RESUMO

Littoral cell angioma is an extremely rare splenic vascular tumor originating from the cells lining the splenic red pulp sinuses. Approximately 150 cases of littoral cell angioma have been reported since 1991. Its clinical manifestation is usually asymptomatic and is mostly diagnosed as an incidental finding through abdominal imaging. Herein, we present a case of littoral cell angioma in a 41-year-old woman with no previous comorbidities, which initially presented as a nonspecific splenic lesion diagnosed on imaging in the emergency room. The patient was treated through laparoscopic intervention.

Assuntos

RESUMO

O baço canino exerce diversas funções, dentre elas linfáticas, hematopoiéticas, imunológicas e circulatórias, sendo que suas características morfológicas e funcionais facilitam a ocorrência de lesões neoplásicas e não neoplásicas. Este trabalho tem como objetivo realizar um estudo retrospectivo dos resultados histopatológicos esplênicos, oriundos do Laboratório do Hospital Escola Veterinário do Centro Universitário de Jaguariúna (HEV- UNIFAJ) Jaguary no período de 2015 a 2020. Foram analisadas 44 amostras esplênicas, nos achados histopatológicos 15/44 (34,1%) se tratavam de neoplasias, 28/44 (63,6%) representaram alterações não neoplásicas, enquanto que 1/44 (2,3%) foi diagnosticado como sítio metastático. Levando em consideração a prevalência das alterações não neoplásica, juntamente com as novas abordagens terapêuticas realizadas na medicina humana, a Medicina Veterinária poderia levar em conta tais fatores na elaboração de modernos planejamentos cirúrgicos e atuais escolhas de tratamentos.(AU)

The canine spleen has several functions, including lymphatic, hematopoietic, immunological and circulatory, and its morphological and functional characteristics facilitate the occurrence of neoplastic and non-neoplastic lesions. This work aims to carry out a retrospective study of splenic histopathological results, from the Laboratory of the Veterinary School Hospital of the Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary in the period from 2015 to 2020. 44 splenic samples were analyzed, in the histopathological findings 15 / 44 (34.1%) were neoplasms, 28/44 (63.6%) represented non-neoplastic alterations, while 1/44 (2.3%) was diagnosed as a metastatic site. Taking into account the prevalence of non-neoplastic alterations, together with the new therapeutic approaches in human medicine, Veterinary Medicine could take such factors into account in the elaboration of modern surgical plans and current treatment choices.(AU)

El bazo canino ejerce diversas funciones, entre ellas linfáticas, hematopoyéticas, inmunológicas y circulatorias, siendo que sus características morfológicas y funcionales facilitan la occurencia de lesiones neoplásicas y no neoplásicas. Este trabajo tiene como objetivo realizar un estudio retrospectivo de los resultados histopatológicos esplénicos, oriundos del Laboratorio del Hospital Escuela Veterinaria del Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary en el período de 2015 a 2020. Se analizaron 44 muestras esplénicas, en los hallazgos histopatológicos 15/44 (34,1%) se trataban neoplasias, 28/44 (63,6%) representaron alteraciones no neoplásicas, mientras que 1/44 (2,3%) fue diagnosticado como sitio metastásico. Teniendo en cuenta la prevalencia de las alteraciones no neoplásicas, junto con los nuevos enfoques terapéuticos realizados en la medicina humana, la Medicina Veterinaria podría tener en cuenta tales factores en la elaboración de modernos planes quirúrgicos y actuales opciones de tratamiento.(AU)

Assuntos

RESUMO

Splenic vascular neoplasms are the most common form of spleen tumors. Among them, littoral cell angioma is rare and it is frequently an incidental finding in imaging studies. It has no specific clinical, laboratory or imaging findings. Splenectomy allows definitive diagnosis throughout a histopathological examination. We report a 52-year-old man presenting with asthenia and abdominal distension. Computed tomography with intravenous contrast showed multiple splenic hypodense masses and a prostatic enlargement. Presuming a lymphoma, a laparoscopic splenectomy was performed. Histopathologic examination diagnosed littoral cell angioma. During urological follow-up, a prostate adenocarcinoma was diagnosed.

Assuntos

RESUMO

Este artículo se publicó solamente con imágenes.

Assuntos

RESUMO

Splenic vascular neoplasms are the most common form of spleen tumors. Among them, littoral cell angioma is rare and it is frequently an incidental finding in imaging studies. It has no specific clinical, laboratory or imaging findings. Splenectomy allows definitive diagnosis throughout a histopathological examination. We report a 52-year-old man presenting with asthenia and abdominal distension. Computed tomography with intravenous contrast showed multiple splenic hypodense masses and a prostatic enlargement. Presuming a lymphoma, a laparoscopic splenectomy was performed. Histopathologic examination diagnosed littoral cell angioma. During urological follow-up, a prostate adenocarcinoma was diagnosed.

Assuntos

RESUMO

O baço canino exerce diversas funções, dentre elas linfáticas, hematopoiéticas, imunológicas e circulatórias, sendo que suas características morfológicas e funcionais facilitam a ocorrência de lesões neoplásicas e não neoplásicas. Este trabalho tem como objetivo realizar um estudo retrospectivo dos resultados histopatológicos esplênicos, oriundos do Laboratório do Hospital Escola Veterinário do Centro Universitário de Jaguariúna (HEV- UNIFAJ) – Jaguary no período de 2015 a 2020. Foram analisadas 44 amostras esplênicas, nos achados histopatológicos 15/44 (34,1%) se tratavam de neoplasias, 28/44 (63,6%) representaram alterações não neoplásicas, enquanto que 1/44 (2,3%) foi diagnosticado como sítio metastático. Levando em consideração a prevalência das alterações não neoplásica, juntamente com as novas abordagens terapêuticas realizadas na medicina humana, a Medicina Veterinária poderia levar em conta tais fatores na elaboração de modernos planejamentos cirúrgicos e atuais escolhas de tratamentos.

The canine spleen has several functions, including lymphatic, hematopoietic, immunological and circulatory, and its morphological and functional characteristics facilitate the occurrence of neoplastic and non-neoplastic lesions. This work aims to carry out a retrospective study of splenic histopathological results, from the Laboratory of the Veterinary School Hospital of the Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary in the period from 2015 to 2020. 44 splenic samples were analyzed, in the histopathological findings 15 / 44 (34.1%) were neoplasms, 28/44 (63.6%) represented non-neoplastic alterations, while 1/44 (2.3%) was diagnosed as a metastatic site. Taking into account the prevalence of non-neoplastic alterations, together with the new therapeutic approaches in human medicine, Veterinary Medicine could take such factors into account in the elaboration of modern surgical plans and current treatment choices.

El bazo canino ejerce diversas funciones, entre ellas linfáticas, hematopoyéticas, inmunológicas y circulatorias, siendo que sus características morfológicas y funcionales facilitan la occurencia de lesiones neoplásicas y no neoplásicas. Este trabajo tiene como objetivo realizar un estudio retrospectivo de los resultados histopatológicos esplénicos, oriundos del Laboratorio del Hospital Escuela Veterinaria del Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary en el período de 2015 a 2020. Se analizaron 44 muestras esplénicas, en los hallazgos histopatológicos 15/44 (34,1%) se trataban neoplasias, 28/44 (63,6%) representaron alteraciones no neoplásicas, mientras que 1/44 (2,3%) fue diagnosticado como sitio metastásico. Teniendo en cuenta la prevalencia de las alteraciones no neoplásicas, junto con los nuevos enfoques terapéuticos realizados en la medicina humana, la Medicina Veterinaria podría tener en cuenta tales factores en la elaboración de modernos planes quirúrgicos y actuales opciones de tratamiento.

Assuntos

RESUMO

Introdução: Tanto o angiossarcoma esplênico quanto o linfoma não Hodgkin (LNH) de células B não só são raros como apresentam desafios diagnósticos. Relato do caso: Paciente do sexo masculino, 45 anos, obeso, sudorese noturna há um ano, e dor abdominal cíclica há dois, com clínica inicial de angiossarcoma, contudo, sob o exame histopatológico e imuno-histoquímico, mostrou tratar-se de LNH de células B com apresentação atípica. A ultrassonografia (US) de abdome total realizada ao início do sintoma de sudorese noturna não teve alterações. Após um ano, a US apresentou massa esplênica. Na ressonância magnética da região abdominal, constatou-se tumoração esplênica expansiva heterogênea no aspecto anterior, suspeita de angiossarcoma esplênico. Após esplenectomia total, pancreatectomia caudal e linfadenectomia retroperitoneal, o exame histopatológico mostrou neoplasia maligna pouco diferenciada extensamente necrótica substituindo o parênquima esplênico. O estudo imuno-histoquímico foi positivo para os marcadores CD20 em diversos focos, para o BCL2 e para o KI67 (em 95% dos núcleos das células neoplásicas). A histopatologia e a imuno-histoquímica foram compatíveis com o diagnóstico de LNH difuso de alto grau, com imunofenótipo B do baço, sem sinal de infiltração de tecidos adjacentes. Após a esplenectomia total e quatro ciclos de quimioterapia, o paciente estava livre do linfoma e sem sintomas. Conclusão: É de suma importância o reconhecimento do diagnóstico correto de neoplasias raras como a relatada. Tanto a clínica quanto os exames de imagem, mesmo que fundamentais, podem ser imprecisos, reiterando a importância dos exames histológico e imuno-histoquímico complementares

Introduction: Both the splenic angiosarcoma and the B-cell non-Hodgkin's lymphoma (NHL) are not only rare but are challenging to diagnose. Case report: Male patient, 45 years old, obese, night sweats for one year, and cyclic abdominal pain for two years, with an initial angiosarcoma clinic, however after immunohistochemistry test, it was revealed a B-cell NHL with atypical presentation. The total abdomen ultrasound (US) performed at the onset of the night sweating symptom showed no alterations. After one year, the US showed a splenic mass. Magnetic resonance imaging of the abdominal region revealed a heterogeneous expansive splenic lesion in the anterior aspect with suspected splenic angiosarcoma. After full splenectomy, caudal pancreatectomy, and retroperitoneal lymphadenectomy, histological analysis showed an area of poorly differentiated necrotic malignancy infiltrated in the splenic parenchyma. Immunohistochemical analysis was positive for CD20 reagents in several foci, BCL2, and for KI67 (in ninety percent of the neoplastic cell nucleus). Histopathology and immunohistochemistry are consistent with high-grade, diffuse, NHL of immunophenotype B in the spleen, with no sign of metastasis to adjacent tissues. After total splenectomy and four rounds of chemotherapy, the patient had remission of the tumor and was asymptomatic. Conclusion: It is extremely important to recognize the relevance of the correct diagnosis of rare neoplasms such as the one reported. Both clinical and imaging tests, although important, can be inaccurate, reiterating the importance of complementary histologic and immunohistochemical tests

Introducción: El angiosarcoma esplénico e el linfoma no Hodgkin (LNH) de células B no solo son raros sino que presentan un reto diagnóstico. Relato del caso: Paciente masculino de 45 años, obeso, con sudoración nocturna durante un año y dolor abdominal cíclico durante dos años, con clínica inicial de angiosarcoma, pero bajo inmunohistoquímica mostró LNH de células B con presentación atípica. En la ecografía de abdomen total realizada al comienzo del síntoma de sudoración nocturna no hubo cambios. Después de un año, la ecografía enseñó una masa esplénica. La resonancia magnética de la región abdominal reveló una lesión esplénica expansiva heterogénea en la cara anterior, sospechosa de angiosarcoma esplénico. Tras la esplenectomía total, la pancreatectomía caudal y la linfadenectomía retroperitoneal, el análisis histológico mostró un área de neoplasia maligna necrótica poco diferenciada infiltrada en el parénquima esplénico. El análisis inmunohistoquímico fue positivo para los reactivos CD20 en varios focos, BCL2 y KI67 en el 95% del núcleo celular, la histología y la inmunohistoquímica son consistentes con LNH difuso de alto grado de inmunofenotipo B en el bazo, sin signos de metástasis. Tras esplenectomía total y cuatro rondas de quimioterapia, el paciente presentó remisión del tumor, así como disminución de síntomas. Conclusión: Es de suma importancia reconocer el diagnóstico de neoplasias raras como la reportada. Tanto las pruebas clínicas como las de imagen, aunque fundamentales, pueden ser inexactas, reiterando la importancia de las pruebas histopatológicas e inmunohistológicas

Assuntos

RESUMO

Los linfomas primarios de bazo afectan al bazo y/o sus ganglios linfáticos inicialmente. Representan <1% de los linfomas e implican un reto diagnóstico, por baja prevalencia y sintomatología inusual. Por lo tanto, el objetivo de este trabajo fue describir el manejo y evolución de un paciente con VIH-SIDA y la presentación de un Linfoma primario de bazo.En este reporte presentamos el caso de un paciente masculino de 52 años con VIH sin apego a tratamiento debuta con dolor abdominal, fiebre y pérdida de peso de 2 meses de evolución. La tomografía computarizada properatoria revela esplenomegalia y lesiones hipodensas sospechosas de neoformación. Es intervenido, realizándose una laparotomía exploratoria, con esplenectomía. El estudio histopatológico reporta linfoma no Hodgkin.El linfoma primario de bazo es poco frecuente. Es necesario su conocimiento para su sospecha diagnóstica y un diagnóstico diferencial en pacientes con esplenomegalia.Primary splenic lymphomas involve the spleen and/or its lymph nodes. They represent <1% of lymphomas and they imply a diagnostic challenge due to its poor symptomatology and low prevalence.There for, the objects this work describe the management and evolution of a patient with HIV-AIDS and presentation of a primary lymphoma of the spleenIn this report we present the case of a 52-year-old male patient with HIV infection without treatment presented with abdominal pain, fever and a 2-month weight loss. The pre-operative computed tomography showed splenomegaly and hypodense lesions suspected to be tumoral. He was operated on, performing an exploratory laparotomy, performing an splenectomy. The histopathological study reported a non-Hodgkin lymphoma.Primary splenic lymphoma is a non frequent entity. It is necessary to be acquainted with it in order to suspect it.

Primary splenic lymphomas involve the spleen and/or its lymph nodes. They represent <1% of lymphomas and they imply a diagnostic challenge due to its poor symptomatology and low prevalence.There for, the objects this work describe the management and evolution of a patient with HIV-AIDS and presentation of a primary lymphoma of the spleenIn this report we present the case of a 52-year-old male patient with HIV infection without treatment presented with abdominal pain, fever and a 2-month weight loss. The pre-operative computed tomography showed splenomegaly and hypodense lesions suspected to be tumoral. He was operated on, performing an exploratory laparotomy, performing an splenectomy. The histopathological study reported a non-Hodgkin lymphoma.Primary splenic lymphoma is a non frequent entity. It is necessary to be acquainted with it in order to suspect it.

Assuntos

RESUMO

Background: Patients with human immunodeficiency virus (HIV) are more likely to develop cancer. Malignant lymphomas are the main cancer group seen in these patients. Diffuse large B-cell lymphoma including central nervous system lymphoma and Burkitt's lymphoma account for 90% of HIV-related non-Hodgkin's lymphomas. Clinical case: A 22-year-old man with fever up to 39 ° C, malaise, excessive tiredness and night sweats, loss of 8 kg of weight, abdominal pain in the right hypochondrium, all 5 months before hospitalization. Hemoglobin: 9.5 g/dL, leukocytes 5.13 x 103/mm3, platelets 124 000 cel/mm3; albumin 2.9 g/dL, alanine aminotransferase 28 IU/L, aspartate aminotransferase 105 IU/L; HIV reactive, beta 2 microglobulin: 20 000 ng/mL. Viral load for HIV 100 034 cp/mL, CD4: 76 cel/mcL (5%). It was performed abdominal ultrasound and denoted cysts in the liver and spleen. Abdominal-pelvic computed tomography with hepatosplenomegaly, retroperitoneal and inguinal adenopathies and free fluid in abdominal cavity. Splenectomy was performed and Burkitt's lymphoma was reported in the histopathological study. Conclusion: HIV predisposes patients to any type of cancer. Intra-abdominal findings should be a warning of lymphoma suspicious and may occur from infiltration of the small intestine, solid organ and soft tissues.

Introducción: los pacientes con virus de inmunodeficiencia humana (VIH) son más propensos a desarrollar cáncer. Los linfomas malignos son el principal grupo de cáncer que se observa en estos pacientes. El linfoma difuso de células grandes B, incluido el del sistema nervioso central y el linfoma de Burkitt, constituyen 90% de los linfomas no Hodgkin relacionados con VIH. Caso clínico: hombre de 22 años de edad, con fiebre de hasta 39 °C, malestar general, cansancio excesivo y sudoración nocturna, pérdida de 8 kg de peso y dolor abdominal en hipocondrio derecho, 5 meses previos a su hospitalización. Se reportó hemoglobina de 9.5 g/dL, leucocitos 5.13 x 103/mm3, plaquetas 124 000 cel/mm3; albúmina 2.9 g/dL; alanino aminotransferasa 28 UI/L, aspartato aminotransferasa 105 UI/L; VIH reactivo, beta 2 microglobulina 20 000 ng/mL. Carga viral para VIH 100 034 cp/mL, CD4 76 cel/mcL (5%). El ultrasonido abdominal mostró quistes en hígado y bazo. La tomografía abdominopélvica reportó hepatoesplenomegalia, adenopatías retroperitoneales e inguinal y líquido libre en cavidad abdominal. Se realizó esplenectomía y en el estudio histopatológico se reportó Linfoma de Burkitt. Conclusión: El VIH predispone a los pacientes a cualquier tipo de cáncer. Los hallazgos intraabdominales deben hacer sospechar de linfoma y se puede presentar desde infiltración del intestino delgado, órgano sólido y tejidos blandos.

Assuntos

RESUMO

Intraoperative ultrasonography (IOUS) is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel) based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.(AU)

A ultrassonografia intraoperatória (USIO) é usada na medicina como método de diagnóstico e orientação para procedimentos em cirurgia oncológica. Os objetivos desse estudo foram avaliar a performance, viabilidade, vantagens e dificuldades da técnica de USIO em cães com suspeita de neoplasia intra-abdominal. O estudo incluiu nove cães com suspeita de neoplasia intra-abdominal (baço, fígado ou intestino) baseada em exame ultrassonográfico transabdominal e que foram subsequentemente encaminhados para laparotomia exploratória. Durante o procedimento cirúrgico, a USIO foi realizada e os resultados da ultrassonografia transabdominal pré-operatória, inspeção e palpação realizada pelo cirurgião e USIO foram comparados com base em uma avaliação caso-a-caso. A USIO contribuiu para determinar a área de ressecção das lesões em todos os casos. Lesões detectadas somente pela USIO foram observadas em sete dos nove casos. A análise dos casos demostrou que a USIO pode auxiliar durante a cirurgia oncológica do fígado, baço e intestino. Cães com neoplasia hepática podem ter lesões pequenas intraparenquimatosas e não palpáveis pelo cirurgião, mas que podem ser verificadas pela USIO.(AU)

Assuntos