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La línea blanca señala el trayecto teórico de la aguja de biopsia desde la pared torácica anterior hasta la masa mediastínica, atravesando la superficie pleural y el parénquima pulmonar izquierdo. B) Imagen axial de la TC de tórax en la que visualiza la creación de una pequeña colección de líquido (flechas) entre la pared torácica anterior y la masa mediastínica. C) Imagen axial de proyección de máxima intensidad de la TC de tórax en la que se observa la aguja de biopsia atravesando la colección de líquido (L) y alcanzando la masa mediastínica (M).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Nicolás Alejandro Almeida-Aróstegui, Paola Arrieta" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Nicolás Alejandro" "apellidos" => "Almeida-Aróstegui" ] 2 => array:2 [ "nombre" => "Paola" "apellidos" => "Arrieta" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212918301484" "doi" => "10.1016/j.arbr.2018.05.006" "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/S1579212918301484?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617304350?idApp=UINPBA00003Z" "url" => "/03002896/0000005400000007/v1_201807020415/S0300289617304350/v1_201807020415/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289617304209" "issn" => "03002896" "doi" => "10.1016/j.arbres.2017.10.023" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1773" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2018;54:386" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1078 "formatos" => array:3 [ "EPUB" => 126 "HTML" => 647 "PDF" => 305 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Secondary Organizing Pneumonia Mimicking Pulmonary Metastasis of a Diffuse Large Cell Lymphoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "386" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumonía organizada secundaria que imita metástasis pulmonares de un linfoma difuso de células grandes" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 880 "Ancho" => 1250 "Tamanyo" => 192387 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Diagnostic PET-CT; (B) reassessment PET-CT after treatment; (C) lung lesion histology revealing an organizing pneumonia (buds of granulation tissue in the distal air spaces and mid infiltrate of alveolar septa). 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Arrows indicate the cavitary lesions in the right upper, right lower, lingula and left lower lobes (from left to right).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 30-year-old male presented with a 6-month history of productive cough, dyspnea, hemoptysis, night sweats and 100-pound weight loss. Physical exam and initial blood work-up were non-revealing. CT scan of the chest revealed bilateral cavities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, first row). Differential diagnoses included malignancy, infections and inflammatory disorders. However, bacterial and mycobacterial stains and cultures were negative. Histoplasma and Blastomyces antigens, ANA, c-ANCA, p-ANCA and HIV serologies were also negative. Bronchoscopy revealed cystic lesions communicating with the airways. Bronchoalveolar fluid cultures were negative for bacteria and fungi. Transbronchial biopsies revealed noncaseating granulomas. Diagnosis of primary cavitary sarcoidosis was established and the patient started on prednisone and methotrexate. Sustained clinical improvement was noted only after six months of treatment. Lung cavitary lesions were noted to have significantly improved at 12 months (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, second row) and almost completely resolved at 21 months (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, third row). Primary cavitary sarcoidosis accounts for less than 0.6% of all sarcoidosis cases.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Lower lobe predominance of the lung cavities, absence of other radiographic abnormalities such as nodularity, lymphadenopathy and calcification, and the presence of severe constitutional symptoms, set our case apart from previously published reports of primary cavitary sarcoidosis.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Previous Presentation: This case was previously presented by the authors at the annual CHEST conference, Los Angles, 2016.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 971 "Ancho" => 1733 "Tamanyo" => 303911 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT scan images showing four representative sections at presentation (first row), 12 months (second row) and 21 months (third row). Arrows indicate the cavitary lesions in the right upper, right lower, lingula and left lower lobes (from left to right).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiographic features of primary cavitary sarcoidosis with “lotus seed-like” manifestations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Okada" 1 => "Y. Ando" 2 => "K. Sugisaki" 3 => "S. Takikawa" 4 => "A. Ono" 5 => "S. Matsumoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.crad.2011.11.007" "Revista" => array:6 [ "tituloSerie" => "Clin Radiol" "fecha" => "2012" "volumen" => "67" "paginaInicial" => "505" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22212636" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary cavitary sarcoidosis: clinico-radiologic characteristics and natural history of a rare form of sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Hours" 1 => "H. Nunes" 2 => "M. Kambouchner" 3 => "Y. Uzunhan" 4 => "M.W. Brauner" 5 => "D. Valeyre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0b013e3181775a73" "Revista" => array:5 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2008" "volumen" => "87" "paginaInicial" => "142" "paginaFinal" => "151" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005400000007/v1_201807020415/S0300289617304295/v1_201807020415/en/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/03002896/0000005400000007/v1_201807020415/S0300289617304295/v1_201807020415/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617304295?idApp=UINPBA00003Z" ]
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