[Gastroesophageal infection caused by cytomegalovirus in immunodepressed patients. Presentation of 3 cases]. / Infección gastroesofágica por citomegalovirus en pacientes inmunodeprimidos. Presentación de tres casos.

We report three cases of upper gastrointestinal infection by Cytomegalovirus in immunocompromised patients. Two patients suffered from AIDS and the other one had a recent heart transplantation and was on immunodepressant drugs for an episode of rejection. The stomach in two cases and the esophagus in the other were the affected organs. In all cases there were upper gastrointestinal symptoms and the diagnosis was established by biopsy of endoscopically suspicious lesions. Antiviral therapy was effective in all three cases. This diagnosis has to be considered whenever immunocompromised patients present with unusual clinical and endoscopic findings.

[Calcified bladder oat cell associated with hypercalcemia and hypophosphoremia]. / Oat cell vesical calcificado asociado a hipercalcemia e hipofosforemia.

Description of a 69-year old male patient presenting calcified vesical tumour which, following a pathoanatomical study was shown to be an non-differentiated oat cell carcinoma associated to transitional carcinoma and adenocarcinoma. Biochemically it presented hypercalcemia and hypophosphoremia and the electron microscope study demonstrated the presence of neurosecretion granules. The immunohistochemical techniques were negative for protein S-100 and cytokeratins, but positive for the membrane epithelial antigen and the neuro-specific enolase. The patient was treated by transurethral resection and polychemotherapy, presenting an initially favourable response but dying 18 months later after widespread metastasis. These data are in agreement with those obtained from the literature review carried out with regard to clinical picture, pathoanatomical studies, aggressiveness and overall poor prognosis with this type of tumours. In our view, the tumour's mixed composition supports an origin of pluripotential cell (steam cell). Presence of neuroendocrine syndromes associated to oat cell vesical tumours is an unusual fact related to the tumour's hormonal secretion.