RESUMEN
Paraganglioma is a rare tumor that should be included in the differential diagnosis of retroperitoneal tumors. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has emerged as an effective tool in the diagnosis of these lesions. A 37-year-old female patient with a history of microcytic anemia underwent EUS-FNA and was diagnosed with a neuroendocrine tumor by histopathological and immunohistochemical analysis. The tumor was surgically removed, and the final diagnosis was paraganglioma. This case report emphasizes the importance of EUS in the evaluation of this type of lesion.
RESUMEN
BACKGROUND: Schistosomiasis is a highly prevalent disease. It can evolve to its hepatosplenic form in up to 10% of the cases. The small-bowel lesions developed during the hepatosplenic stage of the disease have not been described in vivo. OBJECTIVE: The aim of this study was to describe, for the first time, in a pilot study, the endoscopic aspects of the lesions in the small bowel of patients with portal hypertension due to schistosomiasis, using the PillCam SB, and to determine the usefulness of the method for the diagnosis of esophageal varices. DESIGN: Case series. SETTING: Tertiary-care medical center. PATIENTS: Nine nonrandomized patients with hepatosplenic schistosomiasis and esophageal varices without previous GI bleeding were selected based on findings from the PillCam SB. Patients using medications that could alter the coagulation, with history of abdominal surgery, who were undergoing treatment of the portal hypertension other than beta-blocker, and with symptoms suggesting bowel obstruction were excluded. The findings were interpreted by a single endoscopist. RESULTS: Capsule endoscopy was able to diagnose esophageal varices in all 9 patients. All of the patients presented angioectasias and venectasias in the small bowel. Small-bowel varices were present in 22.2% of the patients; edema and erosions were found in 66.7% and 88.9%, respectively. Lesions of so-called "scarred mucosa" were found in 55.5% of the patients. LIMITATIONS: Small number of patients; case series. CONCLUSION: The PillCam SB was effective, giving a significant contribution to the description of the esophageal varices and small-bowel lesions of the patients with portal hypertension caused by Schistosoma mansoni.