Cytologic brushing as a simple and rapid method in the diagnosis of Helicobacter pylori infection.

OBJECTIVE: To assess broad antral cytologic brushing as an alternative approach for the diagnosis of Helicobacter pylori gastric colonization as compared to histology. STUDY DESIGN: Multiple gastric biopsies were taken from the antrum of 117 patients with an endoscopic appearance compatible with antral gastritis. Broad antral brushing was also obtained, and smears were stained with Papanicolaou stain. RESULTS: Chronic gastritis was diagnosed histopathologically in 93 patients. H pylori was identified in 115 cytologic smears. Cytologic smears from 97 patients with H pylori on biopsy specimens contained the organisms. Only two poor-quality cytologic smears with no H pylori had the organisms on biopsy specimens. In 18 patients, H pylori was identified on the cytologic smears and not on the biopsy specimens. CONCLUSION: Broad antral cytologic brushing is a useful alternative approach to histology for the diagnosis of H pylori gastric infection.

[Castleman's disease, plasma-cellular variety: unusual finding in our specialty]. / Enfermedad de Castleman, variedad plasmo-cellular: un raro hallazgo en nuestra especialidad.

Castleman's disease is a disorder of the lymph tissue, of undetermined etiology and with preferentially mediastinal location, although other lymphatic and extra-lymphatic locations are also possible. This entry appears under two varieties: the most frequent, hyalovascular type which generally does not have associated systemic symptoms, and the plasmocellular type associated to multisystemic symptoms in up to 50% cases, such as fever, anaemia, hypergammaglobulinemia, etc. Additional examinations beyond those usually available are not enough to establish a certainty diagnosis against other types of tumours, so an histopathological study is required prior to arrive to this definite diagnosis. Surgery is the choice therapy, although sometimes a favourable response to radiotherapy, used as alternating or adjuvant therapy, can be obtained. Corticoid therapy can be an effective option when dealing with systemic symptoms. The paper submits one case of Castleman's disease of the hyalinovascular type with retroperitoneal location which forced us to establish a differential diagnosis with other disorders in that region more frequent in our specialty. Definite clinical diagnosis was not possible surgery was chosen and the entire lesion removed. As certainty diagnosis was therefore histologic and, up to this point, the patient has shown no signs or symptoms of relapsing.

Acute renal failure in visceral leishmaniasis.

We describe the case of a 33-year-old male patient with an acute visceral leishmaniasis (Leishmania donovani) associated with an acute renal failure. The clinical manifestations were dominated by fever, oliguric renal failure and hepatic alterations. Serum C3 and C4 fractions of complement were decreased, and a renal biopsy demonstrated an interstitial nephritis with no glomerular involvement. The clinical course was favorable with recuperation of renal function without sequels.