSION: The majority of appendectomies carried out in paediatric patients that later develop Crohn's disease are realized by a bias diagnosis of acute appendicitis and the relation between the two of them can be explained as the not yet developed Crohn's disease at the moment of the appendectomy. Appendectomies at a paediatric age are not associated with a potential development of Crohn's disease. There is no evidence of histological changes compatible with Crohn's disease in the first episode.

[Multidetector computed tomography assessment of the degree of differentiation of bronchial carcinoid tumors]. / Hallazgos radiológicos en tomografía computarizada de los tumores carcinoides bronquiales típicos y atípicos.

OBJECTIVE: To define the CT findings for bronchial carcinoid tumors and to determine whether these findings enable these tumors to be classified as typical or atypical. MATERIAL AND METHODS: We reviewed the chest CT studies performed between 1 January 2001 and 31 December 2009 in patients at our hospital diagnosed with bronchial carcinoid tumors. The sample consisted of 52 patients (23 women and 29 men) with a mean age of 47 years (range 11-77 years). The 52 cases were classified as typical or atypical on the basis of the following radiological findings: size, location, focality, type of growth, calcifications, signs secondary to bronchial obstruction, and the presence of significant lymph node enlargement or metastases. These findings were then compared with the histological findings. RESULTS: Typical carcinoid tumors were the most prevalent (46 cases). The variables associated with atypical tumors were: male sex, advanced age at onset, and size >3cm. The accuracy of CT in classifying atypical tumors correctly increased with the number of variables indicative of atypical carcinoid tumors. A negative result for atypical nature made it possible to rule out an atypical carcinoid tumor in 95% of the cases. CONCLUSION: CT is useful for defining and characterizing carcinoid tumors into typical or atypical, although a precise formula for differentiating between the two types remains to be defined.

Adult rhabdomyoma in the masticatory area. New case presentation and review of the literature.

Adult rhabdomyoma is a rare neoplasm of mesenchymal origin which represents approximately 2% of tumors with skeletal muscle differentiation. There are only about 100 cases reported in the literature. It is a benign tumor occurring most frequently in the head and neck region, which affects predominantly male population of a mean age ranging from 54 to 60. The purpose of this article is to present a new case of adult rhabdomyoma located in the masticatory area, arising as a slow-growing mass bulging in the left-side jugal mucosa and temporal region. The most common location for adult rhabdomyoma is the pharyngeal cavity. This type of tumor appears as a solitary mass, though occasionally may be multifocal. This tumor being of low occurrence, correct diagnosis can prevent aggressive surgery.

[Subepithelial hemorrhage of renal pelvis (Antopol-Goldman lesion). Report of 4 cases and review of the literature]. / Hemorragia subepitelial de pelvis renal (lesión de Antopol-Goldman). Presentación de cuatro casos y revisión de la literatura.

OBJECTIVES: The subepithelial hematoma of renal pelvis (Lesion of Antopol-Goldman) is a rare entity that preferably is diagnosed clinically as a neoplasic lesion. METHODS: We present four new cases of subepithelial hematoma of renal pelvis diagnosed in our hospital from 1989. RESULTS: Our cases presented clinically with hematuria and flanc pain, preferably in the left side (3 out of 4). After nephrectomy, all the cases showed a subepithelial hematoma of variable extension that can occupy the renal pelvis and calices, associated to hidronefrosis, cortical infartion, renomegaly or renal angioma. Additionally, two of our patients presented with dilation of the pielocalicial system, and a third one presented with urotelial carcinoma of the ureter, being therefore the lesion of Antopol-Goldman an incidental discovery. In the remaining case, the presence of multiple renal hemangiomas was identified as cause of the renal pelvic hematoma. CONCLUSIONS: The preoperatore diagnosis of the lesion of Antopol-Goldman is difficult although it should be included as differential diagnosis in those cases with hematuria and alterations of renal pelvis in the image techniques, because an early diagnosis could imply a conservative treatment with pieloplastia or partial nephrectomy.