Carmen Montero

Plasmocitoma pulmonar primario: aportación de 3 casos

Extramedullary plasmacytoma is a plasma cell malignancy that most commonly occurs in the upper respiratory tract. Plasmocytoma located in the lung is an unusual finding, and in such cases the disease may be confined to the lung and regional lymph nodes or may be disseminated. When only located in the lower respiratory tract (primary pulmonary plasmacytoma), diagnosis is difficult and is usually based on the excised tissue. We present 3 cases, 2 of which were particularly unusual in that diagnosis was confirmed by bronchial biopsy. Other important findings included the detection of paraprotein in the blood and urine of 2 of the patients, and follow-ups over 10 and 15 years without recurrence of the disease in 2 of the cases.

Three Cases of Primary Pulmonary Plasmacytoma

Abstract Extramedullary plasmacytoma is a plasma cell malignancy that most commonly occurs in the upper respiratory tract. Plasmocytoma located in the lung is an unusual finding, and in such cases the disease may be confined to the lung and regional lymph nodes or may be disseminated. When only located in the lower respiratory tract (primary pulmonary plasmacytoma), diagnosis is difficult and is usually based on the excised tissue. We present 3 cases, 2 of which were particularly unusual in that diagnosis was confirmed by bronchial biopsy. Other important findings included the detection of paraprotein in the blood and urine of 2 of the patients, and follow-ups over 10 and 15 years without recurrence of the disease in 2 of the cases.

Tratamiento endoscópico de metástasis en bronquios principales de sarcoma: aportación de 2 casos

Leiomyosarcoma is a cancer that can affect the soft tissues or organs. The standard treatment is complete tumor resection. Prognosis is difficult to predict and distant metastases can occur after a long disease-free period. Lung metastases are common but metastasis to the main bronchi with pulmonary atelectasis is very rare. We describe 2 cases of pulmonary atelectasis and obstructive pneumonitis due to metastasis to the main bronchi from leiomyosarcoma of the uterus in one of the patients and leiomyosarcoma of the thigh in the other. Both patients were treated with endoscopic resection. We discuss the role of endoscopic laser treatment in the palliation of symptoms and as an initial procedure before other cancer treatments are started.

Carcinoide bronquial y síndrome de neoplasias endocrinas múltiples TIPO 1. Aportación de un caso

Carcinoid tumours of bronchial origin are rare in type 1 multiple endocrine neoplasia (MEN1) syndrome. The prevalence of histologically confirmed cases is approximately 5-8%, although in more recent studies it is estimated that it could be much higher and a possible relationship with the presence of hypergastrinaemia is suggested. We report a patient with a type 1 MEN syndrome, with no respiratory symptoms, with hypergastrinaemia, and in whom a 5mm diameter nodule was detected in the wall of the left main bronchus by computed tomography. The bronchial biopsy confirmed that it was a typical bronchial carcinoid and the octreoscan showed a single focus of high uptake coinciding with this lesion. A bronchoplastic (sleeve) was performed with extirpation of 3 bronchial rings, which also demonstrated that it was a typical carcinoid.

Revista del año de Archivos de Neumología en neumología intervencionista, enfermedades intersticiales y trasplante pulmonar

Resumen Se ha realizado una revision de los originales publicados en la revista Archivos de Bronconeumologia durante el ano 2008 sobre tecnicas invasivas neumologicas, enfermedades intersticiales y trasplante pulmonar. Hemos seleccionado la publicacion de Martinez-Olondrins et al sobre estadificacion mediastinica del carcinoma broncogenico por puncion transbronquial «a ciegas» para destacar el papel de esta tecnica sencilla, segura y economica en un momento en el que la puncion dirigida por ecobroncoscopia se perfila como una alternativa a la estadificacion por mediastinoscopia. Ademas de su utilidad en el estudio de adenopatias, la puncion transbronquial incrementa en un 20% la rentabilidad global de la broncoscopia, lo que obliga a considerarla como una herramienta basica en el estudio del cancer de pulmon. Comentamos tambien el trabajo de Galvis-Caravajal et al, que describen la tecnica de radiofrecuencia percutanea como alternativa a la radioterapia en pequenos tumores pulmonares o metastasicos. En la patologia intersticial difusa, Morell et al analizan los metodos diagnosticos en 500 enfermos con esta presentacion clinico-radiologica, en los que se alcanzo el diagnostico definitivo en el 85%, lograndose de forma no invasiva en el 25% de los casos. Baloira et al analizaron las caracteristicas de 19 pacientes con neumonia intersticial descamativa y bronquiolitis respiratoria asociada a enfermedad pulmonar intersticial, obtenidos a partir del Registro Nacional de Enfermedades Intersticiales. En trasplante pulmonar, Gonzalez Castro et al, en un trabajo restrospectivo de un centro, analizan la incidencia y los factores de riesgo asociados para la disfuncion renal y fallo renal agudo en 138 pacientes trasplantados. Finalmente, nos referiremos al trabajo publicado por Laporta et al, que analizan las caracteristicas clinicas y funcionales de 100 pacientes seleccionados para trasplante en su centro.A review has been made of original articles on invasive pneumology techniques, interstitial diseases and lung transplantation, published in the Archivos de Bronconeumología during the year 2008. We have selected the publication by Martínez-Olondrins et al on the mediastinal staging of bronchogenic carcinoma by <<blind>> transbronchial needle aspiration to highlight the role of this simple, safe and cost-effective technique at a time when aspiration by ultrasound-guided bronchoscopy is profiled as an alternative to staging by mediastinoscopy. Besides its usefulness in the study of lymph nodes, transbronchial needle aspiration increases the overall performance of bronchoscopy by 20%, which means that it should be considered as a basic tool in the study of lung cancer. We also comment on the work by Galvis-Caravajal et al, who describe percutaneous radiofrequency as an alternative to radiotherapy in small lung or metastasic tumours. In diffuse interstitial disease, Morell et al analysed the diagnostic methods in 500 patients with this clinical-radiological presentation in which a definitive diagnosis was achieved in 85%, with 25% of them being obtained by non-invasively. Baloira et al analysed the characteristics of 19 patients with desquamative interstitial pneumonia and respiratory bronchiolitis associated-interstitial lung disease obtained from the National register of Interstitial Diseases.

Bronchial Carcinoid and Type 1 Multiple Endocrine Neoplasia Syndrome. A Case Report

Carcinoid tumours of bronchial origin are rare in type 1 multiple endocrine neoplasia (MEN1) syndrome. The prevalence of histologically confirmed cases is approximately 5-8%, although in more recent studies it is estimated that it could be much higher and a possible relationship with the presence of hypergastrinaemia is suggested. We report a patient with a type 1 MEN syndrome, with no respiratory symptoms, with hypergastrinaemia, and in whom a 5 mm diameter nodule was detected in the wall of the left main bronchus by computed tomography. The bronchial biopsy confirmed that it was a typical bronchial carcinoid and the octreoscan showed a single focus of high uptake coinciding with this lesion. A bronchoplastic (sleeve) was performed with extirpation of 3 bronchial rings, which also demonstrated that it was a typical carcinoid.

Endoscopic Treatment of Metastasis in the Main Bronchi From Sarcoma: A Report of 2 Cases

Leiomyosarcoma is a cancer that can affect the soft tissues or organs. The standard treatment is complete tumor resection. Prognosis is difficult to predict and distant metastases can occur after a long disease-free period. Lung metastases are common but metastasis to the main bronchi with pulmonary atelectasis is very rare. We describe 2 cases of pulmonary atelectasis and obstructive pneumonitis due to metastasis to the main bronchi from leiomyosarcoma of the uterus in one of the patients and leiomyosarcoma of the thigh in the other. Both patients were treated with endoscopic resection. We discuss the role of endoscopic laser treatment in the palliation of symptoms and as an initial procedure before other cancer treatments are started.