RESUMEN
We report a case of a 50 year old man referred to our department with a history of mild cough, dyspnea and dysphagia. The thoracic CT scan showed a large solid mass in the anterior mediastinum, corresponding to the findings in the chest radiographs.A 67Ga scintigraphy was performed and showed high pathological accumulation in the anterior mediastinum. A subsequent fine needle aspiration biopsy (FNAB) showed the presence of malignant cells, suggesting thymic carcinoma. Although this type of tumour is uncommon, it should be taken into account in order to establish the differential diagnosis of gallium-avid mediastinal masses.
Asunto(s)
Carcinoma/diagnóstico por imagen , Radioisótopos de Galio , Radiofármacos , Neoplasias del Timo/diagnóstico por imagen , Recuento Corporal Total , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/análisis , Biopsia con Aguja , Carcinoma/patología , Carcinoma/terapia , Cisplatino/administración & dosificación , Terapia Combinada , Ciclofosfamida/administración & dosificación , Diagnóstico Diferencial , Doxorrubicina/administración & dosificación , Humanos , Linfoma/diagnóstico , Masculino , Persona de Mediana Edad , Cintigrafía , Radioterapia Adyuvante , Sarcoidosis/diagnóstico por imagen , Neoplasias del Timo/patología , Neoplasias del Timo/terapiaRESUMEN
Presentamos el caso de un varón de 50 años, remitido a nuestro departamento con una historia de tos, disnea y disfagia leves. La TAC torácica mostró una gran masa sólida en mediastino anterior, coincidente con los hallazgos en la radiología de tórax. Se realizó una gammagrafía con 67Ga, presentando un intenso acúmulo patológico en mediastino anterior. Posteriormente se practicó una punción-aspiración con aguja fina (PAAF), con presencia de células malignas sugestivas de carcinoma tímico. Aunque este tipo de tumor es poco frecuente, debería ser tenido en cuenta para establecer el diagnóstico diferencial de las masas mediastínicas captantes de 67Ga (AU)
Asunto(s)
Persona de Mediana Edad , Masculino , Humanos , Recuento Corporal Total , Sarcoidosis , Biomarcadores de Tumor , Radioterapia Adyuvante , Radiofármacos , Biopsia con Aguja , Protocolos de Quimioterapia Combinada Antineoplásica , Cisplatino , Carcinoma , Terapia Combinada , Ciclofosfamida , Diagnóstico Diferencial , Linfoma , Radioisótopos de Galio , Neoplasias del Timo , DoxorrubicinaRESUMEN
BACKGROUND: To estimate the prevalence of serologic markers of hepatitis B (SMHB) among residents of an institution for social or mental handicapped children in Castellón, and its association with risk factors. METHODS: A cross-sectional study with determination of SMHB by radioimmunoassay. 98 of the 100 residents participate in the study. RESULTS: Prevalence of SMHB was 24.5% (95% confidence interval: 16.4%-34.1%). Seven residents were hepatitis B surface antigen positive with three hepatitis B e antigen positive. SMHB prevalence was 0 in infants, 18.8% in toddlers, 24.5% in schoolchildren, 11.1% in special education, and 76.9% in permanent residents. Logistic regression analysis found associations of SMHB prevalence with age (Odds ratio [OR] = 5.8, 95% CI: 1.1-29.0), old age at admission with protective character (OR = 0.6, 95% CI: 0.4-0.8), and duration of stay (OR = 1.2 95% CI: 1.0-1.3), adjusting by sex, mental deficiency, and hepatitis B (HB) determinants like surgery, blood transfusion, odontology, bites, and injections. CONCLUSIONS: A predominant transmission of HB in young ages is suggested. Vaccination against HB, hygienic measures, and periodic serologic studies of HB are essential to prevent this disease.
Asunto(s)
Niño Institucionalizado , Hepatitis B/epidemiología , Discapacidad Intelectual , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Transversales , Femenino , Hepatitis B/diagnóstico , Hepatitis B/transmisión , Anticuerpos contra la Hepatitis B/análisis , Antígenos del Núcleo de la Hepatitis B/análisis , Antígenos de Superficie de la Hepatitis B/análisis , Humanos , Lactante , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Radioinmunoensayo , España/epidemiologíaRESUMEN
BACKGROUND: The risk of infection by the hepatitis B virus (HBV) in institutions for children with deficiencies has been established in several studies. The purpose of this work was to know the prevalence of HBV markers, among the employees in an institution of that kind, and its association with several risk factors. METHODS: A transveral epidemiologic survey has been carried out to determine the markers prevalence of infection by hepatitis B virus (HBV) and its association with certain risk factors, among the 200 workers of an institution for children with deficiencies. Determinations, by radioimmunoassay were: HBs Ag, anti-HBs and anti HBe. RESULTS: The participation was 95%, with a prevalence of any marker of 7.9% (IC95 + 4.1-11.7). No HBs Ag carriers were detected, taking occupation as an indicator variable with three categories: Trades and auxiliary health personnel versus teachers, the logistic regression analysis showed odds ratios, adjusted for age, sex and working time, for trades and auxiliary health personnel, respectively. CONCLUSIONS: Vaccination is the preventive recommendation for HBV in these institutions, because of the difficulty to find other factors associated to HBV. The possibility of introducing a universal vaccination is controversial.
