RESUMO
Genital amebiasis by Entamoeba histolytica is rare, even in Mexico where the disease is endemic. We report a case of genital amebiasis in a female patient with a recto-perineal fistula and two-week history of a profuse vaginal discharge, a painful and friable vulvar ulcer and induration in gluteal and inner side of thighs. The PAP smear and the biopsy showed trophozoites, no malignant cells were observed. The findings were compatible with genital amebiasis. The serology test for E. histolytica was positive (> 1: 512). The patient was treated with metronidazol 750 mg tid for 3 weeks. Complete resolution was achieved. The long term fistula, the low socioeconomic status, the poor hygiene and diabetes mellitus of a recent onset were probably the risk factors associated to this infection. We reviewed the literature.
Assuntos
Entamebíase , Doenças da Vulva/parasitologia , Entamebíase/diagnóstico , Entamebíase/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Doenças da Vulva/diagnóstico , Doenças da Vulva/tratamento farmacológicoRESUMO
A case of lipoma of the liver is reported in a 57-year-old woman with a 10-month history of non-insulin dependent diabetes mellitus and 3 days with abdominal pain, distention, nausea, and vomiting. On medical examination, the liver was palpable 5 cm below the right costal margin without splenomegaly or ascites. A CT scan revealed a well-defined fat attenuation tumor and an MR demonstrated a well-circumscribed lesion with bright signal intensity. An extended right hepatic lobectomy was performed. The resected specimen measured 28.6 x 18.3 x 8.2 cm and weighed 2,200 g. The yellow and well-circumscribed tumor measured 15 x 9.5 cm and was composed of mature adipose cells pushing the liver tissue at the periphery. The patient was asymptomatic 6 months after surgery.
Assuntos
Lipoma/patologia , Neoplasias Hepáticas/patologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Hepatectomia , Humanos , Lipoma/complicações , Lipoma/cirurgia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/cirurgia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Obesidade/complicaçõesRESUMO
Recently the association between the Epstein-Barr virus (EBV) and smooth muscle lesions has been described in immunosuppressed children but it is infrequent in adults. The role of EBV in the pathogenesis of these lesions is obscure. We presents a 28 year old man with end stage renal disease transplanted in 1994. Two years later he developed several nodular lesions that affected both lungs, liver, spleen, retroperitoneal ganglia and the left thigh; one year later he died. The surgical specimen from the thigh and a liver biopsy were diagnosed as leiomyosarcoma. Immunohistochemical reactions against vimentin and smooth muscle actin were positive. In situ hybridization disclosed positivity against EBV nuclear antigens (EBNA-2) in neoplasic cells. This is the first case of sarcoma in transplanted patients of our institution and represents a rare case of leiomyosarcoma associated with EBV in adults.