RESUMO
Reactive angioendotheliomatosis (RA) is a rare self-limited skin condition characterized histopathologically by a proliferation of endothelial cells within vascular lumina, usually as a result of different stimuli such as systemic infections, cryoproteinemias, monoclonal gammopathies, allergic conditions, severe peripheral vascular atherosclerotic disease, and iatrogenic arteriovenous fistulas. We report on a 67-year-old woman with a 20-year history of seropositive rheumatoid arthritis who presented with violaceous swelling of her left forearm. A skin biopsy revealed the histopathologic finding of RA with focal glomeruloid features and deposition of periodic acid-Schiff-positive material. In this systemic disorder, cutaneous manifestations may occur secondary to an immune complex-mediated vasculitic mechanism.
Assuntos
Artrite Reumatoide/complicações , Linfoma não Hodgkin/etiologia , Neoplasias Cutâneas/etiologia , Idoso , Artrite Reumatoide/patologia , Biomarcadores Tumorais/análise , Diagnóstico Diferencial , Endotélio Vascular/patologia , Feminino , Humanos , Imuno-Histoquímica , Imunofenotipagem , Linfoma não Hodgkin/química , Linfoma não Hodgkin/patologia , Proteínas de Neoplasias/análise , Neoplasias Cutâneas/química , Neoplasias Cutâneas/patologiaRESUMO
We report the results of a clinicopathologic study of 17 patients with rhinophyma in different stages of evolution, with particular attention paid to the severe form of this disease. On the basis of clinical features, we identified 2 groups of patients: the first group (12/17 patients) included patients with the common form of rhinophyma, whereas the second one (5/17 patients) included patients with the severe form of the disease. There was no link between the clinical aspect and the duration of the disease. Microscopic examination of specimens obtained from the classic type of rhinophyma substantially showed the histopathologic features of fully developed rosacea, except for the presence of prominent sebaceous hyperplasia. The second group showed a very different histologic pattern displaying marked dermal thickness, absence of folliculosebaceous structures, sclerotic collagen bundles with large amounts of mucin, and spreading telangiectasia. The inflammatory infiltrate was inconspicuous, with numerous interstitial spindle and bizarre cells. Most of the interstitial cells were reactive to factor XIIIa. The severe form of rhinophyma shares many histologic characteristics with elephantiasis caused by chronic lymphedema.
Assuntos
Rinofima/etiologia , Rinofima/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
A 27-year-old woman presented with multiple nodules closely grouped on her right upper distal extremity. The lesions, dating from childhood, increased slowly in time. Microscopic examination of one nodule showed the histologic features of spindle cell hemangioendothelioma (SCH). At the periphery of the nodule there were also some features of the so-called sinusoidal hemangioma. Clinically, SCH can present as a solitary lesion or as multiple lesions in zonal distribution. When the lesions are multiple, the diagnosis of Maffucci's syndrome should be considered. SCH may be interpreted as a reactive process secondary to thrombosis and recanalization occurring in angiomatous lesions with different clinical presentations. Spindle cells are probably mesenchymal cells modified by blood pressure. For this entity the term hemangioma seems to be preferable to that of hemangioendothelioma.
Assuntos
Hemangioendotelioma/patologia , Neoplasias Cutâneas/patologia , Adulto , Antígenos CD34/análise , Endotélio Vascular/química , Endotélio Vascular/citologia , Fator VIII/análise , Feminino , Mãos , Hemangioendotelioma/metabolismo , Hemangioma/metabolismo , Hemangioma/patologia , Histiócitos/química , Histiócitos/citologia , Humanos , Imuno-Histoquímica , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Neoplasias Cutâneas/metabolismoRESUMO
Nasal intermittent positive-pressure ventilation (NIPPV) has been showed useful for the treatment of chronic respiratory failure in patients with chest wall diseases due to sequelae of tuberculosis. We present a report of a patient with a thoracoplasty and a cavernostomy in situation of chronic respiratory failure. Nasal intermittent positive pressure ventilation improved diurnal hypoxaemia and hypercapnia.
Assuntos
Serviços de Assistência Domiciliar , Ventilação com Pressão Positiva Intermitente , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/terapia , Insuficiência Respiratória/terapia , Tuberculose Pulmonar/terapia , Idoso , Doença Crônica , Feminino , Humanos , Pulmão/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação , Insuficiência Respiratória/etiologia , Toracoplastia , Tuberculose Pulmonar/complicaçõesRESUMO
La ventilación con presión positiva intermitente por vía nasal (NIPPV) se ha mostrado eficaz en el tratamiento de la insuficiencia respiratoria secundaria a alteraciones de la caja torácica, provocadas a consecuencia del tratamiento quirúrgico de la tuberculosis pulmonar. Presentamos un caso de una paciente sometida a una toracoplastia, seguida de una cavernostomía, que en la actualidad se encontraba en fase de insuficiencia respiratoria. La aplicación de NIPPV ha conseguido mejorar el intercambio de gases mejorando la hipoxemia y corrigiendo la hipercapnia (AU)
