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INTRODUCTION AND OBJECTIVE: Non-Alcoholic Fatty Liver Disease (NAFLD) is a metabolic liver disease related to insulin resistance, which requires invasive methods for diagnosis. The aim of this study was to analyze whether the use of an algorithm involving both clinical indices and hepatic ultrasound measurements improves the accuracy for the non-invasive diagnosis of NAFLD. PATIENTS AND METHODS: Cross-sectional study with patients undergoing elective cholecystectomy. We collected anthropometric, metabolic, liver biopsy, and liver ultrasonography data. We calculated unpaired t-test and Pearson's coefficient, and areas under the receiver-operating characteristic curves (AUROC) for the Fatty Liver Index (FLI), Lipid Accumulation Product (LAP) indexes, right liver index diameter, and for predictive models constructed with discriminant analysis. RESULTS: One hundred patients in groups with and without NAFLD. FLI, LAP, right and caudate liver lobe diameters, and congestion index were higher in NAFLD group (p = 0.011, p = 0.011, p = 0.001, p = 0.027, p = 0.009). The right liver lobe diameter had the highest AUROC. Predictive models that combined sensitivity and specificity for the clinical indexes and liver ultrasound had an AUROC over 0.7. CONCLUSION: The ultrasonography measure of right liver lobe diameter by itself can reliably identify patients with NAFLD with a good sensitivity and specificity, however, this can be improved by adding the LAP mathematical index in our population.

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Among the differential diagnoses that should be considered in acute respiratory failure (ARF) are infectious processes, autoimmune diseases, interstitial pulmonary fibrosis, and pulmonary neoplasia. Timely diagnosis of lung neoplasia is complicated in the early stages. An opportune diagnosis, as well as the specific treatment, decrease mortality. ARF occurs 1 in 500 pregnancies and is most common during the postpartum period. Among the specific etiologies that cause ARF during pregnancy that must be considered are: (1) preeclampsia; (2) embolism of amniotic fluid; (3) peripartum cardiomyopathy; and (4) trophoblastic embolism. The case of a 36-year-old patient with a 33-week pregnancy and ARF is presented. The patient presented dyspnea while exerting moderate effort that progressed to orthopnea and type 1 respiratory insufficiency. Imaging studies showed bilateral alveolar infiltrates and predominantly right areas of consolidation. Blood cultures, a galactomannan assay and IgG antibodies against mycoplasma pneumoniae, were reported as negative. Autoimmune etiology was ruled out through an immunoassay. A percutaneous pulmonary biopsy was performed and an invasive pulmonary adenocarcinoma with lepidic growth pattern (i.e. lepidic pulmonary adenocarcinoma, LPA) result was reported. This etiology is rare and very difficult to recognize in acute respiratory failure cases. After infectious, autoimmune and interstitial lung fibrosis have been excluded the clinician must suspect of lung cancer in a patient with acute respiratory failure and chest imaging compatible with the presence of ground-glass nodular opacities, a solitary nodule or mass with bronchogram, and lung consolidation. In the presence of acute respiratory failure, the suspicion of pulmonary neoplasia in an adult of reproductive age must be timely. Failure to recognize this etiology can lead to fatal results.

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OBJECTIVE: To describe the histopathologic features and clinical presentation of two primary mucinous neoplasms of the renal pelvis. METHODS: We describe two cases and its correlation with histopathologic findings. RESULTS: Primary mucinous neoplasm of the renal pelvis was diagnosed by histopathology in two patients who received medical treatment for abdominal tumor. CONCLUSIONS: Primary mucinous neoplasms of the renal pelvis are extremely rare; the first symptom is usually abdominal growth, followed by hematuria and flank pain; it is difficult to suspect the diagnosis before surgery, because in most cases it is established with biopsy.

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OBJETIVO: Describir las características histopatológicas y presentación clínica de dos neoplasia mucinosas primarias de la pelvis renal.MÉTODO: Se realiza la descripción de dos casos clínicos así como su correlación con los hallazgos histopatológicos.RESULTADO: Neoplasia mucinosa primaria de la pelvis renal diagnosticada por histopatología en dos pacientes que recibieron atención médica por tumoración abdominal.CONCLUSIONES: Las neoplasia mucinosas primarias de la pelvis renal son muy infrecuentes, el primer síntoma suele ser el crecimiento abdominal, seguido de hematuria y dolor en flanco; es difícil sospechar el diagnostico antes de la cirugía, ya que en la mayoría de los casos este se establece con el estudio histopatológico(AU)

OBJECTIVE: To describe the histopathologic features and clinical presentation of two primary mucinous neoplasms of the renal pelvis.METHODS: We describe two cases and its correlation with histopathologic findings.RESULTS: Primary mucinous neoplasm of the renal pelvis was diagnosed by histopathology in two patients who received medical treatment for abdominal tumor.CONCLUSIONS: Primary mucinous neoplasms of the renal pelvis are extremely rare; the first symptom is usually abdominal growth, followed by hematuria and flank pain; it is difficult to suspect the diagnosis before surgery, because in most cases it is established with biopsy(AU)

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