Décio Valente Renck

Linfoma ósseo primário simultâneo a osteocondroma simulando degeneração sarcomatosa: relato de caso*

In the literature, there is no evidence of relationship between primary bone lymphoma and osteochondroma or of coexistence of both of them in a single bone. The present report describes an uncommon case of primary bone lymphoma occurring simultaneously with osteochondroma in the proximal third of the tibia. In the present case, magnetic resonance imaging signs simulated the presence of sarcomatous degeneration.

Fibrodisplasia ossificante progressiva: relato de caso

Os autores descrevem um caso de fibrodisplasia ossificante progressiva, doenca hereditaria caracterizada por calcificacoes heterotopicas do tecido conectivo, geralmente induzida por trauma, gerando imobilidade permanente das articulacoes. Halux valgo, clinodactilia e polegares curtos sao as principais malformacoes congenitas associadas. Manifesta-se na infância, sendo o diagnostico clinico-radiologico importante, pois procedimentos invasivos exacerbam a doenca. Tratamentos disponiveis sao apenas paliativos, tendo a prevencao relevância nesse contexto.

Hérnia lombar adquirida secundária do tipo Grynfeltt: relato de caso

Lumbar hernia is a rare condition whose diagnosis is hardly achieved. The prevalence is higher in elderly men. The present case report describes the case of a male, 78-year-old patient who underwent pleural effusion drainage 17 years before presenting with clinical manifestations and tomographic findings compatible with acquired secondary Grynfeltts hernia.

Metástases pulmonares em homem: localização incomum do tumor primário

We report a case of breast cancer identified in a 72-year-old male as an accidental finding during the course of the investigation of a primary tumor and the search for pulmonary metastases. We address aspects related to the epidemiology, diagnosis, treatment and prognosis of this condition in males.

Comparação entre tomografia computadorizada e mediastinoscopia na avaliação do envolvimento ganglionar mediastínico no carcinoma brônquico não de pequenas células

OBJETIVO: Avaliar o rendimento da tomografia computadorizada toracica, em relacao a mediastinoscopia,na deteccao de metastases ganglionares mediastinais em pacientes portadores de carcinoma bronquicoanalisando o rendimento dessa e identificando as regioes mais problematicas. MATERIAIS E METODOS:Analisamos 195 pacientes portadores de carcinoma bronquico, buscando-se comparar os achados entretomografia computadorizada toracica e mediastinoscopia com biopsia. RESULTADOS: Em relacao as metas-tases nodais mediastinais, 33,9% tinham doenca metastatica ganglionar peribronquica e/ou hilar ipsilateral,46,1% possuiam metastases mediastinais ipsilaterais e/ou subcarinais e 20% apresentavam doenca metas-tatica mediastinal e/ou hilar contralateral, escalenica ou supraclavicular. As regioes com melhores valores desensibilidade foram traqueobronquica direita, paratraqueal direita alta e paratraqueal esquerda alta. As re-gioes nodais com melhores resultados de especificidade foram paratraqueal esquerda alta, paratraqueal di-reita alta e regioes traqueobronquicas. CONCLUSAO: A tomografia computadorizada toracica mostrou-seimportante ferramenta diagnostica na deteccao de anormalidades em gânglios mediastinais; entretanto, anatureza neoplasica desses gânglios deve ser conferida por mediastinoscopia, ou ate mesmo por toracoto-mia, a fim de que a correta decisao quanto ao tratamento possa ser tomada.Unitermos: Câncer de pulmao – diagnostico; Tomografia computadorizada – metodos; Mediastinoscopia –metodos.Comparison between computed tomography and mediastinoscopy in the assessment of mediastinal nodalinvolvement in non-small cell bronchial carcinoma.OBJECTIVE: To evaluate the yielding of chest computed tomography in comparison with mediastinoscopyfor detection of mediastinal nodal metastases in patients with bronchial carcinoma, and identifying the mostproblematic regions. MATERIALS AND METHODS: We have analyzed 195 patients with bronchial carcinoma,comparing the findings of chest computed tomography and mediastinoscopy with biopsy. RESULTS: As regardsmediastinal nodal metastasis, 33.9% of patients presented peribronchial and/or ipsilateral hilar nodal me-tastases, 46.1% ipsilateral and/or subcarinal mediastinal metastases, and 20% contralateral mediastinaland/or hilar, scalenic or supraclavicular metastatic disease. Higher sensitivity values were found in the fol-lowing regions: right tracheobronchial, right upper paratracheal, and left upper paratracheal. Higher specific-ity values were found in the following nodal regions: left upper paratracheal, right upper paratracheal andtracheobronchial. CONCLUSION: Chest computed tomography has shown to be an important diagnostic toolfor detection of mediastinal lymph nodes abnormalities. However, the neoplastic nature of such mediastinalnodes should be confirmed by means of mediastinoscopy or even thoracotomy, aiming at making the cor-rect decision regarding the treatment of patients with non-small cell lung cancer.Keywords: Lung cancer – diagnosis. Computed tomography – methods. Mediastinoscopy – methods.