Imagen clínica
Tormenta de nieve en el lavado broncoalveolar
Snow Storm in the Bronchoalveolar Lavage
Víctor Curull, Roberto Chalela
, Albert Sánchez-Font
Corresponding author
Servei de Pneumologia, Hospital del Mar-IMIM, UAB-UPF, CIBERES, Barcelona, España
Read
9521
Timeswas read the article
2024
Total PDF
7497
Total HTML
Share statistics
array:24 [ "pii" => "S0300289613003037" "issn" => "03002896" "doi" => "10.1016/j.arbres.2013.09.012" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "841" "copyright" => "SEPAR" "copyrightAnyo" => "2013" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2014;50:305" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4193 "formatos" => array:3 [ "EPUB" => 100 "HTML" => 3351 "PDF" => 742 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S1579212914001414" "issn" => "15792129" "doi" => "10.1016/j.arbr.2014.05.005" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "841" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2014;50:305" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2132 "formatos" => array:3 [ "EPUB" => 124 "HTML" => 1498 "PDF" => 510 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Snow Storm in the Bronchoalveolar Lavage" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "305" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tormenta de nieve en el lavado broncoalveolar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Víctor Curull, Roberto Chalela, Albert Sánchez-Font" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Víctor" "apellidos" => "Curull" ] 1 => array:2 [ "nombre" => "Roberto" "apellidos" => "Chalela" ] 2 => array:2 [ "nombre" => "Albert" "apellidos" => "Sánchez-Font" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289613003037" "doi" => "10.1016/j.arbres.2013.09.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613003037?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001414?idApp=UINPBA00003Z" "url" => "/15792129/0000005000000007/v1_201406290026/S1579212914001414/v1_201406290026/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0300289613003104" "issn" => "03002896" "doi" => "10.1016/j.arbres.2013.10.004" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "848" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2014;50:306-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6337 "formatos" => array:3 [ "EPUB" => 115 "HTML" => 5640 "PDF" => 582 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Compresión traqueal secundaria a una luxación esternoclavicular posterior" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "307" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Tracheal Compression Secondary to Posterior Sternoclavicular Dislocation" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 541 "Ancho" => 1300 "Tamanyo" => 94895 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Corte axial y sagital de tomografía computarizada que demuestra el desplazamiento posterior de la cabeza clavicular con compresión traqueal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro M. Rodríguez Suárez, Mohamed Hussein Serhal, Jorge L. Freixinet Gilart" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Pedro M." "apellidos" => "Rodríguez Suárez" ] 1 => array:2 [ "nombre" => "Mohamed" "apellidos" => "Hussein Serhal" ] 2 => array:2 [ "nombre" => "Jorge L." "apellidos" => "Freixinet Gilart" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212914001463" "doi" => "10.1016/j.arbr.2014.05.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001463?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613003104?idApp=UINPBA00003Z" "url" => "/03002896/0000005000000007/v1_201406200113/S0300289613003104/v1_201406200113/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289613002834" "issn" => "03002896" "doi" => "10.1016/j.arbres.2013.08.006" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "837" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2014;50:301-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6262 "formatos" => array:3 [ "EPUB" => 130 "HTML" => 5054 "PDF" => 1078 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nota clínica</span>" "titulo" => "Malformaciones arteriovenosas pulmonares y complicaciones embólicas en pacientes con telangiectasia hemorrágica hereditaria" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "301" "paginaFinal" => "304" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pulmonary Arteriovenous Malformations and Embolic Complications in Patients With Hereditary Hemorrhagic Telangiectasia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Federico Angriman, Bruno L. Ferreyro, Esteban J. Wainstein, Marcelo M. Serra" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Federico" "apellidos" => "Angriman" ] 1 => array:2 [ "nombre" => "Bruno L." "apellidos" => "Ferreyro" ] 2 => array:2 [ "nombre" => "Esteban J." "apellidos" => "Wainstein" ] 3 => array:2 [ "nombre" => "Marcelo M." "apellidos" => "Serra" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212914001451" "doi" => "10.1016/j.arbr.2014.05.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001451?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613002834?idApp=UINPBA00003Z" "url" => "/03002896/0000005000000007/v1_201406200113/S0300289613002834/v1_201406200113/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Tormenta de nieve en el lavado broncoalveolar" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "305" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Víctor Curull, Roberto Chalela, Albert Sánchez-Font" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Víctor" "apellidos" => "Curull" ] 1 => array:4 [ "nombre" => "Roberto" "apellidos" => "Chalela" "email" => array:1 [ 0 => "rchalela@parcdesalutmar.cat" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Albert" "apellidos" => "Sánchez-Font" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servei de Pneumologia, Hospital del Mar-IMIM, UAB-UPF, CIBERES, Barcelona, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Snow Storm in the Bronchoalveolar Lavage" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Un varón de 72<span class="elsevierStyleHsp" style=""></span>años presentó un cuadro de disnea de inicio subagudo e hipoxemia. Era fumador y sus antecedentes patológicos eran anodinos. La radiografía de tórax mostró un patrón difuso en el pulmón derecho, y la tomografía computarizada de tórax evidenció un patrón de pavimentación irregular (<span class="elsevierStyleItalic">crazy paving</span> o «pavimento loco») en el pulmón derecho y opacidades en vidrio esmerilado en el lóbulo inferior izquierdo. Se indicó una broncoscopia flexible bajo sedación consciente. No se observaron signos endobronquiales macroscópicos. Se realizó un lavado broncoalveolar (LBA) y se obtuvieron también biopsias transbronquiales del lóbulo superior derecho. Al aspirar el líquido de LBA se observó una gran cantidad de partículas blanquecinas, con un aspecto de tormenta de nieve (véase el vídeo [<a class="elsevierStyleCrossRef" href="#sec0010">anexo</a>]). Que nosotros sepamos, esta observación en relación con el LBA no se ha descrito anteriormente<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. El análisis citológico de la muestra de LBA reveló la presencia de grupos de células tumorales con atipia nuclear moderada. La biopsia transbronquial mostró espacios alveolares recubiertos de adenocarcinoma que presentaban un patrón predominantemente lepídico. Generalmente, el aspecto endoscópico del líquido de LBA obtenido es un flujo transparente sin partículas en suspensión, como se observó en este caso. La imagen de «tormenta de nieve» puede haber sido causada por la enorme cantidad de células tumorales obtenidas con el líquido de LBA.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0020" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Anexo A" "titulo" => "Material suplementario" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 31404351 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoalveolar lavage in malignancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Poletti" 1 => "G. Poletti" 2 => "L. Saragoni" 3 => "M. Chilosi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Semin Resp Crit Care Med" "fecha" => "2007" "volumen" => "28" "paginaInicial" => "534" "paginaFinal" => "545" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopy for the diagnosis and staging of lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. el-Bayoumi" 1 => "G.A. Silvestri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2008-1076746" "Revista" => array:6 [ "tituloSerie" => "Semin Respir Crit Care Med" "fecha" => "2008" "volumen" => "29" "paginaInicial" => "261" "paginaFinal" => "270" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18506664" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005000000007/v1_201406200113/S0300289613003037/v1_201406200113/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005000000007/v1_201406200113/S0300289613003037/v1_201406200113/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613003037?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 1 | 9 |
| 2024 October | 202 | 18 | 220 |
| 2024 September | 116 | 12 | 128 |
| 2024 August | 108 | 32 | 140 |
| 2024 July | 77 | 26 | 103 |
| 2024 June | 127 | 21 | 148 |
| 2024 May | 105 | 34 | 139 |
| 2024 April | 98 | 19 | 117 |
| 2024 March | 89 | 25 | 114 |
| 2024 February | 53 | 35 | 88 |
| 2023 March | 16 | 2 | 18 |
| 2023 February | 141 | 20 | 161 |
| 2023 January | 80 | 22 | 102 |
| 2022 December | 81 | 27 | 108 |
| 2022 November | 111 | 21 | 132 |
| 2022 October | 95 | 33 | 128 |
| 2022 September | 101 | 25 | 126 |
| 2022 August | 88 | 42 | 130 |
| 2022 July | 53 | 38 | 91 |
| 2022 June | 60 | 32 | 92 |
| 2022 May | 101 | 30 | 131 |
| 2022 April | 77 | 37 | 114 |
| 2022 March | 63 | 47 | 110 |
| 2022 February | 75 | 28 | 103 |
| 2022 January | 81 | 24 | 105 |
| 2021 December | 76 | 39 | 115 |
| 2021 November | 64 | 43 | 107 |
| 2021 October | 107 | 37 | 144 |
| 2021 September | 89 | 57 | 146 |
| 2021 August | 90 | 31 | 121 |
| 2021 July | 56 | 26 | 82 |
| 2021 June | 75 | 47 | 122 |
| 2021 May | 62 | 31 | 93 |
| 2021 April | 169 | 64 | 233 |
| 2021 March | 104 | 21 | 125 |
| 2021 February | 80 | 29 | 109 |
| 2021 January | 68 | 22 | 90 |
| 2020 December | 67 | 24 | 91 |
| 2020 November | 61 | 14 | 75 |
| 2020 October | 100 | 18 | 118 |
| 2020 September | 134 | 13 | 147 |
| 2020 August | 130 | 22 | 152 |
| 2020 July | 90 | 21 | 111 |
| 2020 June | 87 | 6 | 93 |
| 2020 May | 86 | 20 | 106 |
| 2020 April | 63 | 20 | 83 |
| 2020 March | 64 | 19 | 83 |
| 2020 February | 42 | 17 | 59 |
| 2020 January | 76 | 17 | 93 |
| 2019 December | 75 | 12 | 87 |
| 2019 November | 72 | 14 | 86 |
| 2019 October | 59 | 11 | 70 |
| 2019 September | 72 | 20 | 92 |
| 2019 August | 54 | 15 | 69 |
| 2019 July | 43 | 23 | 66 |
| 2019 June | 47 | 12 | 59 |
| 2019 May | 62 | 18 | 80 |
| 2019 April | 79 | 48 | 127 |
| 2019 March | 43 | 19 | 62 |
| 2019 February | 46 | 20 | 66 |
| 2019 January | 59 | 32 | 91 |
| 2018 December | 51 | 20 | 71 |
| 2018 November | 61 | 20 | 81 |
| 2018 October | 101 | 25 | 126 |
| 2018 September | 46 | 14 | 60 |
| 2018 August | 2 | 0 | 2 |
| 2018 July | 4 | 0 | 4 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 54 | 2 | 56 |
| 2018 April | 63 | 5 | 68 |
| 2018 March | 77 | 4 | 81 |
| 2018 February | 59 | 7 | 66 |
| 2018 January | 119 | 8 | 127 |
| 2017 December | 90 | 7 | 97 |
| 2017 November | 38 | 8 | 46 |
| 2017 October | 34 | 8 | 42 |
| 2017 September | 29 | 16 | 45 |
| 2017 August | 44 | 13 | 57 |
| 2017 July | 32 | 18 | 50 |
| 2017 June | 40 | 26 | 66 |
| 2017 May | 40 | 22 | 62 |
| 2017 April | 41 | 12 | 53 |
| 2017 March | 32 | 19 | 51 |
| 2017 February | 23 | 4 | 27 |
| 2017 January | 21 | 7 | 28 |
| 2016 December | 31 | 12 | 43 |
| 2016 November | 43 | 18 | 61 |
| 2016 October | 72 | 21 | 93 |
| 2016 September | 34 | 18 | 52 |
| 2016 August | 42 | 15 | 57 |
| 2016 July | 39 | 11 | 50 |
| 2016 June | 37 | 20 | 57 |
| 2016 May | 46 | 23 | 69 |
| 2016 April | 18 | 6 | 24 |
| 2016 March | 14 | 3 | 17 |
| 2016 February | 20 | 4 | 24 |
| 2016 January | 47 | 16 | 63 |
| 2015 December | 51 | 18 | 69 |
| 2015 November | 53 | 15 | 68 |
| 2015 October | 78 | 6 | 84 |
| 2015 September | 52 | 0 | 52 |
| 2015 August | 87 | 0 | 87 |
| 2015 July | 61 | 0 | 61 |
| 2015 June | 52 | 0 | 52 |
| 2015 May | 60 | 0 | 60 |
| 2015 April | 52 | 0 | 52 |
| 2015 March | 57 | 0 | 57 |
| 2015 February | 43 | 0 | 43 |
| 2015 January | 51 | 0 | 51 |
| 2014 December | 62 | 0 | 62 |
| 2014 November | 59 | 0 | 59 |
| 2014 October | 88 | 0 | 88 |
| 2014 September | 12 | 0 | 12 |
| 2014 August | 21 | 0 | 21 |
| 2014 July | 55 | 0 | 55 |
Show all
