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Carcinoma broncogénico en paciente con linfangioleiomiomatosis
Lung cancer in a patient with lymphangioleiomyomatosis
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B) Imagen axial de la TC de tórax (ventana de parénquima pulmonar), en la que se identifican múltiples lesiones quísticas pulmonares de paredes finas distribuidas de forma difusa por ambos pulmones. C) Imagen axial de la TC de abdomen, en la que se aprecian múltiples tumores renales sólidos bilaterales de atenuación grasa (asteriscos) compatibles con angiomiolipomas.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Presentamos el caso, muy infrecuente, de una mujer de 47 años exfumadora (con un índice acumulado de 10 paquetes/año), que consultó por hemoptisis. Entre sus antecedentes destacaba una forma esporádica de linfangioleiomiomatosis (LLM) diagnosticada en su infancia a raíz de un angiomiolipoma (AML) renal sangrado. Una radiografía de tórax demostró una opacidad paramediastínica en el lóbulo superior derecho. En una tomografía computarizada (TC) de tórax se confirmó una lesión tumoral que englobaba el bronquio principal derecho e infiltraba la carina traqueal y el mediastino (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A), así como múltiples quistes pulmonares de paredes finas bien definidas (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B). En abdomen superior se visualizaban múltiples angiomiolipomas (AML) renales (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>C). Una biopsia bronquial confirmó un adenocarcinoma. La paciente está siendo tratada con quimioterapia, con respuesta parcial al tratamiento.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La LLM es una rara enfermedad sistémica, descrita casi exclusivamente en mujeres en edad fértil, caracterizada por una proliferación intersticial de músculo liso que afecta especialmente al pulmón. El hallazgo radiológico habitual de esta enfermedad es la presencia de múltiples lesiones quísticas distribuidas de forma difusa por ambos pulmones. Entre las neoplasias pulmonares asociadas a la LLM se han descrito algunos casos aislados de AML pulmonares, de hiperplasia micronodular neumocitaria multifocal y de tumores de células claras (tumor «de azúcar»), pero solo se han publicado 2 casos de carcinoma broncogénico en la literatura científica<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</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" => 544 "Ancho" => 1959 "Tamanyo" => 136011 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Imagen axial de la TC de tórax (ventana de mediastino), en la que se observa una masa central que engloba el bronquio principal derecho y la carina traqueal (asterisco). B) Imagen axial de la TC de tórax (ventana de parénquima pulmonar), en la que se identifican múltiples lesiones quísticas pulmonares de paredes finas distribuidas de forma difusa por ambos pulmones. C) Imagen axial de la TC de abdomen, en la que se aprecian múltiples tumores renales sólidos bilaterales de atenuación grasa (asteriscos) compatibles con angiomiolipomas.</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" => "Broncheoalveolar carcinoma associated with pulmonary lymphangioleiomyomatosis and Tuberous Sclerosis Complex: Case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Carneiro" 1 => "N. Gupta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinimag.2010.04.003" "Revista" => array:6 [ "tituloSerie" => "Clin Imaging" "fecha" => "2011" "volumen" => "35" "paginaInicial" => "225" "paginaFinal" => "227" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21513862" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary lymphangioleiomyomatosis and bronchiolo-alveolar carcinoma. Apropos of a case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Casola" 1 => "T. Caulet" 2 => "M. Pluot" 3 => "D. Grimbert" 4 => "O. Ferrand" 5 => "J. Baehrel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Anat Cytol Pathol" "fecha" => "1983" "volumen" => "31" "paginaInicial" => "237" "paginaFinal" => "240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6314915" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000006/v2_201707150129/S030028961630326X/v2_201707150129/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/03002896/0000005300000006/v2_201707150129/S030028961630326X/v2_201707150129/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961630326X?idApp=UINPBA00003Z" ]
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