RESUMO
El linfoma no Hodgkin primario de la glándula suprarrenal es una patología muy poco común. Su diagnóstico inicial es difícil siendo este histológico. El linfoma B difuso de células grandes es el tipo histológico más frecuente. Se presenta el caso mujer de 62 años a la que se le realiza tomografía axial computarizada abdominal que muestra una masa de 18 cms dependiente de la glándula suprarrenal y con características de carcinoma. Se realiza exéresis de la tumoración, siendo la anatomía patológica linfoma difuso de célula grande B. Este tipo de linfoma tiene mal pronóstico describiéndose supervivencias medias en torno a los 13 meses. No existe un régimen terapéutico bien definido; aunque el tratamiento más aceptado es el esquema R-CHOP. El papel de la radioterapia y de la exéresis tumoral no está claramente establecido. El linfoma suprarrenal primario debe tenerse en cuenta en el diagnóstico diferencial de pacientes que presentan una masa suprarrenal. Ante la sospecha de esta patología es preferible realizar una biopsia con aguja guiada por prueba de imagen para evitar una intervención quirúrgica innecesaria(AU)
Primary non- Hodgkin`s lymphoma of the adrenal gland is very rare. Its initial diagnosis is difficult and needs to be histological. Diffuse large B- cell lymphoma is the most common histological type. This is the report of a 62 years old woman, who was performed abdominal tomography to disclose a 18 cm tumor in the adrenal gland with carcinoma characteristics. The tumor was removed and the final pathologic diagnosis was diffuse large B-cell lymphoma. This type of lymphoma has poor prognosis since the average survival rates are roughly 13 months. There is no well-defined therapeutic regimen, although the most widely accepted treatment is R-CHOP scheme. The roles of radiotherapy and tumor resection are not clearly established. Primary adrenal lymphoma should be considered in the differential diagnosis of patients presenting with an adrenal mass. When this condition is suspected, then it is advisable to perform a imaging-guided needle biopsy to avoid unnecessary surgery(AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Glândulas Suprarrenais/patologia , Biópsia por Agulha Fina/efeitos adversos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagemRESUMO
Esophageal ingestion of foreign bodies is a frequent urgency. It occurs more commonly in patients with psychiatric disorders, prisoners and extreme ages of the life. Early upper endoscopy is the method of choice for the treatment of symptomatic patients. Surgery is only considered when a complication is present or the extraction can not be done by the endoscopist. We report a case of a 34-year-old male who voluntarily ingested an uncommon foreign body. Surgical treatment was required because of impaction after endoscopic maneuvers and suspicion of esophageal perforation.
Assuntos
Perfuração Esofágica/etiologia , Esôfago , Corpos Estranhos/complicações , Adulto , Perfuração Esofágica/diagnóstico , Perfuração Esofágica/cirurgia , Esofagoscopia , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Humanos , Masculino , Resultado do TratamentoRESUMO
Acute appendicitis is the most common abdominal surgical emergency. Atypical presentations lead to a late diagnosis with a higher complication rate. Given its rarity, we report a case of a thoracic empyema due to subphrenic appendicitis.
Assuntos
Apendicite/complicações , Empiema Pleural/etiologia , Abscesso Subfrênico/etiologia , Doença Aguda , Idoso , Apendicite/diagnóstico , Apendicite/cirurgia , Drenagem , Empiema Pleural/diagnóstico , Humanos , Masculino , Abscesso Subfrênico/diagnóstico , Abscesso Subfrênico/cirurgiaRESUMO
Lost gallstones after accidental opening of the gallbladder during cholecystectomy usually under laparoscopy, can cause late complications. Intra-abdominal abscess is the most frequent and the diagnosis is based on imaging techniques (abdominal ultrasound or computed tomography scan). Surgical drainage with gallstones removal seems to be the best approach, due to the fact that a simple percutaneous drainage has a high failure rate. However, a posterior abdominal wall abscess as the initial manifestation of intra-abdominal abscess due to retained gallstones is uncommon, and this prompted us to report this case.
Assuntos
Abscesso Abdominal/etiologia , Cálculos Biliares/complicações , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/cirurgia , Idoso , Colecistectomia , Drenagem , Cálculos Biliares/cirurgia , Humanos , Masculino , Radiografia AbdominalRESUMO
Los cálculos abandonados tras apertura accidental durante una colecistectomía, generalmente laparoscópica, pueden producir complicaciones tardías, siendo el absceso intraabdominal la más frecuente. El diagnóstico se basa en la prueba de imagen (ecografía/tomografía computerizada), siendo el drenaje y la extracción quirúrgica de los cálculos la mejor opción terapéutica, ya que el drenaje percutáneo presenta una elevada tasa de fracasos. Sin embargo, el absceso en pared abdominal posterior como manifestación inicial de un absceso intraabdominal debido a colelitiasis retenida es poco frecuente, por lo que reportamos este caso.
Lost gallstones after accidental opening of the gallbladder during cholecystectomy usually under laparoscopy, can cause late complications. Intra-abdominal abscess is the most frequent and the diagnosis is based on imaging techniques (abdominal ultrasound or computed tomography scan). Surgical drainage with gallstones removal seems to be the best approach, due to the fact that a simple percutaneous drainage has a high failure rate. However, a posterior abdominal wall abscess as the initial manifestation of intra-abdominal abscess due to retained gallstones is uncommon, and this prompted us to report this case.