O comportamento da infecção humana pelo Trypanosoma cruzi quando vigente imunodeficiência ainda requer melhores esclarecimentos. Essa necessidade está ficando cada vez mais imperiosa porque a concomitância de doença de Chagas e afecções nas quais o distúrbio imunitário existe é atualmente mais comum e, também, em virtude do maior u s o a t u a l d e f á r m a c o s q u e o r i g i n a m a imunodepressão 2 9 10 . Além disso, a crescente realização de transplantes de órgãos, sendo preciso coibir rejeições, envolve hoje, em várias oportunidades, pacientes acometidos pela enfermidade referida, figurando eles como doadores ou receptores 6 8 11 . O número de relatos de investigações experimentais, sobre a atuação de corticóide, desenvolvidas nos modelos baseados em diferentes tipos de animais, representados sobretudo por camundongos, é razoável. A despeito de não haver unanimidade, as deduções indicam comumente aumentos da parasitemia, do parasitismo tecidual e da mortalidade, revelando também mudança do tropismo em relação aos órgãos que o T. cruzi infecta e atenuação do contingente inflamatório.Tais estudos focalizaram as fases aguda, pós-aguda imediata e crônica, tendo apontado, além do que já citamos, comportamentos diversos de cepas 1 3 5 12 13. Nessas pesquisas, diferentes modalidades de corticóide foram utilizadas, isoladamente ou em associação com compostos tripanossomicidas.No que concerne a pacientes com doença de Chagas, reativações vêm sendo comprovadas quando recebem coração por meio de transplante, corticóide fazendo parte da tática imunossupressora, ou em virtude da administração de certos fár macos para tratamento de leucemias, acrescentando-se a isso, hoje em dia, a participação da síndrome da imunodeficiência adquirida (AIDS)
This malformation can be monitored clinically; however, surgical excision is often performed, probably due to the impossibility of attaining diagnosis with non-invasive methods, such as in the present case, in which the lesion appeared in an unusual position for intra-abdominal extralobar pulmonary sequestration. Therefore, the surgical approach seems to be the key to attain the diagnosis and establish the conduct for this type of congenital malformation.
Objective:To describe an unusual clinical presentation of intra-abdominal extralobar pulmonary sequestration in a 2-year, 9 month-old patient and assess diagnostic and treatment aspects of this pathology.Case description:An undefined intra-abdominal mass was identified in the right adrenal region in a male fetus. Postnatal evaluation with ultrasound images, computed tomography, magnetic resonance imaging and laboratory testing was insufficient to determine the nature of the lesion. After two years, laparoscopic resection of the mass and histopathological examination of the surgical specimen allowed to establish the diagnosis of intra-abdominal extralobar pulmonary sequestration.Comments:This malformation can be monitored clinically; however, surgical excision is often performed, probably due to the impossibility of attaining diagnosis with non-invasive methods, such as in the present case, in which the lesion appeared in an unusual position for intra-abdominal extralobar pulmonary sequestration. Therefore, the surgical approach seems to be the key to attain the diagnosis and establish the conduct for this type of congenital malformation.
Pseudoangiomatous stromal hyperplasia (PASH) is a wellrecognized but poorly understood entity that was initially described in 1986. 1 It has two forms of presentation: as focal expression within the context of other breast lesions or, in rarer situations, as well-defined palpable tumors, with fibroelastic consistency, similar to fibroadenoma or to phyllodes tumors. 2 The tumoral form is infrequent, occurring mainly during the third and fourth decades of life. 3 Because of the rarity of PASH tumors and uncertainty about their clinical behavior, surgical excision has been the recommended treatment. 4 Recently, a series of 12 pediatric patients with PASH was reported, including a 3-year-old boy. PASH was found in 12% of tumors diagnosed preoperatively as fibroadenomas and in 12% of cases diagnosed preoperatively as gynecomastia. 5 The objective of this letter was to report on a case of PASH in a 9-month-old female patient who was referred due to rapid and painless tumor development in the right breast. On physical examination a well-defined nodule of hardened consistency, with little mobility, measuring 5.5 cm, was noted. The child's development to that point had been normal.Ultrasound indicated a peri-areolar hypoechogenic nodule, at 9 o'clock in the right breast, measuring 2.5 ¥ 1.0 cm. It had heterogeneous content and unclear borders, with no posterior shadowing.A core biopsy was performed under sedation and local anesthetic. On histology the presence of breast tissue was noted, with well-defined lesions formed by homogeneous fibrous tissue, without hemorrhagic areas or necrosis, with spaces of fissure type covered by flattened fusiform cells that resembled vascular channels, in both the inter and the intra-lobular stroma. Cell pleomorphism and karyokinetic activity were not observed (Fig. 1a). On immunohistochemistry, avidin-biotin-peroxidase staining was negative for factor VIII and desmin, and positive for CD34 (Fig. 1b) and vimentin (Fig. 1c).Because of the patient's age, it was decided to manage the case expectantly, without performing excision, in order not to alter the breast bud. Two years later, the patient remained asymptomatic. Clinical examination did not show any increase in tumor formation, but early thelarche was observed in the affected
Os autores apresentam dois casos de microlitíase alveolar pulmonar em gêmeos monozigóticos. Os principais achados obtidos em exames radiográficos e de tomografia computadorizada (técnica de alta resolução) são enfatizados, com base em breve revisão literária.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.