Javier Baena-Del Valle

Tumor glómico en pulmón: reporte de un caso y revisión bibliográfica

BACKGROUND Glomus tumours are neoplasms arising from cells of the neuromyoarterial glomus bodies, which almost always occur in a subungual location. A lung location is extremely rare, with few cases reported in the literature. CLINICAL CASE The case is presented of a 33 year-old male, with non-productive cough, dyspnoea at rest, intermittent fever, and mild pain in rib cage. A chest radiograph showed a consolidation in the left lung, and computed tomography revealed a lesion in the hilum that extended to the bronchus of the lingula obstructing, and causing post-obstructive pneumonia. A biopsy was obtained by rigid bronchoscopy biopsy, which showed a well circumscribed tumour constituted by intermediate-sized cells, and abundant cytoplasm that are arranged in a pattern surrounding numerous thin-walled blood vessels, with no pleomorphism, significant mitotic activity or necrosis. Immunohistochemistry revealed diffuse positivity with smooth muscle actin, vimentin, caldesmon; focal reactivity with desmin and CD117, CD34 highlights the vascular pattern. Ki67 proliferation rate was 1%. Synaptophysin, EMA and cytokeratin cocktail were negative, making the diagnosis of glomus tumour. CONCLUSIONS Glomus tumours are rare neoplasms that usually appear in the dermis and subcutaneous tissue, where it is common to find glomus bodies. Occasionally glomus tumours can occur in extra-cutaneous sites such as the gastrointestinal tract, bone and respiratory system, with this case being a new case of rare lung location.

Tumor papilar del saco endolinfático: presentación catastrófica en un escolar

This was a 9-year-old female patient from a rural area, admitted to emergency service due to rapidly progressing deterioration of the state of consciousness. In the clinical examination, she was comatose, with bilateral nonreflective mydriasis, grade IV (House-Brackmann scale) right facial paralysis, absence of right corneal reflex and bilateral extensor motor responses to pain. When asked, the relatives did not report the presence of symptoms before her admission; in fact, they denied that the patient has any symptoms referring to the vestibular-cochlear system, such as vertigo, hypoacusis, hyperacusis, weakness of the facial muscles or instability in walking. The patient presented no other clinical signs that would suggest von Hippel--Lindau (VHL) disease.

Coexistencia de Pseudomonas Aeruginosa y Candida Albicans en Infecciones Nosocomiales en Cartagena de Indias (Colombia)

Nosocomial infections are a major health problem, whose risk factors include prolonged hospitalization, invasive procedures and broad-spectrum antimicrobial treatments. Pseudomonas aeruginosa and Candida albicans are commonly isolated microorganisms from the respiratory tract of seriously ill patients. It has been shown that these pathogens may have an interaction of great significance where the morphological characteristics and virulence of each organism is significantly expanding mutually modulate risk and severity of urinary and respiratory infections, causing high morbidity and mortality. The aim of this paper is to illustrate the clinical and microbiological characteristics that result from the presence of both P. aeruginosa and C. albicans in critically ill patients in hospitals in Cartagena de Indias (Colombia). In all cases, initial bacterial process (in this case caused by P. aeruginosa) was treated according to antimicrobial susceptibility and found to decrease the bacterial agent, led to the growth of C. albicans and the development of a new infection that worsened the clinical condition of these patients. Joint infections P. aeruginosa and C. albicans should always be suspected in a hospitalized patient, especially in intensive care units where they use the tubes, catheters and other invasive study materials, as these organisms are opportunistic in nature and clearly can worsen the prognosis and lead to complications in patients who have been hospitalized for various causes or diseases of low complexity, a longer hospital stay and increasing costs.