Cholesterol granuloma in an antrochoanal polyp. A rare lesion in children / Granuloma por colesterol en un pólipo antrocoanal. Una rara lesión en la edad pediátrica

Antrochoanal polyps (ACPs) are an infrequent clinical entity. Cholesterol granulomas (CGs) are commonly associated with chronic middle ear disease but are rare in the paranasal sinuses. We describe a case of a 10-year-old girl with a concomitant CG in an ACP which was surgically excised by nasosinusal endoscopic surgery. To our knowledge, there are only five previously published cases of CGs in ACPs and of these, only two were pediatric cases. We describe a third case in the youngest patient yet reported. Increased intrasinus pressure may affect venous and lymphatic drainage, leading to hemorrhages with hemolysis and deposition of cholesterol crystals and their esters initiating the formation of granulomas in the polyp. In addition, the insufficient lymphatic drainage prevents the complete elimination of lipids, contributing to the formation of cholesterol granulomas. The treatment and the outcome of an ACP associated with a CG are the same as for usual ACPs

Los pólipos antrocoanales (PAC) son una entidad clínica infrecuente. Los granulomas de colesterol (GC) se asocian comúnmente con la enfermedad crónica del oído medio, pero son raros en los senos paranasales. En este artículo describimos un caso de GC concomitante con un PAC de una niña de 10 años que fue sometida a extirpación quirúrgica nasosinusal endoscópica. En nuestro conocimiento, solamente 5 casos de GC asociados a PAC han sido publicados. De ellos solamente 2 eran casos pediátricos. En el presente artículo describimos un tercer caso que representa el paciente más joven publicado hasta la fecha. El aumento de la presión en la cavidad del seno puede afectar al drenaje venoso y linfático conduciendo a hemorragias con hemólisis y depósito de cristales de colesterol y sus ésteres iniciando la formación de granulomas en el pólipo. Además, el drenaje linfático insuficiente impide la eliminación completa de los lípidos contribuyendo a la formación de granulomas por colesterol. El tratamiento y la evolución del PAC asociado a GC son similares a los del PAC habitual

Cholesterol granuloma in an antrochoanal polyp. A rare lesion in children.

Antrochoanal polyps (ACPs) are an infrequent clinical entity. Cholesterol granulomas (CGs) are commonly associated with chronic middle ear disease but are rare in the paranasal sinuses. We describe a case of a 10-year-old girl with a concomitant CG in an ACP which was surgically excised by nasosinusal endoscopic surgery. To our knowledge, there are only five previously published cases of CGs in ACPs and of these, only two were pediatric cases. We describe a third case in the youngest patient yet reported. Increased intrasinus pressure may affect venous and lymphatic drainage, leading to hemorrhages with hemolysis and deposition of cholesterol crystals and their esters initiating the formation of granulomas in the polyp. In addition, the insufficient lymphatic drainage prevents the complete elimination of lipids, contributing to the formation of cholesterol granulomas. The treatment and the outcome of an ACP associated with a CG are the same as for usual ACPs.

Pasteurella multocida tenosynovitis of the hand: sonographic findings.

Pasteurella multocida is a common cause of infection in humans subsequent to bites or scratches by dogs and, particularly, cats. This infection usually results in superficial skin and soft tissue infections. Sonography can be used for diagnosing inflammatory conditions affecting tendons, including acute and chronic tenosynovitis. P. multocida tenosynovitis is rare, and the diagnosis can be missed if adequate tests are not performed. We report 2 cases of P. multocida tenosynovitis of the hand and wrist in which sonography played a valuable role in assessing the affected tissues and guiding fine-needle aspiration of fluid accumulations in the involved tendon sheaths. The diagnosis was confirmed microbiologically in each case.

Divertículos de uretra femenina. Diagnóstico por ecografía transrectal / Urethral diverticula in women : diagnosis by transrectal ultrasound

OBJETIVO: Valorar el papel de la ecografía transrectal ( E.T.R.) en el diagnóstico de los divertículos de uretra femenina. MATERIAL Y MÉTODOS: Se realizaron E.T.R. con sonda biplana de 5MHz y ecografía translabial con transductor lineal de 7MHz o sectorial de 3.5 MHz en 9 mujeres con sospecha clínica de divertículos de uretra. En 3 pacientes se realizó además cistouretrografía ( C.U.M.S.). RESULTADOS: En la E.T.R. se objetivaron 11 divertículos en 9 pacientes. CONCLUSIONES: Los divertículos de uretra femenina ocurren aproximadamente en un 0,5-6 por ciento de la población general. Su confirmación diagnóstica se realiza por uretroscopia o por métodos de imagen. La E.T.R. es la técnica de elección en el estudio de estos divertículos (AU)