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Tratamiento endoscópico de neurofibroma traqueal
Endoscopic Management of Tracheal Neurofibroma
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B: proliferación de células fusiformes, de núcleos en cigarro y citoplasmas elongados, por debajo del epitelio bronquial, H-E ×20. C: positividad para S100 en dichas células, ×40.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paciente de 24 años con hallazgo de tumoración traqueal en estudio de probable asma por Neumología. Diagnosticado de neurofibromatosis tipo 1 en la infancia.</p><p id="par0010" class="elsevierStylePara elsevierViewall">En el estudio de disnea progresiva de 12 meses de evolución se descubrió una alteración del luminograma traqueal en la radiografía de tórax y un aplanamiento de las curvas F/V. En la broncoscopia se halló una tumoración sésil traqueal a 5<span class="elsevierStyleHsp" style=""></span>cm de las cuerdas vocales, con una obstrucción del 90% de la luz.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Con anestesia general y broncoscopia rígida se realizó la exéresis de la tumoración traqueal mediante resección mecánica y coagulación con láser Nd-YAG (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio anatomopatológico reveló tejido mixoide con células fusiformes, núcleos en cigarro y citoplasmas elongados. En el estudio inmunohistoquímico se comprobó la fuerte manifestación de proteína S100. El diagnóstico fue de neurofibroma endotraqueal (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B y C).</p><p id="par0025" class="elsevierStylePara elsevierViewall">El paciente se encuentra asintomático y libre de recidiva 14 meses después de la intervención.</p><p id="par0030" class="elsevierStylePara elsevierViewall">El tratamiento broncoscópico de tumores neurogénicos se reportó por primera vez en 1983<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. El tratamiento endoscópico sin cirugía puede considerarse definitivo en aquellos tumores benignos polipoideos con una base de implantación menor de 15<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span> y con un componente estrictamente intraluminal, ya que su riesgo de recurrencia es extremadamente bajo<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" => "Imagen 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 558 "Ancho" => 1250 "Tamanyo" => 119545 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: imagen de la tumoración endotraqueal a través del broncoscopio rígido, con la fibra del láser Nd-YAG y sonda aspirativa. B: proliferación de células fusiformes, de núcleos en cigarro y citoplasmas elongados, por debajo del epitelio bronquial, H-E ×20. C: positividad para S100 en dichas células, ×40.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "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" => "Endobronchial neurogenic tumors treated by transbronchial electrical snaring and Nd-YAG laser abrasion: Report of three cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Suzuki" 1 => "Y. Sekine" 2 => "H. Motohashi" 3 => "M. Chiyo" 4 => "M. Suzuki" 5 => "Y. Haga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00595-004-2900-8" "Revista" => array:6 [ "tituloSerie" => "Surg Today." "fecha" => "2005" "volumen" => "35" "paginaInicial" => "243" "paginaFinal" => "246" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15772797" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopic multimodal management of tracheal neurofibroma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Rabeau" 1 => "J. Mazieres" 2 => "C. Hermant" 3 => "F. Projetti" 4 => "A. Didier" 5 => "N. Guibert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/LBR.0000000000000220" "Revista" => array:6 [ "tituloSerie" => "J Bronchology Interv Pulmonol." "fecha" => "2016" "volumen" => "23" "paginaInicial" => "340" "paginaFinal" => "342" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26496086" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005600000002/v4_202007190708/S0300289619301140/v4_202007190708/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/03002896/0000005600000002/v4_202007190708/S0300289619301140/v4_202007190708/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619301140?idApp=UINPBA00003Z" ]
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