Multiple neoplasias: an oncologic reality.
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Biomedical subjects
Publications and source records attributed to C Prados.
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Histiocytosis X is considered a group of diseases of unknown origin. Nevertheless, the presence of certain lymphocytes disorders and immunocomplexes has permitted us to think that it is an immunologic disease. The ankylosing spondylitis is also a disease of unknown origin, but like the histiocytosis X, might be of immunologic origin. In both entities, a defect of T-lymphocytes has been demonstrated. We present a patient in whom both diseases are associated, which is not reported before in the medical literature. We think that these disorders may be related by a common immunologic alteration.
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Although cystic fibrosis (CF) is still the most frequently fatal childhood disease, many adults now survive into their third and fourth decades. Uncommon complications of chronic diseases, such as amyloidosis, while infrequent, may now appear during the course of CF in adulthood. We present a case of a patient with CF who was diagnosed with hypothyroidism due to amyloid deposits in the thyroid.
Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome.
We describe a female renal transplant recipient with cytomegalovirus and Epstein-Barr virus (EBV) infections who developed aggressive polymorphous polyclonal B cell proliferation. She received two courses of OKT3. We found a majority of transformed B cells bearing EBV membrane receptor CR2 and EBV nuclear antigen. Posttransplant lymphoproliferative disorders may be associated with a significant immunological activation, detected in this case by the sudden increase of beta 2-microglobulin and immunoglobulin levels, including immunoglobulin D. These raised levels persisted throughout the short and rapid course of the disease.
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The bronchoalveolar lavage (BAL) is considered a basic technique as a diagnostic aid in Pneumology. However, one of the main problems faced by the clinician is the lack of standardization of the technique. This has been resolved through the drafting of international standards. The other problem is the lack of what might be called a "reference" BAL. In order to establish a reference BAL, we analyzed 203 BAL divided in two groups: a control group and a pathologic group, make up by extrinsic asthma, intrinsic asthma, pulmonary infections, diffuse interstitial pneumopathies, bronchopulmonary tumors and chronic bronchitis. We have studied both the cytologic and the biochemical component of the BAL. Among the biochemical markers, we have considered; carcinoembrionary antigen (CEA), tissular polypeptidic antigen (TPA), neuronal specific enolase (NSE), ferritin (FER), calcitonin (CT), ACTH, histamin (HIS) and prostaglandin (PGE2). In order to establish the reference values, we have used the modified Baye's theorema. The BAL that we obtained was the following: volume 20 ml, cells 35 x 10(5) cells/ml, macrophages 77%, lymphocytes 22%, neutrophils 4%, eosinophils 2%, CEA 14 ng/mg, TPA 84 U/g PT, NSE 5 ng/mg PT, FER 42 ng/mg PT, CT 15 pg/mg PT, ACTH 51 pg/mg PT, HIS 1.22 ng/mg PT, PGE2 35 pg/mg PT.
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We report the cases of six patients with pulmonary alveolar proteinosis (PAP). Four of the patients were adults, two males and two females (mean age 39 +/- 19 yrs). The other two patients were children, both females, one aged 6 years and one 3 days old. The diagnosis was made by thoracotomy-lung biopsy in two subjects, autopsy in two, transbronchoscopic biopsy in one and bronchoalveolar lavage (BAL) in one. Some of our cases presented unusual associations that have not been described previously in the medical literature: renal tubular acidosis, Fanconi's disease, glioblastoma multiforme and atrioventricular septal defect. In two patients, treatment with acetylcysteine and ambroxol was unsuccessful. Therapeutic BAL improved the clinical, analytical, functional and radiological aspects of two cases. In one subject, three months after the diagnosis of PAP, pulmonary tuberculosis appeared. Both diseases disappeared with antituberculous treatment.
Primary liposarcomas of the mediastinum are uncommon tumors. Only six cases of mediastinal liposarcomas with survival after surgery longer than five years have been reported and only one of these was a non-encapsulated tumor. We report a new case of non-encapsulated primary liposarcoma of the mediastinum with long-term survival. The diagnosis was carried out using a CT-guided core-needle biopsy. We emphasize the utility of this technique to diagnose this kind of mediastinal tumors. A non-encapsulated primary liposarcoma of the mediastinum surgically treated with long-term survival is reported. We emphasize the diagnostic utility of CT-guided core-needle biopsy for the tumors.
The Swan-Ganz catheter complications are infrequent, the most typical one being cardiac arrhythmias. The breaking and embolization of a catheter fragment into the pulmonary vascular system are exceptional and, in any case, benign. We present a patient with severe pulmonary hypertension to the embolization of a Swan-Ganz catheter fragment into the right pulmonary artery which disappeared with the movements of the fragment to the lung periphery.