RESUMO
Pleomorphic carcinoma is a rare malignancy belonging to the family of nonsmall cell lung cancers. A 40-year-old man, a smoker, was hospitalized for thoracic pain and dry cough with a deteriorating general condition. The imaging showed a "drop ball" of both lungs. The pathological evidence was obtained by lung biopsy under scanographic control. The presence of supraclavicular and abdominal nodes classified the tumour as stage IV. The patient received six cycles of first-line chemotherapy associating cisplatin and vinorelbine. However, the disease continued to progress and distant metastases were observed. The patient died 6 months after the diagnosis. Pleomorphic carcinoma is identified by purely histological criteria: the concomitant presence of malignant epithelial and homologous sarcomatoid spindle-cell components. Like the other nonsmall cell lung cancers, the treatment is primarily surgical, and the invasive nature of this tumour makes it very difficult. Pleomorphic carcinoma has a poorer prognosis than conventional nonsmall cell lung cancers despite surgery, irradiation and chemotherapy, because relapse occurs early.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Dor no Peito/etiologia , Cisplatino/administração & dosagem , Tosse/etiologia , Progressão da Doença , Evolução Fatal , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Metástase Linfática , Masculino , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Radiografia , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , VinorelbinaRESUMO
The location of bone histoplasmosis is rare. It is a parasitic infection caused by Histoplasma capsulatum, affecting especially the immunocompromised. Diagnosis is difficult, requiring the use of mycological and histopathological studies. Through this observation, we report a rare sequence of the development of sacrum histoplasmosis in a patient treated 10 years ago for a malignant non-Hodgkin lymphoma of the sacrum with complete remission. The clinical and radiological investigations suggested a lymphomatous relapse but the pathological study showed histoplasmosis. Antifungal treatment was started with an encouraging evolution.
