RESUMEN
Pulmonary sequestration is a rare malformation of the respiratory tract that accounts for 0.15-6.4% of all congenital lung anomalies. Treatment requires resection of the lesion, provided that there is no technical contraindication. The lesion should first be evaluated using video thoracoscopy and then resected whenever possible by video-assisted thoracic surgery (VATS). We report a case of extralobar pulmonary sequestration in a 48-year-old woman. She underwent lobectomy by VATS and achieved an excellent outcome.
Asunto(s)
Secuestro Broncopulmonar/cirugía , Neumonectomía/métodos , Cirugía Torácica Asistida por Video , Secuestro Broncopulmonar/complicaciones , Femenino , Hemoptisis/etiología , Humanos , Persona de Mediana Edad , Neumonía/etiología , RecurrenciaRESUMEN
Propósito: Se realiza un estudio clínico, radiológico y patológico de un caso de fibrohistiocitoma maligno retroperitoneal y revisión bibliográfica acerca de tipos histológicos y comportamiento biológico, factores que condicionan el pronóstico y tratamiento. Material y métodos: Mujer de 31 años que consulta por masa en fosa ilíaca derecha (FID), anorexia y pérdida de peso. Diagnosticada, mediante biopsia incisional, de fibrohistiocitoma maligno se administra quimioterapia neoadyuvante y se procede, en un segundo tiempo, a extirpación quirúrgica completa del tumor y quimioterapia coadyuvante. Resultados: Pieza de 22 x 18 x 16 cms de aspecto irregular que infiltra pala ilíaca y músculo glúteo. Areas de necrosis y hemorragia. Microscópicamente presenta patrón común con transiciones entre áreas de células fusiformes que se entrecruzan con áreas pleomórficas donde se observan gran número de células gigantes con núcleos irregulares e hipercromáticos. Conclusiones: Son tumores asintomáticos en estadios precoces que se manifiestan por masa abdominal (80 por ciento) y dolor (70 por ciento), basando el diagnóstico de presunción en la Tomografía Axial Computerizada (TAC) y Resonancia Nuclear Magnética (RNM) que se confirmará con la biopsia.El factor pronóstico más importante es la exéresis completa con un margen no inferior a 2 cms., lo que sólo se puede conseguir en el 40 por ciento de los casos. Se discute el tamaño como factor pronóstico. No hay consenso acerca de la eficacia de quimio y/o radioterapia adyuvante, mostrándose, la mayoría de los autores, contrarios a ellas (AU)
Asunto(s)
Adulto , Femenino , Humanos , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/tratamiento farmacológico , Histiocitoma Fibroso Benigno/cirugía , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/tratamiento farmacológico , Neoplasias Retroperitoneales/cirugíaRESUMEN
A case of myxoid leiomyosarcoma located in the right pulmonary veins is presented. The patient complained of progressive dyspnea, orthopnea, sputum cruentum and right chest pain. Angiography revealed an obliteration of right pulmonary veins by a tumor mass that expanded into the left atrium. Histologically, the lesion contained densely packed fusiform cell areas that alternated with other much less cellular and richer in interstitial myxoid matrix. The tumor cells showed specific immunoreactivity to desmin antibodies and contained abundant thin filaments with focal densities and micropinocytic vesicles.
Asunto(s)
Leiomiosarcoma/patología , Neoplasias de Tejido Muscular/patología , Anciano , Desmina/metabolismo , Atrios Cardíacos/patología , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/secundario , Humanos , Inmunohistoquímica , Leiomiosarcoma/metabolismo , Leiomiosarcoma/ultraestructura , Masculino , Microscopía Electrónica , Neoplasias de Tejido Muscular/metabolismo , Neoplasias de Tejido Muscular/ultraestructura , Venas PulmonaresRESUMEN
We have studied the penetration of cefuroxime and ceftazidime into lung tissue of 40 patients subjected to pulmonary surgery. Samples of blood and lung tissue were taken 1 and 2 h after antibiotic administration. Patients were randomly assigned to four dosage schedule groups: group A received a single intravenous injection of 750 mg cefuroxime; the lung tissue levels at 1 and 2 h were 9.6 +/- 3.1 and 4.54 +/- 2.64 micrograms/g of cefuroxime; the percentage penetration from serum into the lung tissue was 33.7 and 34.6%, respectively. Group B patients received three doses of 750 mg cefuroxime; lung tissue levels were 17.1 +/- 7.7 and 14.7 +/- 5.4 micrograms/g, the percentage of penetration being 89.1 and 102.8% at 1 and 2 h. Group C received a single intravenous injection of 1 g ceftazidime; the lung tissue levels were 16.3 +/- 10.1 and 10 +/- 5.04 micrograms/g; the percentage of penetration from serum was 38.3 and 35.3%. Group D received three doses of 1 g ceftazidime; the lung tissue concentrations were 11.98 +/- 7.5 and 8.5 +/- 7.3 micrograms/g and the percentage of penetration 35.1 and 32.2% at 1 and 2 h after last dose.
Asunto(s)
Ceftazidima/farmacocinética , Cefuroxima/farmacocinética , Cefalosporinas/farmacocinética , Pulmón/metabolismo , Adulto , Anciano , Ceftazidima/sangre , Cefuroxima/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distribución AleatoriaRESUMEN
Eleven patients about to undergo pulmonary surgery received a bolus injection of 1 g of cefoxitin. The concentrations of cefoxitin in the serum 1 and 2 h after dosage were 38.5 +/- 1.89 and 23.7 +/- 2.56 mug/ml; the lung concentrations at the respective times were 12.6 +/- 0.7 and 10.06 +/- 0.43 mug/ml.