Imagen pulmonar cavitada / A lung image with cavitation

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Radiografía simple de tórax

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[Trousseau's syndrome in lung adenocarcinoma. The rare appearance of venous gangrene]. / Síndrome de Trousseau en adenocarcinoma de pulmón. La infrecuente aparición de la gangrena venosa.

Trousseau's syndrome includes a wide range of coagulation disorders, migratory thrombotic phenomena being the main associated entities. Treatment is difficult and venous gangrene constitutes a rare but deadly final stage that is particularly painful for the patient. The outlook after treatment is poor.

[Bronchioloalveolar carcinoma]. / Carcinoma bronquioloalveolar.

We studied 14 patients with bronchioalveolar carcinoma during the last 14 years. In all cases we evaluated the clinical history, the radiologic presentation, and the diagnostic procedures. The mean age of presentation of the illness was 58.5 years. The incidence of smokers was 35%. The time interval from clinical manifestations to diagnosis was 3,3 months. The most frequent symptoms were cough (57%) and dyspnea (43%). The 21% of the cases were asymptomatic. Two patients (14%) had copious amounts of sputum (bronchorrhea). The most revealing radiologic pattern was of alveolar type (43%), followed by multiple pulmonary nodules (29%) and solitary pulmonary nodule pattern (21%). The diagnosis was based in specimen obtained from transbronchial biopsy, bronchoalveolar lavage, transthoracic aspiration biopsy, thoracotomy, or during the necropsy study. Transbronchial biopsy was a sensitive diagnostic method. The 64% of patients were in a extent disease when the diagnosis was established.

[Choroidal metastases as the form of presentation of 2 bronchiolo-alveolar carcinomas]. / Metástasis coroideas como forma de presentación de dos carcinomas bronquioloalveolares.

We report here two cases presenting with visual symptoms secondary to choroidal metastases, without any other remarkable systemic symptom. After an exhaustive investigation in both patients the diagnosis was obtained of bronchoalveolar carcinoma as primary tumor responsible for such lesions. Bronchoalveolar carcinoma is a type of pulmonary adenocarcinoma which rarely begins with clinical symptoms attributable to metastases and even rarer of choroidal location. The presence of such choroidal lesions are usually associated with visual clinical symptoms and they are a diagnostic challenge when manifested as the presenting symptoms. Therapy is directed to the primary tumor usually associated with palliative radiotherapy of choroidal metastases. Their presence implies a poor survival rate.

[Necrotizing myelopathy associated with neoplasia. A clinico-pathological study of 2 cases and a review of the literature]. / Mielopatía necrosante asociada a neoplasia. Estudio clínico-patológico de dos casos y revisión de la literatura.

Two cases of necrotic myelopathy are presented. This is a very rare paraneoplasic syndrome. One patient had clear cell renal carcinoma and other had lymphatic metastasis of malignant melanoma without filiation of the primary tumor. The complete spinal study (MNR, CT, myelography) proved normal. Diagnosis is possible when all other causes of spinal disease have been discarded. Nowadays, it is possible to diagnose this disease premortem. The international literature reviewed showed 31 cases published since 1903, associated mainly to malignant diseases such as lymphomas, lung cancer, renal carcinoma, breast cancer, leukemias, etc. The differential diagnosis appears in the comments, as well as the presentation and evolution of the cases described up until now.