Carta al Director
Lesiones endobronquiales extensas en un paciente con sarcoidosis en estadio 0
Extensive Endobronchial Lesions in a Patient With Stage 0 Sarcoidosis
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(F) Non-caseating epithelioid cell granulomas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alban Lovis, Leslie Noirez, Igor Letovanec, Alexandre Walker" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Alban" "apellidos" => "Lovis" ] 1 => array:2 [ "nombre" => "Leslie" "apellidos" => "Noirez" ] 2 => array:2 [ "nombre" => "Igor" "apellidos" => "Letovanec" ] 3 => array:2 [ "nombre" => "Alexandre" "apellidos" => "Walker" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289614001847" "doi" => "10.1016/j.arbres.2014.03.021" "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/S0300289614001847?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001391?idApp=UINPBA00003Z" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001391/v1_201506250123/en/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S0300289614001707" "issn" => "03002896" "doi" => "10.1016/j.arbres.2014.04.004" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "966" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:366-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2937 "formatos" => array:3 [ "EPUB" => 95 "HTML" => 2239 "PDF" => 603 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Perforación yeyunal por metástasis de mesotelioma pleural maligno" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "367" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Jejunal Perforation by Metastasis of Malignant Pleural Mesothelioma" ] ] "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" => 610 "Ancho" => 1350 "Tamanyo" => 122802 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">TC abdominal: engrosamiento mural de un segmento de intestino delgado (yeyuno), cambios inflamatorios y burbujas de aire extraluminales adyacentes.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Inmaculada Navarro García, Ainhoa Sánchez Pérez, 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"<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Lesiones endobronquiales extensas en un paciente con sarcoidosis en estadio 0" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Sr. Director:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "367" "paginaFinal" => "368" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alban Lovis, Leslie Noirez, Igor Letovanec, Alexandre Walker" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Alban" "apellidos" => "Lovis" "email" => array:1 [ 0 => "alban.lovis@chuv.ch" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Leslie" "apellidos" => "Noirez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Igor" "apellidos" => "Letovanec" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Alexandre" "apellidos" => "Walker" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Respiratory Medicine, University Hospital of Lausanne, Lausana, Suiza" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, Lausanne University Hospital, Lausana, Suiza" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Lungen- und Schlafzentrum, Lindenhofspital, Bremgartenstrasse, Berna, Suiza" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Extensive Endobronchial Lesions in a Patient With Stage 0 Sarcoidosis" ] ] "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" => 2612 "Ancho" => 1638 "Tamanyo" => 511156 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: La función pulmonar mostró una obstrucción leve. B: La TC de tórax mostró principalmente bronquiectasias en el lóbulo inferior izquierdo. C-E: La broncoscopia reveló la presencia de lesiones granulosas minúsculas diseminadas, que se extendían de la parte superior de la tráquea a los bronquios segmentarios y subsegmentarios bilaterales, con una distribución circular en todas las partes membranosas y cartilaginosas de las vías aéreas. F: Granulomas de células epitelioides no caseosos.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Presentamos el caso de un varón caucásico de 61<span class="elsevierStyleHsp" style=""></span>años de edad con disnea de grado<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">ii</span> de la NYHA y tos no productiva durante varios meses. Era exfumador (20 paquetes-años, con interrupción durante 20<span class="elsevierStyleHsp" style=""></span>años). La función pulmonar mostró (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A)una obstrucción leve (volumen espiratorio forzado en un segundo [FEV<span class="elsevierStyleInf">1</span>] 2,43<span class="elsevierStyleHsp" style=""></span>l, 74% del valor predicho [VP], índice de Tiffeneau 61%, volumen residual [RV] 2,29<span class="elsevierStyleHsp" style=""></span>l, 94% del VP, capacidad pulmonar total [TLC] 6,2<span class="elsevierStyleHsp" style=""></span>l, 89% del VP, RV/TLC 37%) y una reducción leve del intercambio gaseoso (DLCO 53% del VP, KCO 75% del VP, volumen alveolar 4,94<span class="elsevierStyleHsp" style=""></span>l, 71% del VP). La radiografía de tórax era normal (estadio<span class="elsevierStyleHsp" style=""></span>0) y la TC de tórax (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B) mostró principalmente bronquiectasias en el lóbulo inferior izquierdo, sin adenopatías mediastínicas ni hiliares. La broncoscopia (<a class="elsevierStyleCrossRef" href="#fig0005">figs. 1</a>C-E) reveló la presencia de lesiones granulosas minúsculas diseminadas, que se extendían de la parte superior de la tráquea a los bronquios segmentarios y subsegmentarios bilaterales, con una distribución circular en todas las partes membranosas y cartilaginosas de las vías aéreas. El lavado broncoalveolar reveló la presencia de linfocitosis en un 45% con elevación del cociente CD4/CD8 a 4,5, y la biopsia bronquial (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>F) identificó granulomas de células epitelioides no caseosos. Los resultados de las tinciones y cultivos de microorganismos acidorresistentes y hongos fueron negativos. La sarcoidosis endoluminal extensa sin afectación ganglionar y con una afectación parenquimatosa tan solo de carácter menor es una forma de presentación muy poco frecuente<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. El tratamiento de la enfermedad endoluminal diseminada constituye un verdadero reto y tiene como objetivo evitar una obstrucción fija. Se introdujeron corticosteroides inhalados y broncodilatadores con un seguimiento clínico funcional y endoscópico.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicto de intereses</span><p id="par0010" class="elsevierStylePara elsevierViewall">Ninguno de los autores tiene conflicto de intereses en relación con el presente manuscrito.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicto de intereses" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2612 "Ancho" => 1638 "Tamanyo" => 511156 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: La función pulmonar mostró una obstrucción leve. B: La TC de tórax mostró principalmente bronquiectasias en el lóbulo inferior izquierdo. C-E: La broncoscopia reveló la presencia de lesiones granulosas minúsculas diseminadas, que se extendían de la parte superior de la tráquea a los bronquios segmentarios y subsegmentarios bilaterales, con una distribución circular en todas las partes membranosas y cartilaginosas de las vías aéreas. F: Granulomas de células epitelioides no caseosos.</p>" ] ] ] "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" => "Airway involvement in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.S. Polychronopoulos" 1 => "U.B. Prakash" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.08-2569" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2009" "volumen" => "136" "paginaInicial" => "1371" "paginaFinal" => "1380" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19892676" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopy in sarcoidosis: Diagnostic and therapeutic interventions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.T. Chapman" 1 => "A.C. Mehta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Opin Pulm Med" "fecha" => "2003" "volumen" => "9" "paginaInicial" => "402" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12904711" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005100000007/v2_201506280052/S0300289614001847/v2_201506280052/es/main.assets" "Apartado" => array:4 [ "identificador" => "9222" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the Director / Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005100000007/v2_201506280052/S0300289614001847/v2_201506280052/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614001847?idApp=UINPBA00003Z" ]
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