B. C. Steen, S. Flórez Martín, L. Fernández Fáu, J. García Tirado, J. J. Jareño Esteban, J. Ancochea Bermúdez
Primary mediastinal leiomyosarcomas are malignant sarcomas with unknown etiology not deriving from the smooth muscle fiber of the esophagus, trachea or main vessels. Very few cases have been reported in the literature and, although they are clinically unspecific, their histology is unique. The case described here is a 66-year-old woman with a leiomyosarcoma localized at the medium and posterior mediastinum, clinically presented as a mediastinal emergency.
{"title":"[Mediastinal leiomyosarcoma].","authors":"B. C. Steen, S. Flórez Martín, L. Fernández Fáu, J. García Tirado, J. J. Jareño Esteban, J. Ancochea Bermúdez","doi":"10.32388/af52dw","DOIUrl":"https://doi.org/10.32388/af52dw","url":null,"abstract":"Primary mediastinal leiomyosarcomas are malignant sarcomas with unknown etiology not deriving from the smooth muscle fiber of the esophagus, trachea or main vessels. Very few cases have been reported in the literature and, although they are clinically unspecific, their histology is unique. The case described here is a 66-year-old woman with a leiomyosarcoma localized at the medium and posterior mediastinum, clinically presented as a mediastinal emergency.","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49188415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Khosravi Shahi, A. del Castillo Rueda, G. Pérez Manga
Mantle cell lymphoma accounts for approximately 7% of adult Non-Hodgkin Lymphomas. It is a neoplasm of monomorphous small to medium-sized B cells with irregular nuclei. The tumor cells express strong IgM and IgD, and B-cell-associated antigens. Nuclear cyclin D1 protein is present in all cases and is the gold standard for the diagnosis. The t(11;14) (q13;q32) in the majority of the cases results in rearrangement of the BCL-1 locus and overexpression of the cyclin D1 gene. Most patients present with disseminated disease. Mantle cell lymphoma is an incurable neoplasm, but it may be treated with different chemotherapy regimen (R-Hyper-CVAD, R-CHOP, bortezomib) and young patients should be considered for high-dose therapy and autologous or allogeneic bone marrow transplantation.
{"title":"[Mantle cell lymphoma].","authors":"P. Khosravi Shahi, A. del Castillo Rueda, G. Pérez Manga","doi":"10.32388/a6i1f3","DOIUrl":"https://doi.org/10.32388/a6i1f3","url":null,"abstract":"Mantle cell lymphoma accounts for approximately 7% of adult Non-Hodgkin Lymphomas. It is a neoplasm of monomorphous small to medium-sized B cells with irregular nuclei. The tumor cells express strong IgM and IgD, and B-cell-associated antigens. Nuclear cyclin D1 protein is present in all cases and is the gold standard for the diagnosis. The t(11;14) (q13;q32) in the majority of the cases results in rearrangement of the BCL-1 locus and overexpression of the cyclin D1 gene. Most patients present with disseminated disease. Mantle cell lymphoma is an incurable neoplasm, but it may be treated with different chemotherapy regimen (R-Hyper-CVAD, R-CHOP, bortezomib) and young patients should be considered for high-dose therapy and autologous or allogeneic bone marrow transplantation.","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43076974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Garćia Castaño, M. García Román, B. Pinilla Llorente, C. Gilsanz Fernández
Dear Editor, The clinical features of an uncommon hypersensitivity to neurolepitcs were first described by Preston, 1 and was subsequently known as neuroleptic malignant syndrome (NMS). The incidence of NMS report elsewhere is between 0.07% 2 7 and the mortality rate is up to 25%. 8, 9 The condition appears to be an idiosyncratic reaction to a therapeutic dose of the antipsychotic drugs especially dopamine receptor antagonists and a dose relationship has been postulated. 10, 11 Despite the sporadic occurrence of NMS in our psychiatric units, no case has been reported from Nigeria. A 21-year-old female nurse who was Gravida 1, Para 1+ developed acute postpartum psychosis of manic type, two days following childbirth. She developed the psychosis on a background of normal personality and absence of any family history of psychiatric or neurological illness. She was initially admitted at a general hospital, where she works. On admission, she was given massive dose of chlorpromazine and paraldehyde intramuscularly (the relations could not ascertain the amount of dosage given). On the third day of admission, she became more restless, confused, pyrexic and developed generalized stiffness. She was transferred to another hospital where a lumbar puncture was done to exclude meningitis, but the cerebrospinal fluid was normal. She was then referred for electroencephalogram (EEG) to exclude organic brain disease. By the time the patient was brought to the EEG clinic, her temperature was 42c and she had marked body rigidity of plastic type with occasional choreoform movement of the limbs and in addition was comatose. Pulse rate was 110 per minute, regular and normal volume and blood pressure 140/95mmHg. The EEG showed diffuse mixture of fast and slow waves and the background activity consisted of muscle artifact on all channels and NMS was suspected. Blood samples were taken for complete blood count, serum electrolytes and urea, liver function tests and serum creatine kinase. All neuroleptic drugs were discontinued and she was moved into an airconditioned room and tepid sponged with water. Bromocriptine was commenced (10mg 6 hourly) along with 10mg diazepam 6 hourly and benzhexol 5mg 8 hourly. All the medications were given intramuscularly for the first 48 hours and orally by nasogastric tube. By the second temperature dropped to 37.5c, blood pressure remained 140/90 mmHg and level of consciousness improved. By this time laboratory results became available; haemogram was 11.5g/dl, white cell count 11.3 x 10/L; serum sodium was 140mmol/l, potassium 6.0mmoI/l, urea 20mg%, aspertate transaminase 50 iu/l, erythrocyte sedimentation rate 22mm/hr and creatine kinase 3600 iu/l. On the 4 day, temperature was normal, and she could recognize familiar people and was able to speak. Her body rigidity became less and she was able to walk with some help. By the 7 day, the patient started becoming restless and talkative, as a result she was placed on thioridazine 100mg 12 hourly
{"title":"[The neuroleptic malignant syndrome].","authors":"J. Garćia Castaño, M. García Román, B. Pinilla Llorente, C. Gilsanz Fernández","doi":"10.32388/bdk2dh","DOIUrl":"https://doi.org/10.32388/bdk2dh","url":null,"abstract":"Dear Editor, The clinical features of an uncommon hypersensitivity to neurolepitcs were first described by Preston, 1 and was subsequently known as neuroleptic malignant syndrome (NMS). The incidence of NMS report elsewhere is between 0.07% 2 7 and the mortality rate is up to 25%. 8, 9 The condition appears to be an idiosyncratic reaction to a therapeutic dose of the antipsychotic drugs especially dopamine receptor antagonists and a dose relationship has been postulated. 10, 11 Despite the sporadic occurrence of NMS in our psychiatric units, no case has been reported from Nigeria. A 21-year-old female nurse who was Gravida 1, Para 1+ developed acute postpartum psychosis of manic type, two days following childbirth. She developed the psychosis on a background of normal personality and absence of any family history of psychiatric or neurological illness. She was initially admitted at a general hospital, where she works. On admission, she was given massive dose of chlorpromazine and paraldehyde intramuscularly (the relations could not ascertain the amount of dosage given). On the third day of admission, she became more restless, confused, pyrexic and developed generalized stiffness. She was transferred to another hospital where a lumbar puncture was done to exclude meningitis, but the cerebrospinal fluid was normal. She was then referred for electroencephalogram (EEG) to exclude organic brain disease. By the time the patient was brought to the EEG clinic, her temperature was 42c and she had marked body rigidity of plastic type with occasional choreoform movement of the limbs and in addition was comatose. Pulse rate was 110 per minute, regular and normal volume and blood pressure 140/95mmHg. The EEG showed diffuse mixture of fast and slow waves and the background activity consisted of muscle artifact on all channels and NMS was suspected. Blood samples were taken for complete blood count, serum electrolytes and urea, liver function tests and serum creatine kinase. All neuroleptic drugs were discontinued and she was moved into an airconditioned room and tepid sponged with water. Bromocriptine was commenced (10mg 6 hourly) along with 10mg diazepam 6 hourly and benzhexol 5mg 8 hourly. All the medications were given intramuscularly for the first 48 hours and orally by nasogastric tube. By the second temperature dropped to 37.5c, blood pressure remained 140/90 mmHg and level of consciousness improved. By this time laboratory results became available; haemogram was 11.5g/dl, white cell count 11.3 x 10/L; serum sodium was 140mmol/l, potassium 6.0mmoI/l, urea 20mg%, aspertate transaminase 50 iu/l, erythrocyte sedimentation rate 22mm/hr and creatine kinase 3600 iu/l. On the 4 day, temperature was normal, and she could recognize familiar people and was able to speak. Her body rigidity became less and she was able to walk with some help. By the 7 day, the patient started becoming restless and talkative, as a result she was placed on thioridazine 100mg 12 hourly","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46921808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-07DOI: 10.1007/springerreference_39113
C. L. de Ancos Aracil, J. R. Rebollar Mesa
{"title":"[Microscopic polyarteritis].","authors":"C. L. de Ancos Aracil, J. R. Rebollar Mesa","doi":"10.1007/springerreference_39113","DOIUrl":"https://doi.org/10.1007/springerreference_39113","url":null,"abstract":"","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41708658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-07-01DOI: 10.4321/s0212-71992008000700020
M A Sancho Zamora, L M González López, M A Martínez García, A M Puig Rullán
{"title":"[Giant cell arteritis: and uncommon cause of chronic cough].","authors":"M A Sancho Zamora, L M González López, M A Martínez García, A M Puig Rullán","doi":"10.4321/s0212-71992008000700020","DOIUrl":"https://doi.org/10.4321/s0212-71992008000700020","url":null,"abstract":"","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28052048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-07-01DOI: 10.4321/s0212-71992008000700008
E Alonso Formento, F Rodero Alvarez, C M Ros Tristán, M J Calpe Gil, A Martínez Oviedo
Subarachnoid hemorrhage implies the presence of blood within the subarachnoid space from some pathologic process. The initial study of choice is an urgent Cranial Computed Tomography scan, but its sensitivity declines with time. So that it is recommended that patients with severe sudden headache but normal Cranial Computed Tomography scan, should have a lumbar puncture performed, more than 12 hours after the onset of symptoms, to rule out subarachnoid hemorrhage. The methods for distinguishing among traumatic lumbar puncture and true Subarachnoid hemorrhage include the erythrocyte level, the "three tube test", D-dimer assay and ferritin in cerebrospinal fluid. But the best technique is the xanthochromia o yellow-to-orange cerebrospinal fluid supernatant, measured spectrographically. We report a case of a young woman with a subarachnoid hemorrhage diagnosed by xanthochromia after 18 days after the onset of bleeding.
{"title":"[Diagnosis of the spontaneous subarachnoid hemorrhage with short bleeding or long evolution: report of one case].","authors":"E Alonso Formento, F Rodero Alvarez, C M Ros Tristán, M J Calpe Gil, A Martínez Oviedo","doi":"10.4321/s0212-71992008000700008","DOIUrl":"https://doi.org/10.4321/s0212-71992008000700008","url":null,"abstract":"<p><p>Subarachnoid hemorrhage implies the presence of blood within the subarachnoid space from some pathologic process. The initial study of choice is an urgent Cranial Computed Tomography scan, but its sensitivity declines with time. So that it is recommended that patients with severe sudden headache but normal Cranial Computed Tomography scan, should have a lumbar puncture performed, more than 12 hours after the onset of symptoms, to rule out subarachnoid hemorrhage. The methods for distinguishing among traumatic lumbar puncture and true Subarachnoid hemorrhage include the erythrocyte level, the \"three tube test\", D-dimer assay and ferritin in cerebrospinal fluid. But the best technique is the xanthochromia o yellow-to-orange cerebrospinal fluid supernatant, measured spectrographically. We report a case of a young woman with a subarachnoid hemorrhage diagnosed by xanthochromia after 18 days after the onset of bleeding.</p>","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28051530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-07-01DOI: 10.4321/s0212-71992008000700009
J Barquero-Romero, V López Cupido, O Torrado Sierra, M Valencia Terrón
Superior vena cava syndrome is obstruction of blood flow through the superior vena cava (SVC). It is most commonly caused by neoplasm, especially lung cancer. An obstructed SVC initiates collateral venous return to the heart from the upper half of the body and the classic symptoms and signs become obvious. Superior vena cava síndrome is a rare cause of ocular manifestations. We report a case of periorbital swelling, conjunctival edema an orbital proptosis in a male patient presenting malignant superior vena cava obstruction.
{"title":"[Severe ocular symptoms as an initial manifestation of superior vena cava syndrome].","authors":"J Barquero-Romero, V López Cupido, O Torrado Sierra, M Valencia Terrón","doi":"10.4321/s0212-71992008000700009","DOIUrl":"https://doi.org/10.4321/s0212-71992008000700009","url":null,"abstract":"<p><p>Superior vena cava syndrome is obstruction of blood flow through the superior vena cava (SVC). It is most commonly caused by neoplasm, especially lung cancer. An obstructed SVC initiates collateral venous return to the heart from the upper half of the body and the classic symptoms and signs become obvious. Superior vena cava síndrome is a rare cause of ocular manifestations. We report a case of periorbital swelling, conjunctival edema an orbital proptosis in a male patient presenting malignant superior vena cava obstruction.</p>","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28051531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-07-01DOI: 10.4321/s0212-71992008000700010
A Villalobos Sánchez, A Muñoz Morente, I Pérez de Pedro, A Navarro Piñero, J M Reguera Iglesias, R Gómez Huelgas
Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung's duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported so far suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases.
{"title":"[Autoimmune pancreatitis. Related to a case].","authors":"A Villalobos Sánchez, A Muñoz Morente, I Pérez de Pedro, A Navarro Piñero, J M Reguera Iglesias, R Gómez Huelgas","doi":"10.4321/s0212-71992008000700010","DOIUrl":"https://doi.org/10.4321/s0212-71992008000700010","url":null,"abstract":"<p><p>Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung's duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported so far suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases.</p>","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28051532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-07-01DOI: 10.4321/s0212-71992008000700012
P Khosravi Shahi, A Del Castillo Rueda, G Pérez Manga
Neoplastic angiogenesis is an essential process in the progressive growth of neoplasms and the production of metastasis. Angiogenesis consists of a series of linked and sequential steps that ultimately leads to the development of a neovascular blood supply to the tumor mass. VEGF has got an essential role in neoplastic angiogenesis, therefore it is an important target in the treatment of neoplasms. Bevacizumab, a humanized monoclonal antibody, inhibits VEGF, and may also improve the delivery of chemotherapy to the tumor mass. Multi-kinase ihibitors (sorafenib and sunitinib) are orally administered small-molecules, that inhibit different receptors (essentials in the neoplastic angiogenesis), such as the VEGFR or PDGFR. These agents are useful in the treatment of advanced renal-cell carcinoma, and are under investigation in several tumors.
{"title":"[Neoplastic angiogenesis].","authors":"P Khosravi Shahi, A Del Castillo Rueda, G Pérez Manga","doi":"10.4321/s0212-71992008000700012","DOIUrl":"https://doi.org/10.4321/s0212-71992008000700012","url":null,"abstract":"<p><p>Neoplastic angiogenesis is an essential process in the progressive growth of neoplasms and the production of metastasis. Angiogenesis consists of a series of linked and sequential steps that ultimately leads to the development of a neovascular blood supply to the tumor mass. VEGF has got an essential role in neoplastic angiogenesis, therefore it is an important target in the treatment of neoplasms. Bevacizumab, a humanized monoclonal antibody, inhibits VEGF, and may also improve the delivery of chemotherapy to the tumor mass. Multi-kinase ihibitors (sorafenib and sunitinib) are orally administered small-molecules, that inhibit different receptors (essentials in the neoplastic angiogenesis), such as the VEGFR or PDGFR. These agents are useful in the treatment of advanced renal-cell carcinoma, and are under investigation in several tumors.</p>","PeriodicalId":50798,"journal":{"name":"Anales De Medicina Interna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28052040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}