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Obstrucción traqueobronquial secundaria a linfoma mediastínico primario
Tracheobronchial obstruction caused by primary mediastinal lymphoma
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En la TAC torácica se observa una masa en el segmento anterior del LSD, que invade el mediastino, rodeando la bifurcación traqueal, con signos de invasión traqueal del bronquio principal derecho y de la vena cava superior. Pese a la resección por fibrobroncoscopia de la tumoración mamelonada que obstruía el 50% de la luz traqueal, no se llegó a un diagnóstico hasta realizar una biopsia mediastínica por VATS, que permitió confirmar el diagnóstico de linfoma no Hodgkin de célula grande B primario mediastínico. Tras finalizar 6 ciclos de quimioterapia con rituximab, ciclofosfamida, doxorrubicina, vincristina, etopósido y prednisona (R-CHOEP), en la PET-TAC con <span class="elsevierStyleSup">18</span>FDG se aprecia una respuesta radiológica y metabólica completa, encontrándose en completa remisión.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">El linfoma B primario mediastínico es un linfoma B de células grandes, originado en el timo, afecta fundamentalmente a adultos jóvenes y constituye el 2-3% de los linfomas no Hodgkin del adulto. La forma de presentación clínica más frecuente son los síntomas derivados de la compresión de estructuras mediastínicas (síndrome de vena cava superior, parálisis del nervio frénico, disfagia, disfonía o tos), siendo la afectación endobronquial excepcional.</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" => 750 "Ancho" => 900 "Tamanyo" => 107058 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Obstrucción traqueobronquial secundaria a linfoma mediastínico primario.</p>" ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Agradecimientos" "texto" => "<p id="par0015" class="elsevierStylePara elsevierViewall">Nuestros agradecimientos a los Servicios de Neumología, Cirugía Torácica, Anatomía Patológica y Medicina Nuclear del Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000004/v1_201704070048/S0300289616302381/v1_201704070048/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/03002896/0000005300000004/v1_201704070048/S0300289616302381/v1_201704070048/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302381?idApp=UINPBA00003Z" ]
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