Cristian Carrasco L

Quiste broncogénico cervical: Reporte de un caso

Resumen es: Los quistes broncogenicos son malformaciones congenitas del arbol traqueobronquial que se ubican preferentemente en pulmones y mediastino, siendo excepci...

Parásitos de Fasciola hepática intracoledociano

La fasciolasis es una enfermedad parasitaria producida por el trematodo digeneo Fasciola hepatica. Durante la fase cronica de la enfermedad los parasitos pueden entran en los conductos biliares, y ser causa de ictericia obstructiva, colangitis, pancreatitis y otras complicaciones. Se presenta el caso clinico de una paciente intervenida por sospecha de colelitiasis y coledocolitiasis, a la cual durante la exploracion coledociana intraoperatoria le fueron extraidos multiples parasitos adultos de Fasciola hepatica. Este hallazgo solo fue aclarado posteriormente en la biopsia diferida. Se realiza una revision breve del tema, metodos de diagnostico, tratamiento medico y alternativas quirurgicas de tratamiento

Hialohifomicosis invasiva hepatoesplénica: comunicación de un caso

Invasive fungal infections are an increasingly common problem in patients with cancer and other vulnerable groups. We report a case of hepatosplenic hialohifomycosis probably by Aspergillus sp. In a patient with acute leukemia, and prolonged neutropenia, treated with corticosteroids and broad spectrum antibiotics. A review concerning diagnosis, clinical course and treatment of this condition is presented. (Rev Med Chile 2000; 128: 641-6).

Mastopatía diabética: Un diagnóstico poco habitual

Diabetic mastopathy is a rare condition that occurs in type I dia-betic patients and that may mimic a breast cancer due to its intense fibrosis and inflammation.We report a 34 years old female consulting for a firm, painless and mobile retroareolar breastlump measuring 3.5 x 4 cm, that lead to the suspicion of a breast cancer. Mammography,mammary ultrasound and fine needle cytology were unspecific. A core biopsy confirmed thediagnosis of diabetic mastopathy. The patient continues under periodical assessments (Rev MedChile 2003; 131: 1305-08 ).(

NEOPLASIAS MALIGNAS PRIMARIAS DEL APÉNDICE CECAL: ESTUDIO COMPARATIVO ENTRE 2 HOSPITALES REGIONALES

Primary malignant tumors of appendix Background: Primary malignant tumors of appendix are uncommon and usually found during the pathological examination of surgical pieces of appendectomies. aim: To report the clinical and pathological features of appendiceal malignant tumors. material and methods: Review of medical and pathological re ports of patients subjected to an appendectomy between 1998 and 2006 in two regional hospitals. results: Fifteen appendiceal malignant tumors in 2,687 pathological studies were detected (0.55% of all studies) in one hospital. In the other 10 tumors were detected in 4,939 studies (0.2%). nine bearers of tumors were male. In each hospital 93 and 80% of patients had an acute appendicitis, respectively. The pathology report informed a neuroendocrine tumor in 87 and 70% of patients of each hospital, respectively, followed by non-Hodgkin lymphoma and adenocarcinoma. In nine patients a staging study was performed. Four patients died during follow up, one of them due to tumor disseminations. conclusions: Although appendiceal tumors appear in only 0.3% of all appendectomies, the pathological study of the excised appendix is fundamental for the diagnosis.

Mastitis granulomatosa idiopática: Diagnóstico y tratamiento en 14 casos

Introduccion: La mastitis granulomatosa idiopatica es una enfermedad inflamatoria benigna, infrecuente, de etiologia desconocida. Puede simular carcinoma mamario, por lo cual su diagnostico definitivo es histopatologico. No existe consenso respecto a su tratamiento. Realizamos una caracterizacion clinica de esta patologia considerando su forma de presentacion, metodos diagnosticos y tratamiento con especial enfasis en la efectividad de la corticoterapia. Material y metodo: Estudio retrospectivo realizado mediante protocolo tipo. Se revisaron los registros y fichas clinicas de los pacientes manejados con diagnostico de mastitis granulomatosa idiopatica en el Hospital Regional Valdivia entre los anos 1995-2006. Resultados: La serie corresponde a 14 pacientes de sexo femenino. El promedio de edad fue de 31,6 anos. La presentacion clinica mas frecuente fue absceso mamario en 9/14. Se realizo estudio imagenologico en 11/ 14 casos mediante mamografia en 7/14 y ecotomografia en 10/14. Las muestras para estudio histopatologico fueron obtenidas por biopsia percutanea en 8/14 y quirurgica en 6/14. Se realizo tratamiento corticoidal con prednisona en 12/14 pacientes logrando buena respuesta en todos los casos. Se presentaron 2 recidivas durante el seguimiento que comprende un promedio de 28 meses. Conclusiones: La presentacion clinica de las mastitis fue similar a la reportada en la literatura. La respuesta al tratamiento corticoesteroidal logro el control de la enfermedad en todos los casos. Las reacciones adversas al tratamiento fueron menores y las 2 recidivas fueron de menor magnitud y duracion respecto al cuadro inicial

Linfoma tiroideo.: Comunicación de un caso

Thyroid lymphoma represents less than 1% of malignant thyroid tumors and its diagnosis is difficult. We report a 25 years old woman, admitted with the diagnosis of diffuse euthyroid goiter and thyroid cancer. She was subjected to a subtotal thyroidectomy and the pathological study of the surgical piece showed a Hodgkin lymphoma, subtype nodular sclerosis. The patient was treated with three cycles of chemotherapy, using cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastin and radiotherapy. She refused to continue treatment after the third cycle and after 3 years and 5 months of follow up, is well and free of disease (Rev Med Chile 2000; 128: 783-6).

Sarcoma mieloide: Caso clínico con trisomia 11

: Myeloid sarcoma is a form of extra-medullary myeloid neoplasia. Cytogenetic characterization is hampered in the absence of invasion to the bone marrow, origin of cells that are usually studied in cytogenetic studies. We report a 13 years old mole presenting with a mass in the right shoulder. A biopsy of the tumor disclosed a Myeloid Sarcoma. A conventional cytogenetic study of a bone marrow aspirate did not show t (8;21) translocation. A fluorescent in situ hybridization (FISH) performed in the paraffin embedded biopsy of the tumor, detected a chromosome 11 trisomy.

Gastrectomía subtotal en el cáncer gástrico antral mal diferenciado e indiferenciado

Subtotal gastrectomy for poorly differentiated and undifferentiated antral gastric cancer Background: Total gastrectomy is recommended by some groups for poorly differentiated gastric can- cer due to the multicentric nature of this tumor. Aim: To assess if subtotal gastrectomy achieves a good disease control in patients with undifferentiated or poorly differentiated gastric cancer. Material and Methods: Re- trospective review of medical records of patients with undifferentiated or poorly differentiated gastric cancer, subjected to a subtotal gastrectomy between 1988 and 2006. Five years survival was calculated. Results: Fifty two patients aged 23 to 80 years were identifi ed (30 males). Three had undifferentiated and 49 poorly differen- tiated tumors. One patient had a positive proximal margin. After a median follow up of 52 months, fi ve years survival was 47%. Thirteen percent were lost from follow up. Conclusions: Five years survival of patients with undifferentiated or poorly differentiated gastric cancer and subjected to subtotal gastrectomy, was 47%.

Púrpura trombocitopénico inmune asociado a infección por virus hepatitis C en paciente hemofílico: Caso clínico

Hepatitis C Virus (HCV) is a cause of secondary chronic immune thrombocytopenic purpura (ITP). We report a 43 year old man with mild Hemophilia A, who received blood transfusions during childhood, that consulted for epistaxis and ecchymoses. The laboratory showed a platelet count of 23.000/mm3, positive HCV serology and elevated transaminases. Steroids administered in pulses followed by oral doses resulted in a partial response requiring a second pulse and association of azathioprine. A steroidal diabetes appeared. Given his refractoriness, splenectomy and liver biopsy were performed. He continued on azathioprine maintaining a platelet count near 50.000/mm3 but continued with bleeding episodes. Liver biopsy showed a chronic active hepatitis.