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Ilustramos la dificultad en el diagnóstico y tratamiento del sarcoma pulmonar
An example of difficulty in diagnosising and treating lung sarcoma
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B) Imagen axial de TC de tórax (ventana de parénquima pulmonar) en la que se observan áreas de atenuación en vidrio deslustrado y un engrosamiento del intersticio en el parénquima pulmonar herniado, compatibles con zonas de congestión venosa y edema.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Ana María Ayala Carbonero, María Ángeles Fernández Méndez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Ana María" "apellidos" => "Ayala Carbonero" ] 2 => array:2 [ "nombre" => "María Ángeles" "apellidos" => "Fernández Méndez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916300301" "doi" => "10.1016/j.arbr.2016.03.024" "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/S1579212916300301?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961500112X?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000006/v1_201605260144/S030028961500112X/v1_201605260144/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289615001027" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.02.013" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1153" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2016;52:329-30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4113 "formatos" => array:3 [ "EPUB" => 103 "HTML" => 3371 "PDF" => 639 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Resolución de los linfangioleiomiomas torácicos y abdominales en una paciente con linfangioleiomiomatosis tratada con sirolimus" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "329" "paginaFinal" => "330" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Resolution of Thoracic and Abdominal Lymphangioleiomyomas in a Patient With Lymphangioleiomyomatosis Treated With Sirolimus" ] ] "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" => 1039 "Ancho" => 1500 "Tamanyo" => 188209 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tomografía axial computarizada (TAC) torácica (A) donde se observa una lesión quística paravertebral derecha de 3,2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1,9<span class="elsevierStyleHsp" style=""></span>cm, compatible con un linfangioleiomioma retrocrural. 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B) Tomografía por emisión de positrones; masa inferior izquierda con aumento acusado del metabolismo glicídico que contacta con pleura posterior, espacio paravertebral y cisura mayor.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 59 años con importante historia de tabaquismo que consulta por tos. En la radiografía de tórax se observa una masa pulmonar de 4 centímetros en hemitórax izquierdo. Se completa el estudio con tomografía por emisión de positrones que confirma captación a ese nivel y descarta afectación secundaria (cT2cN0) (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>); con broncoscopia que es normal y con punción con aguja fina guiada por TAC. La anatomía patológica es sugestiva de carcinoma no microcítico de pulmón. Con estos datos se planifica la cirugía realizándose una neumonectomía izquierda y linfadenectomía hilio-mediastínica. La histología definitiva muestra un carcinoma sarcomatoide pleomórfico con áreas de diferenciación escamosa.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">El sarcoma pulmonar es una neoplasia infrecuente (0,5-1%) y difícil de diagnosticar ya que guarda ciertas similitudes con el carcinoma de pulmón aunque presenta una evolución más tórpida<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. Un problema añadido es la dificultad de llevar a cabo un diagnóstico sobre una muestra de biopsia dada la heterogeneidad tumoral, ya que en muchas ocasiones se diagnostican erróneamente como carcinomas escamosos, hecho que hace que la planificación del tratamiento no siempre sea la más correcta<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>.</p></span>" "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" => 679 "Ancho" => 1501 "Tamanyo" => 90902 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Radiografía de tórax: masa paracardiaca izquierda. B) Tomografía por emisión de positrones; masa inferior izquierda con aumento acusado del metabolismo glicídico que contacta con pleura posterior, espacio paravertebral y cisura mayor.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Synovial sarcoma: A clinicopathologic, staging, and prognostic assessment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.J. Spillane" 1 => "R. A’Hern" 2 => "I.R. Judson" 3 => "C. Fisher" 4 => "J.M. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.2000.18.22.3794" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2000" "volumen" => "18" "paginaInicial" => "3794" "paginaFinal" => "3803" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11078492" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: A study of the French Sarcoma Group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Italiano" 1 => "N. Penel" 2 => "Y.M. Robin" 3 => "B. Bui" 4 => "A. Le Cesne" 5 => "S. Piperno-Neumann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mdn678" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2009" "volumen" => "20" "paginaInicial" => "425" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19088169" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000006/v1_201605260144/S0300289615001052/v1_201605260144/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000006/v1_201605260144/S0300289615001052/v1_201605260144/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001052?idApp=UINPBA00003Z" ]
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