[Behavioural variant of frontotemporal dementia as the presenting symptom of corticobasal degeneration]. / Variante conductual de la demencia frontotemporal como forma de presentacion de la degeneracion corticobasal.

INTRODUCTION: The behavioural variant of frontotemporal dementia is characterised by progressive social, cognitive and personality deterioration associated with several molecular pathologies of frontotemporal lobar dementia (FTLD): FTLD-tau, FTLD-TDP and FTLD-FUS. Its diagnosis requires pathological studies. CASE REPORT: A 61-year-old male, with a three-year progressive history of behavioural disorder, apathy, poor language skills, perseveration, lack of empathy, bulimia and executive dysfunction. Neuroimaging revealed right-dominant frontal cortical atrophy, and a single-photon emission tomography brain scan showed bilateral frontal hypoperfusion with thalamic and caudate involvement. Clinically, he was diagnosed with probable frontotemporal dementia, behavioural variant. On his death, his brain was donated to the Neurological Tissue Bank and the neuropathological diagnosis was corticobasal degeneration. CONCLUSIONS: Corticobasal degeneration is one of the FTLD-tau tauopathies. The 2013 diagnostic criteria for corticobasal degeneration include executive dysfunction and behavioural and personality disorders similar to those of this patient as a clinical phenotype. The anatomoclinical case presented illustrates the absence of any correlation between the clinical phenotype and the underlying neuropathological diagnosis in frontotemporal dementia, and the need to conduct a histopathological study in order to reach a definitive diagnosis.

TITLE: Variante conductual de la demencia frontotemporal como forma de presentacion de la degeneracion corticobasal.Introduccion. La variante conductual de la demencia frontotemporal se caracteriza por el deterioro progresivo de la personalidad, social y cognitivo que se asocia con diversas patologias moleculares de la degeneracion lobar frontotemporal (DLFT): DLFT-tau, DLFT-TDP y DLFT-FUS. El estudio anatomopatologico es necesario para su diagnostico. Caso clinico. Varon de 61 años, con un cuadro progresivo de tres años de evolucion de trastorno conductual, apatia, lenguaje pobre, perseveracion, falta de empatia, bulimia y disfuncion ejecutiva. En la neuroimagen se objetivo una atrofia cortical frontal de predominio derecho, y en la tomografia simple por emision de foton unico cerebral, una hipoperfusion frontoparietotemporal bilateral con afectacion de talamos y caudados. Clinicamente, se le diagnostico probable demencia frontotemporal, variante conductual. Tras su fallecimiento, se dono el cerebro al Banco de Tejidos Neurologicos y el diagnostico neuropatologico fue el de degeneracion corticobasal. Conclusiones. La degeneracion corticobasal es una de las taupatias de la DLFT-tau. Los criterios diagnosticos de degeneracion corticobasal de 2013 contemplan como fenotipo clinico la disfuncion ejecutiva, las alteraciones conductuales y de personalidad similar al de este paciente. El caso anatomoclinico presentado ilustra la falta de correlacion entre el fenotipo clinico y el diagnostico neuropatologico subyacente en la demencia frontotemporal, y la necesidad de realizar el estudio histopatologico para llegar al diagnostico definitivo.

[Detection of bronchopleural fistula by ventilation scintigraphy. Based on one case]. / Detección de fístula broncopleural mediante gammagrafía de ventilación. A propósito de un caso.

Bronchopleural fistula (BPF) is a rare but extremely serious complication of lung resection surgery. Its diagnosis is often overlooked in the clinical evolution of the patients undergoing surgery due to the subacute presentation of the picture. The procedures used to detect it are either invasive or have low accuracy. We report the case of a patient with lung carcinoma treated by left pneumonectomy in whom BPF was suspected after an episode of coughing and expectoration. The conventional chest x-ray did not show any significant findings while the (99m)Tc-DTPA ventilation lung scintigraphy demonstrated bronchopleural communication in a very early phase.