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Micosis fungoide con localización pulmonar detectada con 18F-FDG PET/TC
Mycosis Fungoides Involving the Lungs Detected by 18F-FDG PET/CT
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"nombre" => "Giorgio" "apellidos" => "Treglia" "email" => array:1 [ 0 => "giorgio.treglia@eoc.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" => "Jessica" "apellidos" => "Barizzi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Luca" "apellidos" => "Giovanella" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Medicina Nuclear y Centro PET/TC, Instituto Oncológico de Baja Suiza, Bellinzona, Suiza" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Patología del Cantón Ticino, Locarno, Suiza" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mycosis Fungoides Involving the Lungs Detected by <span class="elsevierStyleSup">18</span>F-FDG PET/CT" ] ] "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" => 1125 "Ancho" => 1633 "Tamanyo" => 387009 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La imagen de cuerpo entero con proyección de máxima intensidad (MIP) mediante <span class="elsevierStyleSup">18</span>F-FDG PET (A) y las imágenes axiales PET/TC fusionadas (B, C) mostraron zonas con aumento del valor de captación de <span class="elsevierStyleSup">18</span>F-FDG correspondientes a nódulos pulmonares bilaterales (flechas). El análisis histológico de uno de los nódulos pulmonares demostró la presencia de infiltración intersticial de elementos linfoides de tamaño pequeño-mediano con citoplasma claro (D). En el análisis inmunohistoquímico, las células tumorales expresaron CD3 (E) y CD4 (F). El diagnóstico definitivo fue de micosis fungoide con afectación pulmonar.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Se realizó una tomografía por emisión de positrones/axial computarizada (PET/TAC) con F<span class="elsevierStyleSup">18</span>-fluorodeoxiglucosa <span class="elsevierStyleBold">(</span><span class="elsevierStyleSup">18</span>F-FDG PET/TC) a un varón de 72 años con antecedentes de micosis fungoide con afectación cutánea, en remisión clínica postratamiento, para realizar de nuevo la estadificación tras la reciente detección de nódulos pulmonares en una TC. Las imágenes de PET/TC mostraron múltiples zonas de aumento del valor de captación del radiofármaco correspondientes a varios nódulos pulmonares bilaterales (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A-C).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">En consecuencia, se realizó la biopsia de uno de los nódulos pulmonares del paciente. El análisis histológico demostró la presencia de infiltración intersticial de elementos linfoides de tamaño pequeño-mediano con citoplasma claro. En el análisis inmunohistoquímico, las células tumorales expresaron CD3 y CD4 (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>D-F).</p><p id="par0015" class="elsevierStylePara elsevierViewall">A partir de estos hallazgos, el diagnóstico definitivo fue de micosis fungoide (MF) con afectación pulmonar y se remitió el paciente a quimioterapia.</p><p id="par0020" class="elsevierStylePara elsevierViewall">La MF es una enfermedad linfoproliferativa rara, pero es la forma más habitual de linfomas cutáneos primarios de linfocitos T. Se distingue por una evolución característica a largo plazo y por la proliferación de linfocitos T malignos. Diagnosticar MF no es sencillo, sobre todo por el cuadro clínico atípico en fase temprana. La MF con afectación visceral es muy poco habitual<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">En nuestro caso, la <span class="elsevierStyleSup">18</span>F-FDG PET/TC ha sido muy útil a la hora de restablecer la estadificación en un caso poco habitual de MF con afectación pulmonar.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicto de intereses</span><p id="par0030" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen conflicto de intereses alguno que manifestar.</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" => 1125 "Ancho" => 1633 "Tamanyo" => 387009 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La imagen de cuerpo entero con proyección de máxima intensidad (MIP) mediante <span class="elsevierStyleSup">18</span>F-FDG PET (A) y las imágenes axiales PET/TC fusionadas (B, C) mostraron zonas con aumento del valor de captación de <span class="elsevierStyleSup">18</span>F-FDG correspondientes a nódulos pulmonares bilaterales (flechas). El análisis histológico de uno de los nódulos pulmonares demostró la presencia de infiltración intersticial de elementos linfoides de tamaño pequeño-mediano con citoplasma claro (D). En el análisis inmunohistoquímico, las células tumorales expresaron CD3 (E) y CD4 (F). El diagnóstico definitivo fue de micosis fungoide con afectación pulmonar.</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" => "Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): Part I. Diagnosis: Clinical and histopathologic features and new molecular and biologic markers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.I. Jawed" 1 => "P.L. Myskowski" 2 => "S. Horwitz" 3 => "A. Moskowitz" 4 => "C. Querfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.10.050" "Revista" => array:4 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2014" "volumen" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24438953" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): Part II. Prognosis, management, and future directions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.I. Jawed" 1 => "P.L. Myskowski" 2 => "S. Horwitz" 3 => "A. Moskowitz" 4 => "C. Querfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.10.050" "Revista" => array:4 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2014" "volumen" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24438953" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005100000010/v1_201509302001/S0300289614004499/v1_201509302001/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/03002896/0000005100000010/v1_201509302001/S0300289614004499/v1_201509302001/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614004499?idApp=UINPBA00003Z" ]
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