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Dados los antecedentes del paciente y los hallazgos radiológicos la primera sospecha diagnóstica es tuberculosis, orientándose inicialmente las pruebas y el tratamiento hacia un proceso infeccioso, sin mejoría clínica.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Se completa estudio mediante TAC apreciándose innumerables nódulos pulmonares, cuyo tamaño oscila entre un tamaño milimétrico y 3,2<span class="elsevierStyleHsp" style=""></span>cm, en su inmensa mayoría cavitados.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Múltiples adenopatías peribronquiales bilaterales y una masa ganglionar subcarinal de 3,9<span class="elsevierStyleHsp" style=""></span>cm, presentando también conglomerado adenopático en axila derecha.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Se biopsia la masa axilar con resultado de sarcoma indiferenciado de alto grado que presenta un alto porcentaje de necrosis (aproximadamente el 75%).</p><p id="par0030" class="elsevierStylePara elsevierViewall">El paciente recibe quimioterapia con doxorrubicina 25<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/día asociado a ifosfamida 3<span class="elsevierStyleHsp" style=""></span>g/m<span class="elsevierStyleSup">2</span>/día durante 3 días, con mala evolución desde el punto de vista respiratorio, produciéndose el fallecimiento a las 4 semanas del ingreso.</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" => 1252 "Ancho" => 1196 "Tamanyo" => 134447 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Rx de tórax: nódulos pulmonares bilaterales, la mayoría cavitados.</p>" ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000012/v1_201711290729/S0300289617301473/v1_201711290729/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/03002896/0000005300000012/v1_201711290729/S0300289617301473/v1_201711290729/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617301473?idApp=UINPBA00003Z" ]
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