RESUMEN
Acute renal failure due to idiopathic tubulo-interstitial nephritis associated with bilateral uveitis (TINU syndrome) is a rare clinical event, contracted mainly by girls or women. Here we report the clinical follow-up regarding a 22-year-old woman with acute renal failure (creat. clearance 13.5 ml/min) due to idiopathic tubulo-interstitial nephritis documented by renal biopsy, after bilateral uveitis which healed with local prednisone. The clinical history and the clinical follow-up of our patient were typical of the TINU syndrome. We were able to exclude all diseases causing acute tubulo-interstitial nephritis such as systemic infection, hypersensitivity to drugs, Behcet's disease, Sjogren syndrome, sarcoidosis, systemic lupus or vasculitides. The patient recovered after systemic prednisone.
Asunto(s)
Lesión Renal Aguda/etiología , Lesión Renal Aguda/patología , Nefritis Intersticial/complicaciones , Nefritis Intersticial/patología , Uveítis/complicaciones , Lesión Renal Aguda/diagnóstico , Adulto , Biopsia con Aguja , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Nefritis Intersticial/diagnóstico , Síndrome , Uveítis/diagnósticoRESUMEN
This paper is a report on a case of gastric carcinoma of diffuse type in a young female patient aged 38. The patient was still asymptomatic at hospital admission, her only pathological sign being the finding of malignant cells of indeterminate origin at a routine Pap-test examination. Subsequent investigations showed the presence of a poorly differentiated gastric carcinoma, with metastatic diffusion to uterus, ovaries and peritoneum. Only a few cases of gastric carcinomas without cervical localization, detected by Pap-test, are reported in literature. A few other cases with cervical localization have been described. The aim of this work is to point out that a Pap-test smear may reveal the presence of extragenital tumors still unappreciated.
Asunto(s)
Adenocarcinoma/secundario , Carcinoma/diagnóstico , Carcinoma/patología , Neoplasias Ováricas/secundario , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Neoplasias Uterinas/secundario , Frotis Vaginal , Adulto , Femenino , HumanosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the usefulness of RF interstitial thermal ablation for treating hepatic cancer. SUBJECTS AND METHODS: Fifty patients, 39 who had 41 hepatocellular carcinoma nodules and 11 who had 13 hepatic metastatic nodules, underwent RF interstitial thermal ablation. In all but one, a thermal necrosis volume greater than the tumoral nodule volume was created to obtain total tumor destruction. One large tumor was treated for debulking purposes. RESULTS: Hepatocellular carcinoma nodule destruction was achieved in a mean of 3.3 sessions of RF interstitial thermal ablation. During a mean follow-up of 22.6 months (range, 3-66 months), 16 (41%) of 39 patients had recurrences; two (5%) of these patients showed local recurrences and the remaining 14 (36%) had new lesions. Nine of these 16 patients underwent further RF interstitial thermal ablation that proved effective. RF interstitial thermal ablation was also successfully repeated in four patients who had a second recurrence. With RF interstitial thermal ablation, we treated 54 hepatocellular carcinoma nodules in 39 patients. Eleven (28%) of the 39 patients died: five from hepatic failure due to advanced cancer and six from causes other than cancer. Autopsy was performed on three patients who died from causes other than cancer, one had had two new courses of RF interstitial thermal ablation for two new lesions. Gross examination failed to detect two treated tumor nodules; histologic examination of three other treated tumor nodules showed total necrosis in two nodules and a 3-mm focus of viable cancer cells in the other nodule. Cumulative survival curves showed the median survival time to be 44 months. The survival rate for the first year was 0.94, 0.86 for the second year, 0.68 for the third year, and 0.40 for the fourth and fifth years. In the patients treated for metastatic nodules, posttreatment imaging studies showed necrosis that varied from 80% to 100% in all cases. Pathologic studies performed on two patients who underwent surgery after RF interstitial thermal ablation showed 100% necrosis in one case and 80% necrosis in the other. CONCLUSION: RF interstitial thermal ablation is a useful percutaneous treatment for hepatic cancer.
Asunto(s)
Carcinoma Hepatocelular/cirugía , Electrocoagulación , Neoplasias Hepáticas/cirugía , Anciano , Biopsia con Aguja , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/mortalidad , Supervivencia sin Enfermedad , Electrocoagulación/instrumentación , Electrocoagulación/métodos , Femenino , Estudios de Seguimiento , Humanos , Hígado/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/secundario , Masculino , Recurrencia Local de Neoplasia , Factores de Tiempo , Resultado del TratamientoRESUMEN
The second known case of sporotrichosis caused by Sporothrix schenckii var. luriei in a patient living in Piacenza, Italy is described. In the absence of cultures, the diagnosis was based on histologic studies. Stained tissue sections (Hematoxylin and eosin, & Gomori methenamine silver) revealed hyaline, large, thick walled tissue form cells that had divided by septation or a budding process. These forms, along with the striking "eyeglass" configuration of incompletely separated cells that were also present, are the diagnostic features of this apparently rare variety. The use of a fluorescent antibody reagent, specific for S. schenckii, confirmed the identity of the etiologic agent.
Asunto(s)
Enfermedades de la Piel/etiología , Sporothrix/aislamiento & purificación , Esporotricosis/etiología , Anciano , Anciano de 80 o más Años , Humanos , Italia , Masculino , Enfermedades de la Piel/patología , Esporotricosis/patologíaRESUMEN
An unusual case of multiple relapsing Spitz nevus (SN) in a patient with pseudohypoparathyroidism is described. It arose initially as a single lesion, and recurred twice as multiple agminated lesions that maintained the same histological pattern as the original SN. Nevertheless, the clinical behavior led to a diagnosis of metastasis from malignant melanoma at another medical institution. This case emphasizes the need for relying on accurate histopathological criteria to distinguish SN from malignant melanoma if inappropriate and detrimental therapeutic procedures are to be avoided.