Parathyroid hemangioma.

BACKGROUND: Hemangiomas are benign neoplasms of capillary proliferation that arise from a developmental anomaly where angioblastic mesenchyme fails to form canals. Most hemangiomas arise in the head and neck region, either superficially in the skin or deeper within endocrine organs such as the parotid gland. Parathyroid hemangiomas, however, are extremely rare, with only five cases previously reported in the literature. CASE PRESENTATION: Herein, we present a case of a 68-year-old man with a hemangioma almost completely replacing the right upper parathyroid gland, grossly measuring 1.3 × 1.3 × 1.2 cm and weighing 700 mg, associated with primary hyperparathyroidism. CONCLUSIONS: Parathyroid gland enlargement due to vascular neoplasms such as hemangiomas can mimic, both clinically and radiographically, hyperplasias and/or adenomas. Surgeons need to be aware of the presence of this entity and should consider it in the differential diagnosis of hyperparathyroidism or parathyroid gland enlargement.

[Levels of 25 hydroxy vitamin D of serum and broncho-alveolar lavage in patients with pulmonary tuberculosis]. / Concentraciones de 25 hidroxi vitamina D séricas y en lavado bronco-alveolar en pacientes con tuberculosis pulmonar.

BACKGROUND: Alteration of vitamin D is a risk factor for tuberculosis (TB). AIM: To evaluate the pulmonary and serum levels of 25-hydroxy vitamin D (25OHD) in patients with and without pulmonary TB. METHODS: Two-stage study: the first part was retrospective cross-sectional and the second prospective. Those > 18 years of age who underwent fiberoptic bronchoscopy for suspected pulmonary TB and in whom the infection was confirmed were included. Patients with another type of infection without TB and non-infectious diseases were taken as controls for the first stage and infectious controls without TB in the prospective phase. The measurement of 25OHD was performed by ELFA (enzyme-linked fluorescence assay). The Kruskal-Wallis test was used to evaluate association, considering a value of p < 0.05 to be significant. The data were processed with the SPSS version 23 program. RESULTS: The total sample was 77 patients (35 in the first stage and 42 in the second). The characteristics between the groups were homogeneous. Serum (second phase) and broncho-alveolar lavage (first and second phase) levels of 25OHD were lower in TB patients compared to controls and were independent of serum calcium level (serum: 22.4 ng/mL vs 33 ng/mL, p = 0.006 and broncho-alveolar lavage: 9.7 ng/mL vs 12.2 ng/mL; p = 0.012). CONCLUSIONS: There was a significant difference between the levels of 25OHD in both serum and broncho-alveolar lavage in patients with pulmonary TB in relation to their controls.

Concentraciones de 25 hidroxi vitamina D séricas y en lavado bronco-alveolar en pacientes con tuberculosis pulmonar / Levels of 25 hydroxy vitamin D of serum and broncho-alveolar lavage in patients with pulmonary tuberculosis

INTRODUCCIÓN: La alteración de la vitamina D es un factor de riesgo para enfermar de tuberculosis (TBC). OBJETIVO: Evaluar la concentración pulmonar y sérica del compuesto 25-hidroxi-vitamina D (25OHD) en pacientes con y sin TBC pulmonar. METODOLOGÍA: Estudio de dos etapas: la primera parte fue de corte transversal, retrospectiva, y la segunda prospectiva. Se incluyeron > 18 años a los que se les realizó fibrobroncoscopia por sospecha de TBC pulmonar y en quienes se confirmó la infección. Se tomaron como controles a pacientes con otro tipo de infección no TBC, y enfermedades no infecciosas para la primera etapa y controles infecciosos sin TBC en la fase prospectiva. La medición de 25OHD se realizó mediante ELFA (ensayo de fluorescencia ligado a enzima). Se empleó la prueba de Kruskal-Wallis para evaluar asociación considerando significativo un valor de p < 0,05. Los datos se procesaron con el programa SPSS versión 23. RESULTADOS: La muestra total fue de 77 pacientes (35 en la primera etapa y 42 en la segunda). Las características entre los grupos fueron homogéneas. Las concentraciones en suero (segunda fase) como en el lavado bronco-alveolar (primera y segunda fase) de 25OHD fueron más bajas en pacientes con TBC comparado con los controles e independientes de la concentración de calcio sérico (suero: 22,4 ng/mL vs 33 ng/mL, p = 0,006 y lavado bronco-alveolar: 9,7 ng/mL vs 12,2 ng/mL; p = 0,012). CONCLUSIONES: Hubo una diferencia significativa entre las concentraciones de 25OHD, tanto en suero como en lavado bronco-alveolar, en pacientes con TBC pulmonar con relación a sus controles.

BACKGROUND: Alteration of vitamin D is a risk factor for tuberculosis (TB). AIM: To evaluate the pulmonary and serum levels of 25-hydroxy vitamin D (25OHD) in patients with and without pulmonary TB. METHODS: Two-stage study: the first part was retrospective cross-sectional and the second prospective. Those > 18 years of age who underwent fiberoptic bronchoscopy for suspected pulmonary TB and in whom the infection was confirmed were included. Patients with another type of infection without TB and non-infectious diseases were taken as controls for the first stage and infectious controls without TB in the prospective phase. The measurement of 25OHD was performed by ELFA (enzyme-linked fluorescence assay). The Kruskal-Wallis test was used to evaluate association, considering a value of p < 0.05 to be significant. The data were processed with the SPSS version 23 program. RESULTS: The total sample was 77 patients (35 in the first stage and 42 in the second). The characteristics between the groups were homogeneous. Serum (second phase) and broncho-alveolar lavage (first and second phase) levels of 25OHD were lower in TB patients compared to controls and were independent of serum calcium level (serum: 22.4 ng/mL vs 33 ng/mL, p = 0.006 and broncho-alveolar lavage: 9.7 ng/mL vs 12.2 ng/mL; p = 0.012). CONCLUSIONS: There was a significant difference between the levels of 25OHD in both serum and broncho-alveolar lavage in patients with pulmonary TB in relation to their controls.

Parathyroid hemangioma

Background Hemangiomas are benign neoplasms of capillary proliferation that arise from a developmental anomaly where angioblastic mesenchyme fails to form canals. Most hemangiomas arise in the head and neck region, either superficially in the skin or deeper within endocrine organs such as the parotid gland. Parathyroid hemangiomas, however, are extremely rare, with only five cases previously reported in the literature. Case presentation Herein, we present a case of a 68-year-old man with a hemangioma almost completely replacing the right upper parathyroid gland, grossly measuring 1.3 × 1.3 × 1.2 cm and weighing 700 mg, associated with primary hyperparathyroidism. Conclusions Parathyroid gland enlargement due to vascular neoplasms such as hemangiomas can mimic, both clinically and radiographically, hyperplasias and/or adenomas. Surgeons need to be aware of the presence of this entity and should consider it in the differential diagnosis of hyperparathyroidism or parathyroid gland enlargement.

Aneurisma de arteria pulmonar: un hallazgo incidental / Pulmonary artery aneurysm: an incidental finding

Resumen Los aneurismas de la arteria pulmonar son entidades infrecuentes y su tratamiento es tema de discusión. Desde el punto de vista etiológico pueden ser congénitos o adquiridos. Los primeros, generalmente se asocian a malformaciones cardiacas que producen hipertensión pulmonar, siendo el ductus arterioso la más frecuente. Otras anomalías incluyen defectos auriculares o ventriculares. Las causas adquiridas pueden ser idiopáticas o estar asociadas a infecciones (tuberculosis, sífilis), traumatismos o colagenopatías. Presentamos el caso de una mujer de 62 años, quien consultó por un cuadro clínico en el que se destacaba su sintomatología neurológica e infecciosa, con posterior progresión a un choque séptico y en quien los hallazgos de las imágenes mostraron un aneurisma gigante de la arteria pulmonar siendo este un hallazgo incidental y sin relación a la sintomatología de la paciente.

Abstract Aneurysms of the pulmonary artery are rare entities and their treatment is a matter of discussion. From the etiological point of view, they can be congenital or acquired. Those in the first group are generally associated with cardiac malformations that generate pulmonary hypertension, with the ductus arteriosus being the most frequent. Other abnormalities include atrial or ventricular defects. The acquired causes may be idiopathic or associated with infections (tuberculosis, syphilis), trauma, or collagen disease. We present the case of a 62-year-old woman, which consulted for a clinical condition where neurological and infectious symptoms stood out, with subsequent progression to a state of septic shock, and in whom the imaging finding showed a giant pulmonary artery aneurysm. this being an incidental finding and unrelated to the patient's symptoms.

Evaluación de la médula ósea en pacientes citopénicos infectados con el virus de la inmunodeficiencia humana tipo 1 en hospital colombiano del tercer nivel / Evaluation of the bone marrow in cytopenic patients infected with human immunodeficiency virus type 1 in a third level Colombian hospital

Resumen Objetivo: describir los hallazgos en el estudio de medula ósea de los pacientes con infección por virus de inmunodeficiencia humana que presentaron algún tipo de citopenia. Materiales y métodos: estudio descriptivo retrospectivo con 37 pacientes adultos con infección confirmada por el virus de inmuno deficiencia humana que presentaron algún tipo de citopenia, durante enero 2011 a diciembre de 2014 en el Hospital Universitario Hernando Moncaleano Perdomo de Neiva. Resultados: la mediana de edad fue 35 años, el 59 % fueron hombres; en el 48,6 % el tiempo de diagnóstico de la infección fue inferior a un año y el 59 % no recibían terapia antiretroviral al momento de ingreso. La mediana de recuento leucocitario de 2 400 células/mm3, neutró filos de 1 400 células/mm3 y de linfocitos CD4 de 43 células/mm3. El estudio de medula ósea fue positivo en el 27 %, encontrando infección oportunista diseminada en seis pacientes; dos con neoplasias, además de uno con hipo plasia medular y otro con anemia megaloblástica. Conclusión: el estudio de medula ósea en los pacientes con infección por virus de inmunodeficiencia humana es una herramienta útil y se debe realizar a todos los pacientes con enfermedad avanzada en el estudio de citopenia asociada o no a fiebre.

Abstract Objective: To describe the findings in the study of bone marrow of patients with human immunodeficiency virus (HIV) infection who present some type of cytopenia in a highly complex hospital in southern Colombia. Materials and methods: Retrospective descriptive study of case series. All adult pa tients with confirmed HIV infection who presented some type of cytopenia during January 2011 to December 2014 at the University Hospital Hernando Moncaleano Perdomo de Neiva, were included. A total of 37 patients com pleted the inclusion criteria. Results: the median age was 35 years, 59 % men; in 48.6 % of the individuals, the time of diagnosis by HIV was less than one year and 59 % did not receive antiretroviral therapy at the time of admission. A median was found in a leukocyte count of 2400 cells / mm3, neutrophils of 1400 cells / mm3, CD4 lymphocytes of 43 cells / mm3. The bone marrow study was positive in 27 % of the cases (10 patients), finding disseminated opportunistic infection in six patients; two neoplasms, plus a medullar hypoplasia and a case of megaloblastic anemia. Conclusion: The study of bone marrow in patients with HIV infection is a useful tool and should be performed in all patients with HIV infection with advanced disease in the study of cytopenia associated or not with fever.