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Autoimmunity linked to COVID-19 immunization has been recorded throughout the pandemic. Herein we present six new patients who experienced relapses of previous autoimmune disease (AD) or developed a new autoimmune or autoinflammatory condition following vaccination. In addition, we documented additional cases through a systematic review of the literature up to August 1st, 2022, in which 464 studies (928 cases) were included. The majority of patients (53.6%) were women, with a median age of 48 years (IQR: 34 to 66). The median period between immunization and the start of symptoms was eight days (IQR: 3 to 14). New-onset conditions were observed in 81.5% (n: 756) of the cases. The most common diseases associated with new-onset events following vaccination were immune thrombocytopenia, myocarditis, and Guillain-Barré syndrome. In contrast, immune thrombocytopenia, psoriasis, IgA nephropathy, and systemic lupus erythematosus were the most common illnesses associated with relapsing episodes (18.5%, n: 172). The first dosage was linked with new-onset events (69.8% vs. 59.3%, P = 0.0100), whereas the second dose was related to relapsing disease (29.5% vs. 59.3%, P = 0.0159). New-onset conditions and relapsing diseases were more common in women (51.5% and 62.9%, respectively; P = 0.0081). The groups were evenly balanced in age. No deaths were recorded after the disease relapsed, while 4.7% of patients with new-onset conditions died (P = 0.0013). In conclusion, there may be an association between COVID-19 vaccination and autoimmune and inflammatory diseases. Some ADs seem to be more common than others. Vaccines and SARS-CoV-2 may induce autoimmunity through similar mechanisms. Large, well-controlled studies are warranted to validate this relationship and assess additional variables such as genetic and other environmental factors.

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Autoimmunity following COVID-19 vaccination has been reported. Herein, a 79-year-old man with clinical and immunological features of autoimmune hepatitis type 1 after ChAdOx1 nCoV-19 vaccination is presented. Clinical manifestations rapidly remitted after the instauration of immunomodulatory management. This case, together with a comprehensive review of the literature, illustrates the association between COVID-19 vaccines and the development of autoimmune conditions.

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Objective: To describe the radiological characteristics of congenital pulmonary and airway malformations which are frequently found in pediatric patients, from three hospitals in Bogotá between the years 2010 - 2016. Materials and methods: Retrospective, observational and descriptive study with a sample of 27 patients, with an average age of 5 months, who met inclusion criteria: patients between 0 months and 17 years of age, with a confirmed diagnosis of congenital malformation of the lung, who underwent surgery for lung or airway lesion and whose histopathological study was compatible with congenital malformation of the lung. Results: The prevalence of congenital malformations is higher in females. 80% of cases had prenatal diagnosis, with cystic adenomatoid malformation being the most common and the main radiological feature being the cyst. Conclusion: Computed tomography allows detailed studies of these malformations, achieving greater accuracy compared to conventional techniques such as chest radiography and ultrasound.

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Juvenile polyposis syndrome (JPS) is an infrequent autosomal dominant hereditary predisposition to the occurrence of hamartomatous polyps in the colon and rectum. We describe the case of a 12-year-old boy with JPS associated with an abdominal tumor. Histological sections of the abdominal tumor showed components of adenocarcinoma, osteosarcoma, and choriocarcinoma. Immunohistochemistry was AE1/AE3, CK7, HCG and SALL4 positive. Juvenile polyposis syndrome patients are at increased risk of colorectal adenocarcinoma. However, we present a case of an adenocarcinoma associated with other unusual components. This association has not been reported before.

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Las estrongiloidiosis es una infección parasitaria frecuente en zonas tropicales y subtropicales. Suele ser asintomática y limitarse al intestino. Sin embargo, pueden darse casos de infección extraintestinal diseminada y potencialmente fatales en pacientes inmunocomprometidos. Se presenta el caso de una paciente diagnosticada con estrongiloidiosis mediante una muestra de lavado broncoalveolar procesada con los métodos de cytospin y citología convencional...

Strongyloidiasis is a parasitic infection found especially in tropical and subtropical regions. It is usually an asymptomatic and limited disease of the gut. However, potentially fatal cases of disseminated hyperinfection in immunosuppressed patients can occur. We present the case of a female patient with strongyloidiasis in bronchoalveolar lavage specimen processed as cytospin preparations and conventional cytology...

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Basados en geometría fractal se hizo un diagnóstico objetivo y reproducible de células de cuello uterino, que diferencia las normales de aquellas con lesión de bajo grado (LEIBG) o cancerígenas, identificando en forma cuantitativa las células ASCUS. Objetivo: establecer una metodología diagnóstica de las células cervicales normales y preneoplásicas con aplicación simultánea de geometría fractal y euclidiana para definir parámetros matemáticos distintivos de cada uno de dichos estados. Métodos: fotografías digitales de doce células de citologías de mujeres entre 20 y 55 años (tres normales superficiales, tres normales intermedias, tres LEIBG y tres ASCUS). Mediante un programa se calculó la dimensión fractal de tres objetos matemáticos: núcleo, citoplasma y totalidad, a partir del método box-counting; de manera simultánea se determinó el número de pixeles ocupados por la superficie de cada uno y los espacios ocupados por el borde de estos objetos en cada una de las cinco rejillas, para comparar los valores obtenidos. Resultados: al superponer las rejillas de dos y cuatro pixeles los valores de los espacios de ocupación del núcleo permiten establecer diferencias matemáticas entre los grupos de células, presentando como valores en la rejilla dos: normales superficiales (53-56), normales intermedias (75), LEIBG (120-159) y ASCUS (104-121). Conclusiones: se estableció una metodología matemática diagnóstica que diferencia estados preneoplásicos con base en medidas fractales y euclidianas simultáneas del borde del núcleo celular...

An objective and reproducible diagnosis of cervix cytology was made based on fractal geometry, to discriminate between normal cells and low-grade lesion (LSIL) or cancer cells, quantitatively identifying ASCUS cells. Objective: to establish a diagnostic methodology of cervix normal cells and pre-neoplastic cells applying fractal and Euclidian geometry simultaneously to define distinctive mathematical parameters of each of these states. Methods: digital photographs of twelve cytology smears of women between 20 and 55 years of age (three normal-appearing superficial cells, three normal-appearing intermediate cells, three LSIL and three ASCUS). The fractal dimension of three mathematical objects: nuclei, cytoplasm and whole cells was calculated by means of a program based on the box-counting method; simultaneously determining the number of pixels occupied by the area of each of them and the spaces occupied by the outer margin of these objects in each of the five grids, to compare the obtained values. Results: when two and four pixel grids were superimposed on the cell, values of the occupied spaces of the nuclei allow mathematical differences to be established between groups of cells, presenting values in grid two: normal superficial (53-56), normal intermediate (75), LSIL (120-159) and ASCUS (104-121). Conclusions: a mathematical diagnostic methodology was developed differentiating pre-neoplastic states based on simultaneous fractal and Euclidian measures of the peripheral margin of the cell nuclei...

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El hemoneumotórax espontáneo es una condición inusual, caracterizada por la acumulación de aire y sangre en la cavidad pleural, no precedida por trauma. La radiografía de tórax es la herramienta principal en el diagnóstico de esta entidad. Se presenta el caso de un hombre de 22 años con hemoneumotórax espontáneo. El paciente se recuperó sin complicaciones luego de la cirugía.

Spontaneous hemopneumothorax is an unusual condition, characterized by the accumulation of air and blood in the pleural cavity, not preceded by trauma. Chest radiography is the main tool in the diagnosis of this entity. We present, a case of a 22-year-old male with spontaneous hemopneumothorax. The patient recovered after surgery with no complications.

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El carcinoma gástrico es una patología cuya incidencia ha aumentado en muchos países, entre ellos Colombia, con alta prevalencia, constituyendo la segunda causa de muerte por cáncer a nivel mundial. Como herramienta que facilita el diagnóstico y el tratamiento, ha surgido en los últimos años la posibilidad de realizar el estudio para determinar la sobreexpresión del gen que codifica el factor de crecimiento epidérmico-2 (HER2) por inmunohistoquímica, en especímenes y biopsias con el fin de dirigir la terapia con trastuzumab a los tumores positivos para esta prueba. Objetivo: determinar la frecuencia de sobreexpresión de HER2 en carcinoma gástrico en nuestra institución, así como obtener datos locales en cuanto a características epidemiológicas. Metodología: se tomaron 58 muestras de tejido de 2005 a 2009 con diagnóstico de adenocarcinoma gástrico en biopsias o gastrectomía en el servicio de patología, a las cuales se les realizó la detección de HER2 por inmunohistoquímica. Resultados: de las 58 muestras 27 fueron biopsias y 31 gastrectomías con predominio de localización en el antro gástrico, de tipo intestinal en su mayoría. Se detectó HER2 positivo en cinco casos, negativo en 51 y dos fueron indeterminados. Conclusión: la frecuencia de sobreexpresión de HER2 en los casos incluidos en el presente estudio es baja, acercándose al límite inferior informado en la literatura...

Incidence of gastric cancer has increased in many countries including Colombia, showing high prevalence, and remains the second leading cause of cancer mortality in the world. In recent years a new facilitating diagnostic and treatment tool, immunohistochemistry testing to determine the frequency of the gene encoding epidermal growth factor 2 (HER2) overexpression in both surgical and biopsy specimens may be used in order to deliver HER2-positive gastric cancer targeted therapy with trastuzumab. Objective: to determine the frequency of HER2 overexpression in gastric cancer in our hospital, as well as to obtain local data on epidemiologic features. Methodology: from 2005 to 2009, 58 samples obtained by biopsy or gastrectomy were diagnosed as gastric adenocarcinoma at the pathology laboratory. HER2 testing by inmmunohistochemistry was conducted in all 58 samples. Results: out of 58 samples, 27 were biopsies and 31 were gastrectomies predominantly gastric antrum intestinal-type adenocarcinoma. Five cases were HER2 positive, 51 were HER2 negative and 2 were undetermined. Conclusion: frequency of HER2 overexpression of cases included in this study is low, comparable to nearly the lower limit described in literature...

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In 1954, McKittrick and Wheelock described for the first time a syndrome presenting chronic lost of fluid and electrolytes secondary to chronic diarrhea, associated to large rectal villous adenomas. We report a case of a 75-year-old female who presented chronic diarrhea (3 to 4 depositions per day in the last year), accompanied by acute renal failure. In the rectal tact, we objective the presence of a mass of soft consistency with an irregular surface, occupying approximately two thirds of the circumference, at about 3 cm from the anal margin. It was confirmed by the colonoscopy and the patology was informed as villous adenoma, producing chronic diarrhea or McKittrick-Wheelock syndrome. We decide the surgical approach after the normalization of patient's general status and a proctectomy with coloanal anastomosis was performed. We conclude that we must think about this syndrome in aged patients with chronic diarrhea, alterations of the electrolyte balance and presence of renal failure. Surgery treatment after the replacement of water and electrolytes is the unique curative treatment. The absence of this can cause the death of these patients.

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Se presenta el hallazgo histopatológico de médula ósea en un caso de teratoma del mediastino anterior, en un paciente de 20 años que fue llevado a manejo quirúrgico sin complicaciones. Se analizan las características de estas neoplasias y las manifestaciones clínicas encontradas en esta localización.

We hereby describe a histopathologic finding showing bone with marrow elements in an anterior mediastinum teratoma obtained during an uneventful surgical procedure in a 20-year-old patient. Features and clinical manifestations of anterior mediastinum teratomas were reviewed.

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