Asunto(s)

RESUMEN

CASE PRESENTATION: A 49-year-old man was sent by his primary care physician to the rheumatology clinic with complaints of several months of bilateral lower extremity swelling. The swelling migrated from both ankles up to his knees. Presenting symptoms consisted of bilateral knee pain as well as bilateral wrist and hand pain with swelling. Pulmonary symptoms consisted of a nagging productive cough of several months. He also complained of significant weight loss: 50 pounds over 12 months. He was a never smoker. The examination was notable for bilateral knee effusions. Radiographs of his wrists, hands, and knee were obtained, along with a chest radiograph. He was then referred to a pulmonologist for further workup.

Asunto(s)

RESUMEN

A solitary fibrous tumor originates in the pleura with variable degrees of invasion. Hypertrophic osteoarthropathy, known as Pierre-Marie-Bamberger syndrome, is characterized by clubbing of the fingers due to bone surface and soft tissue calcification, historically known as a bronchogenic carcinoma paraneoplastic syndrome; however, a few cases have been associated with solitary fibrous tumors. We describe the case of a 38-year-old woman who presented with clubbing of the fingers. Studies revealed an intrathoracic fibrous tumor that was successfully treated with improvement in symptoms.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Hypertrophic osteopathy is commonly associated with primary lung neoplasms. It may also be secondary to intrathoracic lesions such as pulmonary metastasis, granulomatous pleurisy and chronic pneumonia, among others. It is characterized by progressive proliferation of sub periosteal bone tissue in limb bones. Clinically, patient usually exhibits lameness. It is a rare disease most frequently observed in dogs among domestic animals. A case of a dog with pulmonary hypertrophic osteopathy associated with pulmonary metastases coming from an appendicular periosteal osteosarcoma is reported.(AU)

Asunto(s)

RESUMEN

Hypertrophic osteopathy is commonly associated with primary lung neoplasms. It may also be secondary to intrathoracic lesions such as pulmonary metastasis, granulomatous pleurisy and chronic pneumonia, among others. It is characterized by progressive proliferation of sub periosteal bone tissue in limb bones. Clinically, patient usually exhibits lameness. It is a rare disease most frequently observed in dogs among domestic animals. A case of a dog with pulmonary hypertrophic osteopathy associated with pulmonary metastases coming from an appendicular periosteal osteosarcoma is reported.

Asunto(s)

Asunto(s)

RESUMEN

Background: hypertrophic osteopathy is a periosteum disturb characterized by diffuse new bone formation which leads tosignificant thickening and deformity of members. Secondary in nature, it usually follows large pulmonary lesions such asabscesses and neoplasms. Extraskeletal osteosarcomas are rare and extremely malignant mesenchymal neoplasms. Theycomprise approximately 1% of all domestic animals’ osteosarcomas and develop in the absence of a primary bone lesion.The aim of this paper was to describe a case of hypertrophic osteopathy, involving joints and upper limbs bones includingilium, secondary to a mediastinal chondroblastic osteosarcoma with pulmonary metastasis.Case: A 10-year-old spayed female mixed breed dog, weighing 9 kg, was presented with painful limbs, lameness, hind limbsswelling and a four-month history of weight loss. Radiographic examination revealed bilateral and asymmetric periostealreactions on diaphyseal and/or epiphyseal areas of all proximal phalanges; metacarpal, metatarsal, carpal and tarsal bones;radius; ulna; tibia; fibula; humerus; femur and right ilium. An increased soft tissue radiopacity was noted on the lateral sideof the right knee joint. Thoracic radiographies and ultrasonography suggested the presence of a 5-cm neoplasm or abscessin the left caudal lung lobe. At necropsy, the lobe showed a firm and solid, oval white mass measuring 5.2 x 2.9 cm. Anothermass was found in the caudal mediastinum, near the diaphragm, with same color and more irregular aspect, measuring 3.3cm of diameter. Intense periosteal new-bone formation was seen in the entire length of the four limbs bones, characterizedby thickening of the bone surface and formation of irregular trabeculae perpendicular to the cortex. Significant swelling andthickening of the joint capsule was noted in the right knee. There was no microbial growth on aerobic or anaerobic culturesfrom the masses samples sent to culture. [...]

Asunto(s)

RESUMEN

Background: hypertrophic osteopathy is a periosteum disturb characterized by diffuse new bone formation which leads tosignificant thickening and deformity of members. Secondary in nature, it usually follows large pulmonary lesions such asabscesses and neoplasms. Extraskeletal osteosarcomas are rare and extremely malignant mesenchymal neoplasms. Theycomprise approximately 1% of all domestic animals osteosarcomas and develop in the absence of a primary bone lesion.The aim of this paper was to describe a case of hypertrophic osteopathy, involving joints and upper limbs bones includingilium, secondary to a mediastinal chondroblastic osteosarcoma with pulmonary metastasis.Case: A 10-year-old spayed female mixed breed dog, weighing 9 kg, was presented with painful limbs, lameness, hind limbsswelling and a four-month history of weight loss. Radiographic examination revealed bilateral and asymmetric periostealreactions on diaphyseal and/or epiphyseal areas of all proximal phalanges; metacarpal, metatarsal, carpal and tarsal bones;radius; ulna; tibia; fibula; humerus; femur and right ilium. An increased soft tissue radiopacity was noted on the lateral sideof the right knee joint. Thoracic radiographies and ultrasonography suggested the presence of a 5-cm neoplasm or abscessin the left caudal lung lobe. At necropsy, the lobe showed a firm and solid, oval white mass measuring 5.2 x 2.9 cm. Anothermass was found in the caudal mediastinum, near the diaphragm, with same color and more irregular aspect, measuring 3.3cm of diameter. Intense periosteal new-bone formation was seen in the entire length of the four limbs bones, characterizedby thickening of the bone surface and formation of irregular trabeculae perpendicular to the cortex. Significant swelling andthickening of the joint capsule was noted in the right knee. There was no microbial growth on aerobic or anaerobic culturesfrom the masses samples sent to culture. [...](AU)

Asunto(s)

RESUMEN

A 4-year-old Criollo stallion was presented at the equine clinic of veterinary hospital of the Federal University of Santa Maria, RS, with a 30-day history of progressive weight loss, anemia and swelling of the forelimbs and face. Physical examination revealed that the swelling was firm and had a bone-like consistency, also radiographs showed extensive periosteal proliferation on the forelimb long bones that suggested hypertrophic osteopathy (Marie´s disease). Physical examinations identified no respiratory findings. However, during ultrasound examination, superficial lung disease was identified. The animal was treated with antibiotics and nonsteroidal anti-inflammatory drugs for 12 days. Due to a complete lack of response to this treatment, the horse was euthanized. At necropsy several granulomatous lesions were identified in the thorax, abdomen and testicular tunics. Bony proliferation was evident on many bones of the appendicular skeleton and face. Based on these findings the diagnosis of hypertrophic osteopathy associated with sarcoidosis was established. It is important to perform a thorough clinical examination and include hypertrophic osteopathy in the differential diagnosis of diseases that are accompanied by swelling of the face and limbs as edema from various causes, fibrous osteodystrophy, for example.(AU)

Um garanhão Crioulo, 4 anos de idade, foi atendido na clínica de equinos do hospital veterinário da Universidade Federal de Santa Maria, RS, com histórico de emagrecimento progressivo há 30 dias, anemia e aumento de volume dos membros torácicos e da face. O exame físico revelou que o aumento de volume era firme e apresentava consistência óssea. Radiografias também mostraram extensa proliferação periosteal nos ossos longos dos membros anteriores, o que sugeriu a osteopatia hipertrófica (doença de Marie). Os exames físicos não identificaram alteração respiratória. No entanto, durante o exame ultrassonográfico, foi identificada doença pulmonar superficial. O animal foi tratado com antibióticos e anti-inflamatórios não esteróides durante 12 dias. Devido a uma completa falta de resposta ao tratamento, o cavalo foi sacrificado. Durante a necropsia, várias lesões granulomatosas foram identificadas no tórax, abdômen e túnicas testiculares. Proliferação óssea era evidente em vários ossos do esqueleto apendicular e da face. Com base nestes resultados o diagnóstico de osteopatia hipertrófica associada à sarcoidose foi estabelecido. É importante realizar um exame clínico completo e incluir a osteopatia hipertrófica no diagnóstico diferencial de enfermidades que vêm acompanhadas de aumento de volume da face e dos membros como edema por diversas causas e osteodistrofia fibrosa, por exemplo.(AU)

Asunto(s)

Asunto(s)

RESUMEN

Background: Most of the primary pulmonary tumors in dogs are malignant and from epithelial origin, being bronchioalveolar tumors more prevalent. Adenocarcinoma of clear cells, however, is a very rare pulmonary tumor and its origin is still unknown. It is related to several clinical abnormalities, including hypertrophic osteopathy, an unusual paraneoplastic syndrome characterized by a periosteal reaction along the shaft of long bones. Because of the unusual presentation of the pulmonary adenocarcinoma, the aim of this study was to describe the radiographic, histopathological, and immunohistochemical findings of a dog afflicted with hypertrophic osteopathy secondary to an undifferentiated pulmonary adenocarcinoma of clear cells. Case: A 12-year-old, 45 kg, not castrated male Great Dane dog was presented with painful swelling of all four limbs and moderate respiratory distress. Radiographic examination and computed tomography of the limbs showed palisade-like periosteal bone proliferation involving radius, ulna, femur, patella, tibia, fibula, tarsus, metacarpal, metatarsal and digits, suggesting hypertrophic osteopathy. Radiographic examination and computed tomography of the lungs also showed a round mass well delimited localized in the right diaphragmatic lobe. A lobectomy of the right diaphragmatic lobe and partial lobectomy of accessory lobe were performed. A poorly different...(AU)

Asunto(s)

RESUMEN

Background: Most of the primary pulmonary tumors in dogs are malignant and from epithelial origin, being bronchioalveolar tumors more prevalent. Adenocarcinoma of clear cells, however, is a very rare pulmonary tumor and its origin is still unknown. It is related to several clinical abnormalities, including hypertrophic osteopathy, an unusual paraneoplastic syndrome characterized by a periosteal reaction along the shaft of long bones. Because of the unusual presentation of the pulmonary adenocarcinoma, the aim of this study was to describe the radiographic, histopathological, and immunohistochemical findings of a dog afflicted with hypertrophic osteopathy secondary to an undifferentiated pulmonary adenocarcinoma of clear cells. Case: A 12-year-old, 45 kg, not castrated male Great Dane dog was presented with painful swelling of all four limbs and moderate respiratory distress. Radiographic examination and computed tomography of the limbs showed palisade-like periosteal bone proliferation involving radius, ulna, femur, patella, tibia, fibula, tarsus, metacarpal, metatarsal and digits, suggesting hypertrophic osteopathy. Radiographic examination and computed tomography of the lungs also showed a round mass well delimited localized in the right diaphragmatic lobe. A lobectomy of the right diaphragmatic lobe and partial lobectomy of accessory lobe were performed. A poorly different...

Asunto(s)

RESUMEN

This article presents an updated overview of hypertrophic osteoarthropathy and digital clubbing for the practicing rheumatologist. Discussion includes a brief historical perspective, its definition, incidence and prevalence, classification, pathology and pathophysiology, clinical manifestations, demographics, findings on physical examination, imaging techniques for its detection, differential diagnosis, and treatment modalities.

Asunto(s)

RESUMEN

Malignant neoplasms of the nasopharynx are very rare and has two peaks of incidence: below the age of 30, and between the 4th and 5th decade of life. It is, however, uncommon after the 60 years of age. In rare cases, some patients may present, in the form of paraneoplastic syndrome, hypertrophic osteoarthropathy (HOA). In this case report, we describe a case of HOA from lymphoepithelioma of the nasopharynx in a 77-year-old male patient, representing an extremely unusual condition.

Neoplasias malignas de nasofaringe são muito raras e apresentam dois picos de incidência: antes dos 30 anos e entre a 4ª e 5ª década de vida. No entanto, é incomum após os 60 anos de idade. Em raros casos, alguns pacientes apresentam na forma de síndrome paraneoplásica a Osteoartropia Hipertrófica (OAH). Este relato de caso, nós descrevemos um caso de OAH associada a linfoepitelioma de nasofaringe em um paciente de 77 anos, representando um condição extremamente incomum.

Asunto(s)

RESUMEN

Os achados clínico-patológicos de sete casos de osteopatia hipertrófica em cães foram estudados. Os cães afetados apresentavam sinais clínicos indicativos de envolvimento ósseo e lesões macroscópicas principalmente nos ossos longos dos membros. As lesões consistiram de neoformação óssea periosteal detectada em exame radiográfico, na inspeção óssea durante a necropsia e, com grande nível de detalhamento, em espécimes ósseos macerados. A proliferação óssea observada era parcialmente circunferencial e ocorreu principalmente na diáfise dos ossos longos. Era constituída por trabéculas ósseas de tamanho e espessura irregulares que estavam dispostas de forma perpendicular ao córtex ósseo original. Em todos os casos as lesões de osteopatia hipertrófica foram associadas a neoplasmas pulmonares (primários ou metastáticos).(AU)

Clinical and pathological aspects of hypertrophic osteopathy in seven dogs were studied. Affected dogs had clinical signs of bone involvement and lesions mainly in the long bones of the limbs. The lesions consisted of periosteal new bone formation detected on radiographic examination, inspection of bones during the necropsy, and with great detail, in macerated bone specimens. The bone proliferation observed was partially circumferential and occurred mainly in the diaphysis of long bones. It consisted of bone trabeculae of irregular size and thickness that were arranged perpendicularly to the original bone cortex. In all cases the lesions were associated with lung neoplasms (primary or metastatic).(AU)

Asunto(s)

RESUMEN

Os achados clínico-patológicos de sete casos de osteopatia hipertrófica em cães foram estudados. Os cães afetados apresentavam sinais clínicos indicativos de envolvimento ósseo e lesões macroscópicas principalmente nos ossos longos dos membros. As lesões consistiram de neoformação óssea periosteal detectada em exame radiográfico, na inspeção óssea durante a necropsia e, com grande nível de detalhamento, em espécimes ósseos macerados. A proliferação óssea observada era parcialmente circunferencial e ocorreu principalmente na diáfise dos ossos longos. Era constituída por trabéculas ósseas de tamanho e espessura irregulares que estavam dispostas de forma perpendicular ao córtex ósseo original. Em todos os casos as lesões de osteopatia hipertrófica foram associadas a neoplasmas pulmonares (primários ou metastáticos).

Clinical and pathological aspects of hypertrophic osteopathy in seven dogs were studied. Affected dogs had clinical signs of bone involvement and lesions mainly in the long bones of the limbs. The lesions consisted of periosteal new bone formation detected on radiographic examination, inspection of bones during the necropsy, and with great detail, in macerated bone specimens. The bone proliferation observed was partially circumferential and occurred mainly in the diaphysis of long bones. It consisted of bone trabeculae of irregular size and thickness that were arranged perpendicularly to the original bone cortex. In all cases the lesions were associated with lung neoplasms (primary or metastatic).

Asunto(s)

RESUMEN

Paraneoplastic rheumatic syndromes are defined as those events associated with cancer that occur away from the primary tumor or its metastases and are induced by the presence of the tumor through biological products like hormones, peptides, autocrine or paracrine mediators, antibodies or cytotoxic lymphocytes. Of these, hypertrophic osteoarthropathy, carcinomatous polyarthritis, dermatomyositis/polymyositis, and paraneoplastic vasculitis are the most frequently recognized. Other less known associations are based upon a smaller number of case reports, and include palmar fasciitis, panniculitis, erythema nodosum, Raynaud¥s phenomenon, erythromelalgia and Lupus-like syndrome. Usually the clinical course of rheumatic paraneoplastic syndrome and cancer parallels the resolution of the tumor usually leads to resolution of this syndrome. It is difficult make the distinction between idiopathic rheumatic syndromes from those that result from cancer. Still, there are several clinical data that can guide us to the presence of an occult malignancy, and should be identified as the detection of cancer can lead to early treatment and better prognosis.

Asunto(s)

Asunto(s)