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1.
Braz J Infect Dis ; 28(3): 103768, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38851212

RESUMEN

We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. CONCLUSIONS: PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area.


Asunto(s)
Enfermedades Pulmonares Fúngicas , Metotrexato , Paracoccidioidomicosis , Humanos , Femenino , Paracoccidioidomicosis/tratamiento farmacológico , Persona de Mediana Edad , Metotrexato/uso terapéutico , Metotrexato/efectos adversos , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Enfermedad Crónica , Itraconazol/uso terapéutico , Tomografía Computarizada por Rayos X , Antifúngicos/uso terapéutico , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico
2.
Braz. j. infect. dis ; Braz. j. infect. dis;28(3): 103768, 2024. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1568959

RESUMEN

Abstract Summary We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. Conclusions PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area.

3.
Med Int (Lond) ; 3(5): 50, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37745152

RESUMEN

The present study describes a case of cystic neutrophilic granulomatous mastitis. The clinical and radiological findings of the patient were consistent with idiopathic granulomatous mastitis. Cystic neutrophilic granulomatous mastitis is a rare subtype of mastitis with a distinct histological pattern that is associated with the Corynebacterium species. The diagnosis and treatment of cystic neutrophilic granulomatous mastitis remains a significant challenge due to the scarcity of available data. The present study describes a classic case of cystic neutrophilic granulomatous mastitis that includes clinical, radiological and histopathological findings. To the best of our knowledge, this is the first case documenting radiological findings before and after treatment. This report encourages the consideration of this entity in the differential diagnoses of mastitis.

4.
Neuroradiology ; 63(8): 1215-1225, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33459822

RESUMEN

PURPOSE: Meningiomas are the most common extra-axial intracranial neoplasms with typical radiological findings. In approximately 2% of cases, histopathological reports reveal different neoplasms or non-neoplastic lesions that can closely mimic meningiomas. We describe radiological features of meningioma mimics highlighting imaging red flags to consider a differential diagnosis. METHODS: A total of 348 lesions with radiological diagnosis of meningiomas which underwent to surgical treatment or biopsy between December of 2000 and September of 2014 were analyzed. We determined imaging features that are not a typical finding of meningiomas, suggesting other lesions. The following imaging characteristics were evaluated on CT and MRI: (a) bone erosion; (b) hyperintensity on T2WI; (c) hypointensity on T2WI; (d) bone destruction; (e) dural tail; (f) leptomeningeal involvement; (g) pattern of contrast enhancement; (h) dural displacement sign. RESULTS: We have a relatively high prevalence of meningioma mimics (7.2%). Dural-based lesions with homogeneous contrast enhancement (52%) are easily misdiagnosed as meningiomas. Most lesions mimic convexity (37.5%) or parafalcine (21.9%) meningiomas. We have determined five imaging red flags that can alert radiologists to consider meningioma mimics: (1) bone erosion (22.2%); (2) dural displacement sign (36%); (3) marked T2 hypointensity (32%); (4) marked T2 hyperintensity (12%); (5) absence of dural tail (48%). The most common mimic lesion in our series was hemangiopericytomas, followed by lymphomas and schwannomas. CONCLUSION: The prevalence of meningioma mimics is not negligible. It is important to have awareness on main radiological findings suggestive of differential diagnosis due to a wide range of differentials which lead to different prognosis and treatment strategies.


Asunto(s)
Hemangiopericitoma , Neoplasias Meníngeas , Meningioma , Neurilemoma , Humanos , Imagen por Resonancia Magnética , Neoplasias Meníngeas/diagnóstico por imagen , Meningioma/diagnóstico por imagen
5.
Front Digit Health ; 3: 662343, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35112097

RESUMEN

Both reverse transcription-PCR (RT-PCR) and chest X-rays are used for the diagnosis of the coronavirus disease-2019 (COVID-19). However, COVID-19 pneumonia does not have a defined set of radiological findings. Our work aims to investigate radiomic features and classification models to differentiate chest X-ray images of COVID-19-based pneumonia and other types of lung patterns. The goal is to provide grounds for understanding the distinctive COVID-19 radiographic texture features using supervised ensemble machine learning methods based on trees through the interpretable Shapley Additive Explanations (SHAP) approach. We use 2,611 COVID-19 chest X-ray images and 2,611 non-COVID-19 chest X-rays. After segmenting the lung in three zones and laterally, a histogram normalization is applied, and radiomic features are extracted. SHAP recursive feature elimination with cross-validation is used to select features. Hyperparameter optimization of XGBoost and Random Forest ensemble tree models is applied using random search. The best classification model was XGBoost, with an accuracy of 0.82 and a sensitivity of 0.82. The explainable model showed the importance of the middle left and superior right lung zones in classifying COVID-19 pneumonia from other lung patterns.

6.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;53: e20200241, 2020. tab, graf
Artículo en Inglés | Sec. Est. Saúde SP, Coleciona SUS, LILACS | ID: biblio-1136836

RESUMEN

Abstract The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords 'non-tuberculous mycobacteria', 'lung disease and computed tomography (CT)' and 'radiological findings'. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.


Asunto(s)
Humanos , Enfermedades Pulmonares , Infecciones por Mycobacterium no Tuberculosas , Calidad de Vida , Estudios Retrospectivos , Irán , Micobacterias no Tuberculosas
7.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;87(3): 177-185, ene. 2019. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1250016

RESUMEN

Resumen OBJETIVO: Evaluar la relación entre los hallazgos radiológicos e inmunofenotipos tumorales de pacientes con cáncer de mama. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y transversal, efectuado en el Hospital ABC de la Ciudad de México, entre 2013 y 2017. Se incluyeron pacientes con diagnóstico de cáncer de mama establecido por biopsia percutánea o escisional, que contaran con estudios de inmunohistoquímica e imagen (mastografía, ultrasonido o ambos). Para evaluar la relación entre las características morfológicas de las lesiones observadas en los estudios radiológicos y el inmunofenotipo se utilizó la prueba de χ2. RESULTADOS: Se registraron 182 pacientes. En cuanto a las características de las lesiones se encontró relación significativa entre las masas de morfología irregular con bordes espiculados y las calcificaciones agrupadas con tumores luminales, y entre las calcificaciones de morfología amorfa con los tumores luminales A y las pleomórficas finas con los tumores luminales B. CONCLUSIÓN: Existe relación entre los hallazgos morfológicos por imagen y el inmunofenotipo de los tumores mamarios. Es importante que el médico radiólogo especialista en imagen mamaria conozca esta relación, con la finalidad de proporcionar información de la inmunohistoquímica al momento del estudio diagnóstico de imagen.


Abstratc OBJECTIVE: Establish if there is a relationship between the radiological findings and the immunophenotype of breast cancer. MATERIALS AND METHODS: An observational, cross-sectional, retrospective study realized at the ABC Medical Center, over a period of 4 years, that included patients diagnosed with breast cancer performed by percutaneous or excisional biopsy, with an immunohistochemical study and images (mammography and/or ultrasound). The relationship between the morphological characteristics of the lesions observed in the radiological studies and the immunophenotyped was studied by means of the χ2 test. RESULTS: We included 182 patients, among the characteristics of the lesions we found a significant relationship between the masses of irregular morphology with spiculate edges and the calcifications grouped with luminal tumors; calcifications of amorphous morphology with luminal A and pleomorphic fine tumors with luminal B. CONCLUSION: The results suggest that there is a relationship between the morphological findings by imaging and the immunophenotype of mammary tumors.

8.
Cienc. Serv. Salud Nutr ; 8(1): 36-44, abr. 2017.
Artículo en Español | LILACS | ID: biblio-982226

RESUMEN

Introducción El presente artículo hace una revisión sobre los hallazgos radiológicos mediante radiografía simple, así como también los hallazgos clínicos en el diagnóstico de la osteopetrosis una enfermedad poco común que afecta el desarrollo normal óseo, se trata de un caso clínico reportado en el Hospital Pediátrico Baca Ortiz de la Ciudad de Quito. Reporte de Caso: Nos apoyamos en la presentación de un caso clínico de una paciente que acude por consulta externa con cuadro de fatiga y decaimiento de 2 años de evolución, se realizan exámenes complementarios demostrando presencia de anemia así como los hallazgos característicos de osteopetrosis por imagen posteriormente detallados. Conclusiones: La osteopetrosis es una enfermedad poco común, compleja y por lo menos con cuatro subtipos que difieren en la forma de herencia o de las manifestaciones adicionales asociadas, sin embargo todas se caracterizan por presentarse clínicamente con fatiga debido a anemia crónica, puede presentar o no hepatoesplenomegalia, conjuntamente asociadas siempre a osteoesclerosis difusa con ensanchamiento óseo, fracturas patológicas.


Introduction This article reviews the radiological findings by simple radiography as well as the clinical findings in the diagnosis of osteopetrosis, a rare disease that affects normal bone development. This is a case report reported in the Hospital Pediátrico Baca Ortiz at Quito City. Case Report: We rely on the presentation of a clinical case of a patient who goes by external consultation with fatigue and decay of 2 years of evolution, complementary tests are performed demonstrating the presence of anemia as well as the characteristic findings of osteopetrosis by image later detailed. Conclusions: Osteopetrosis is an uncommon, complex disease and with at least four subtypes that differ in the form of inheritance or associated additional manifestations, however all are characterized by presenting clinically with fatigue due to chronic anemia, may present or not hepatosplenomegaly, Always associated with diffuse osteosclerosis with bone spreading, pathological fractures.


Asunto(s)
Humanos , Femenino , Preescolar , Osteopetrosis , Radiología , Anemia , Ecuador , Fatiga
9.
Radiol Bras ; 48(5): 275-81, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26543277

RESUMEN

OBJECTIVE: To describe the radiological findings of pulmonary tuberculosis in indigenous patients from the city of Dourados, MS, Brazil, according to age and sex. MATERIALS AND METHODS: Chest radiographic images of 81 patients with pulmonary tuberculosis, acquired in the period from 2007 to 2010, were retrospectively analyzed by two radiologists in consensus for the presence or absence of changes. The findings in abnormal radiographs were classified according to the changes observed and they were correlated to age and sex. The data were submitted to statistical analysis. RESULTS: The individuals' ages ranged from 1 to 97 years (mean: 36 years). Heterogeneous consolidations, nodules, pleural involvement and cavities were the most frequent imaging findings. Most patients (55/81 or 67.9%) were male, and upper lung and right lung were the most affected regions. Fibrosis, heterogeneous consolidations and involvement of the left lung apex were significantly more frequent in males (p < 0.05). Presence of a single type of finding at radiography was most frequent in children (p < 0.05). CONCLUSION: Based on the hypothesis that indigenous patients represent a population without genetically determined resistance to tuberculosis, the present study may enhance the knowledge about how the pulmonary form of this disease manifests in susceptible individuals.


OBJETIVO: Descrever os aspectos radiológicos da tuberculose pulmonar em pacientes indígenas da cidade de Dourados, MS, Brasil, de acordo com idade e sexo. MATERIAIS E MÉTODOS: Radiografias de tórax de 81 pacientes com tuberculose pulmonar, realizadas de 2007 a 2010, foram analisadas retrospectivamente por dois radiologistas, em consenso quanto à presença ou ausência de alterações. Os achados em radiografias anormais foram classificados de acordo com as alterações observadas e correlacionados com idade e sexo. Os dados foram submetidos a análise estatística. RESULTADOS: A idade dos indivíduos variou de 1 a 97 anos (idade média de 36 anos). Os achados mais frequentes foram consolidações heterogêneas, nódulos, acometimento pleural e escavações. As regiões pulmonares superiores e o pulmão direito foram mais afetados pela tuberculose e a maioria dos pacientes (55/81 ou 67,9%) era do sexo masculino. Fibrose, consolidações heterogêneas e envolvimento do ápice pulmonar esquerdo foram significativamente mais frequentes no sexo masculino (p < 0,05). Presença de apenas um tipo de achado radiográfico foi mais frequente em crianças (p < 0,05). CONCLUSÃO: Com base na hipótese de que pacientes indígenas representam pessoas ainda não geneticamente selecionadas para a resistência à tuberculose, esta pesquisa pode ampliar o conhecimento sobre como esta doença, em sua forma pulmonar, manifesta-se em indivíduos suscetíveis.

10.
Radiol. bras ; Radiol. bras;48(5): 275-281, tab, graf
Artículo en Inglés | LILACS | ID: lil-764615

RESUMEN

AbstractObjective:To describe the radiological findings of pulmonary tuberculosis in indigenous patients from the city of Dourados, MS, Brazil, according to age and sex.Materials and Methods:Chest radiographic images of 81 patients with pulmonary tuberculosis, acquired in the period from 2007 to 2010, were retrospectively analyzed by two radiologists in consensus for the presence or absence of changes. The findings in abnormal radiographs were classified according to the changes observed and they were correlated to age and sex. The data were submitted to statistical analysis.Results:The individuals' ages ranged from 1 to 97 years (mean: 36 years). Heterogeneous consolidations, nodules, pleural involvement and cavities were the most frequent imaging findings. Most patients (55/81 or 67.9%) were male, and upper lung and right lung were the most affected regions. Fibrosis, heterogeneous consolidations and involvement of the left lung apex were significantly more frequent in males (p < 0.05). Presence of a single type of finding at radiography was most frequent in children (p < 0.05).Conclusion:Based on the hypothesis that indigenous patients represent a population without genetically determined resistance to tuberculosis, the present study may enhance the knowledge about how the pulmonary form of this disease manifests in susceptible individuals.


ResumoObjetivo:Descrever os aspectos radiológicos da tuberculose pulmonar em pacientes indígenas da cidade de Dourados, MS, Brasil, de acordo com idade e sexo.Materiais e Métodos:Radiografias de tórax de 81 pacientes com tuberculose pulmonar, realizadas de 2007 a 2010, foram analisadas retrospectivamente por dois radiologistas, em consenso quanto à presença ou ausência de alterações. Os achados em radiografias anormais foram classificados de acordo com as alterações observadas e correlacionados com idade e sexo. Os dados foram submetidos a análise estatística.Resultados:A idade dos indivíduos variou de 1 a 97 anos (idade média de 36 anos). Os achados mais frequentes foram consolidações heterogêneas, nódulos, acometimento pleural e escavações. As regiões pulmonares superiores e o pulmão direito foram mais afetados pela tuberculose e a maioria dos pacientes (55/81 ou 67,9%) era do sexo masculino. Fibrose, consolidações heterogêneas e envolvimento do ápice pulmonar esquerdo foram significativamente mais frequentes no sexo masculino (p < 0,05). Presença de apenas um tipo de achado radiográfico foi mais frequente em crianças (p < 0,05).Conclusão:Com base na hipótese de que pacientes indígenas representam pessoas ainda não geneticamente selecionadas para a resistência à tuberculose, esta pesquisa pode ampliar o conhecimento sobre como esta doença, em sua forma pulmonar, manifesta-se em indivíduos suscetíveis.

11.
Acta odontol. venez ; 51(2)2013. tab
Artículo en Español | LILACS | ID: lil-706233

RESUMEN

El objetivo del presente estudio fue determinar la prevalencia de hallazgos radiográficos en pacientes mayores de 60 años, atendidos en el Servicio de Radiología del Centro de Clínicas Odontológicas de la Universidad de Talca entre los meses de marzo y octubre del año 2010. Se evaluaron 190 radiografías panorámicas digitales de pacientes mayores de 60 años de edad. Se determinó la presencia de lesiones radiolúcidas (RL), lesiones radiopacas (RO), restos radiculares (RR), lesiones apicales (LA), cuerpos extraños (CE), dientes incluidos (DI), calcificaciones en tejidos blandos (CTB) y calcificaciones del complejo estilohioídeo (CCE). El 58,9 % del total de la muestra tuvo hallazgos. En pacientes edéntulos totales, el 51,4% de las radiografías tuvieron algún hallazgo, mientras que en edéntulos parciales, el porcentaje el 60,6% presentaron hallazgos radiográficos. Estos en el total de la muestra se encontraron en orden decreciente fueron CCE 25,26%; CTB 24,21%; LA 19%; RO 11,05%; RR 7,36%; PI 4,21%; RL 3,68%. No se encontró cuerpos extraños. La mayoría de los hallazgos se encontró de manera única (57%). Nuestros resultados sugieren que sería adecuado solicitar una radiografía panorámica antes de iniciar el tratamiento rehabilitador de un paciente adulto mayor, para obtener información que permita la realización de un tratamiento odontológica de forma segura


The aim of this study was to determine prevalence of radiological findings in digital panoramic radiographs of 60-year-old patients and more, treated in Radiological Service of Universidad de Talca`s Dental Clinical Center during the period between March and October of year 2010. 190 digital panoramic radiographs from elderly patients were observed. Radiolucent lesions (RL), radiopaque lesions (RO), periapical radiolucent lesions (LA), root fragments (RF), foreign bodies (FB), unerupted teeth (UT), soft tissue calcifications (STC) and calcified stylohyoid complex (CSC) were assessed. 58,9 % of full sample showed radiological findings. In edentulous mouths, 51,4% of radiographs had findings, whereas in partially edentulous, percentage of Rx with findings was 60,6%. Radiological findings of full sample in decreasing order were as next: CSC 25,26%; STC 24,21%; LA 19%; RO 11,05%; RF 7,36%; UT 4,21%; RL 3,68%. Foreign bodies were not found. Radiological findings were seen multiple in 43%. Our results suggest that prescribe a panoramic radiograph before starting a rehabilitation treatment to an elderly patient, would be beneficial in order to obtain useful information for safer dental treatments


Asunto(s)
Femenino , Anciano , Radiografía Dental Digital , Radiografía Dental , Radiografía Panorámica , Odontología
12.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;43(6): 719-722, Nov.-Dec. 2010. tab
Artículo en Portugués | LILACS | ID: lil-569439

RESUMEN

INTRODUÇÃO: Entre os Suruí de Rondônia foram registradas incidências médias de TB > 2.500/100.000 habitantes, entre 1991-2002. Aproximadamente 50 por cento desses casos foram notificados em < 15 anos. MÉTODOS: Trata-se de um estudo clínico-epidemiológico que teve como objetivo descrever as características clínico-radiológicas em crianças e adolescentes identificados como contatos de doentes de TB. Além disto, aplicar o sistema de pontuação para o diagnóstico de TB na infância e verificar se as condutas adotadas no nível local foram concordantes com as diretrizes nacionais. RESULTADOS: Foram analisados 52 Rx de 37 indígenas. Deste conjunto, 48,1 por cento foram normais e 51,9 por cento anormais. Alguns dos Rx apresentaram duas ou mais alterações, totalizando 36 eventos independentes. Observou-se infiltrados (38,9 por cento), calcificações (38,9 por cento), cavitações (11,1 por cento) e atelectasias/derrame pleural (11,1 por cento). Nas imagens anormais, 22,2 por cento eram TB provavelmente ativa e 33,3 por cento sequelas. A confrontação com as diretrizes constatou 52,6 por cento de condutas discordantes. CONCLUSÕES: A presença da infecção tuberculosa latente (ITBL) e TB ativa, entre crianças e adolescentes, são indicadores de transmissão ativa e continuada do Mycobacterium tuberculosis. Os Rx mostrando alta frequência de infiltrados e calcificações é compatível com primo-infecção em idade precoce. Entretanto, essas alterações não são diferentes daquelas observadas entre outros grupos, não sugerindo comprometimento imunológico. As discordâncias apontadas indicam que o momento ideal para o tratamento da ITBL passou despercebido. Conclui-se que é fundamental a utilização do sistema de pontuação para o correto diagnóstico de TB na infância, assim como a realização de baciloscopia e cultura de escarro em adolescentes capazes de expectorar.


INTRODUCTION: The average incidence coefficient of tuberculosis in Suruí Indians from Rondônia was 2.500/100.000 inhabitants in 1991-2002. About 50 percent of these cases were reported in children < 15 years-old. METHODS: This study aimed to describe the clinical and radiological characteristics of children and adolescents identified as TB case contacts. A score system for the diagnosis of childhood TB was used and the procedures adopted by local health services were in accordance with national guidelines. RESULTS: 52 chest X-rays of 37 indigenous subjects were analyzed; of these, 51.9 percent were abnormal. Some X-rays showed more than two lesions, making a total of 36 independent events. Infiltrates (38.9 percent), calcifications (38.9 percent), cavitations (11.1 percent) and atelectasis/pleural effusion (11.1 percent) were observed. Among the abnormal images, 22.2 percent were probably indicated active TB and 33.3 percent showed sequelae. Confrontation with the guidelines revealed 52.6 percent of divergent procedures. CONCLUSIONS: The presence of latent tuberculosis infection (LTBI) and active TB between children and adolescents are indicators of active and progressive transmission of Mycobacterium tuberculosis. The X-rays showed high frequencies of infiltrates and calcifications, which are compatible with primary infection in early childhood. However, these lesions are not different from those observed among other groups and do not suggest immune deficiencies. The divergences presented show that the best moment for the treatment of LTBI went unnoticed by local personnel. In conclusion, the use of a score system is fundamental for the correct diagnosis of TB in childhood, as is conducting bacilloscopy and sputum culture in adolescents able to expectorate.


Asunto(s)
Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Indígenas Sudamericanos/estadística & datos numéricos , Tuberculosis Latente/epidemiología , Tuberculosis Pulmonar/epidemiología , Brasil/epidemiología , Incidencia , Tuberculosis Latente , Tuberculosis Pulmonar
13.
Radiol. bras ; Radiol. bras;41(6): 379-383, nov.-dez. 2008. ilus
Artículo en Portugués | LILACS | ID: lil-507118

RESUMEN

OBJETIVO: Avaliar as características radiológicas do câncer de mama medular em pacientes submetidas atratamento cirúrgico no Instituto Nacional de Câncer (INCA) û Ministério da Saúde, Rio de Janeiro, RJ, correlacionando os achados com estudo histopatológico. MATERIAIS E MÉTODOS: Foi realizado estudo descritivo retrospectivo de mulheres submetidas a tratamento cirúrgico no INCA, no período de janeiro de 1997 adezembro de 2006, para identificação das pacientes com carcinoma medular e análise dos achados radiológicos.RESULTADOS: Foram identificadas 21.287 pacientes com diagnóstico de carcinoma neste período, sendo 76 pacientes com diagnóstico de carcinoma medular típico (0,357%). Nessas pacientes selecionadas, a idade média foi de 51,9 anos (32 a 81 anos). Dezenove pacientes apresentavam lesão na mamografia, sendo 17 (89,5%) nódulos e 2 assimetrias focais (10,5%). Entre as pacientes com nódulo, 15 (88,1%) apresentavam alta densidade e 2 eram isodensos (11,9%). Doze pacientes apresentavam achados ultra-sonográficos e, destas, 11 (91,6%) apresentavam nódulos hipoecóicos. Foi observada uma paciente com nóduloanecóico com áreas de degeneração cística. CONCLUSÃO: O nódulo foi o achado radiológico dominante (89,5%), dos quais 88,1% apresentaram nódulos com alta densidade e margens circunscritas. Apesar das características radiológicas de benignidade, um nódulo com alta densidade, sólido, margens circunscritas e crescimento rápido deve ser investigado para confirmar o diagnóstico.


OBJECTIVE: To evaluate radiological findings in patients submitted to surgical treatment for medullary breast cancer at Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil, correlating them with histological results. MATERIALS AND METHODS: A retrospective descriptive study was developed with patients submitted to surgery at INCA, in the period from January 1997 to December 2006, for identifying the presence of medullary breast carcinoma and analyzing radiological findings. RESULTS: Among 21,287 patients diagnosed with carcinoma, 76 (0.357%) had typical medullary breast carcinoma. The age range of these patients was 32û81 years (mean = 59.1 years). Mammography demonstrated lesions in 19 of these patients, 17 (89.5%) of them with masses, and 2 with focal asymmetry. Among the patients with masses, 15 (88.1%) presented with high density and 2 (11.9%) with isodensity. Twelve patients presented sonographic findings, 11 (91.6%) of them with hypoechoic masses, and one with an anechoic mass with areas of cystic degeneration. CONCLUSION: Nodular mass was the predominant radiological finding (89.5%), 88.1% of them corresponding to masses with high density and circumscribed margins. Despite the radiological characteristics of benignity, a solid, fastgrowing, highly dense mass with circumscribed margins should be further investigated to confirm the diagnosis.


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Carcinoma Medular/diagnóstico , Carcinoma Medular/fisiopatología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/fisiopatología , Brasil , Interpretación de Imagen Asistida por Computador , Estudios Retrospectivos
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