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Carcinoma pleomorfo pulmonar con presentación como masa subsólida por extensa hemorragia peritumoral: a propósito de 2 casos
Two Cases of Pleomorphic Carcinoma of the Lung Presenting as a Subsolid Mass due to Extensive Peritumoral Hemorrhage
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Mass with central solid cavitary component (arrow) and extensive surrounding ground glass opacities. 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Nódulos pulmonares cavitados periféricos (flechas) en el lóbulo superior derecho e izquierdo y neumotórax derecho.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Horacio Matías Castro, Clara Lucia Torres Cabreros, Esteban Javier Wainstein" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Horacio Matías" "apellidos" => "Castro" ] 1 => array:2 [ "nombre" => "Clara Lucia" "apellidos" => "Torres Cabreros" ] 2 => array:2 [ "nombre" => "Esteban Javier" "apellidos" => "Wainstein" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212920300999" "doi" => "10.1016/j.arbr.2019.06.025" "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/S1579212920300999?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619302923?idApp=UINPBA00003Z" "url" => "/03002896/0000005600000007/v2_202007230732/S0300289619302923/v2_202007230732/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen Clínica</span>" "titulo" => "Carcinoma pleomorfo pulmonar con presentación como masa subsólida por extensa hemorragia peritumoral: a propósito de 2 casos" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "458" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Helena Gómez Herrero, Irene Amat Villegas" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Helena" "apellidos" => "Gómez Herrero" "email" => array:1 [ 0 => "hgomezhe@cfnavarra.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Irene" "apellidos" => "Amat Villegas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, Navarra, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Two Cases of Pleomorphic Carcinoma of the Lung Presenting as a Subsolid Mass due to Extensive Peritumoral Hemorrhage" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 708 "Ancho" => 1000 "Tamanyo" => 131999 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B) TC tórax con contraste iv: ventana de pulmón. Masa con parte central sólido cavitada (flecha) y extensa área en vidrio deslustrado circundante. C) Pieza macroscópica de la lobectomía del caso A). Se aprecia la lesión nodular cavitada central (estrella) rodeada de una extensa hemorragia perilesional (flechas) que se correspondía con el vidrio deslustrado de la TC.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">El carcinoma pleomorfo pulmonar está incluido dentro de los carcinomas sarcomatoides pulmonares. Son neoplasias raras, y representan menos del 1% de los tumores pulmonares. La apariencia radiológica de los carcinomas pleomorfos no presenta ningún dato característico, aunque se ha descrito una mayor frecuencia de presentación de estos tumores como masas sólidas de predominio en lóbulos superiores, periféricas, con invasión de pared torácica y que puede presentar componente de necrosis<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Presentamos 2 casos de pacientes varones de 64 y 57 años, que consultaron por hemoptisis, presentando en la TC masas pulmonares con similares características radiológicas en forma de nódulos subsólidos con un componente sólido central cavitado y una extensa área de vidrio deslustrado circundante (<a class="elsevierStyleCrossRef" href="#fig0005">figs. 1</a>A y B). En el estudio de PET la parte sólida presentaba una captación más elevada (A: 8 SUV, B: 6,2 SUV) y la parte en vidrio deslustrado una captación menor (A: 2 SUV).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Se realizó PAAF transtorácica accediendo a la parte periférica con resultado hemorrágico y con diagnóstico anatomopatológico en la pieza quirúrgica de carcinoma pleomorfo pulmonar con extensa hemorragia peritumoral (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>C).</p><p id="par0020" class="elsevierStylePara elsevierViewall">En la literatura se han descrito casos de carcinoma pleomorfos con áreas de vidrio deslustrado circundante, pero han sido descritos con relación al componente asociado de adenocarcinomas pulmonares o con infiltración de células inflamatorias<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">En los casos descritos se obtuvo material en las PAAF transtorácica de la zona de vidrio deslustrado, lo que condicionó el resultado de falso negativo de la citología, al corresponder a hemorragia. Por ese motivo en un paciente con hemoptisis se debe considerar siempre la hemorragia como causa del componente en vidrio deslustrado de un nódulo subsólido.</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" => 708 "Ancho" => 1000 "Tamanyo" => 131999 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B) TC tórax con contraste iv: ventana de pulmón. Masa con parte central sólido cavitada (flecha) y extensa área en vidrio deslustrado circundante. C) Pieza macroscópica de la lobectomía del caso A). Se aprecia la lesión nodular cavitada central (estrella) rodeada de una extensa hemorragia perilesional (flechas) que se correspondía con el vidrio deslustrado de la TC.</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" => "CT findings of surgically resected pleomorphic carcinoma of the lung in 30 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.S. Kim" 1 => "J. Han" 2 => "K.S. Lee" 3 => "Y.J. Jeong" 4 => "S.H. Kwak" 5 => "H.S. Byun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.185.1.01850120" "Revista" => array:6 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2005" "volumen" => "185" "paginaInicial" => "120" "paginaFinal" => "125" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15972411" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pleomorphic carcinoma of lung: Comparison of CT features and pathologic findings" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.H. Kim" 1 => "S.J. Kim" 2 => "Y.H. Ryu" 3 => "H.J. Lee" 4 => "J.M. Goo" 5 => "J.G. Im" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2322031201" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2004" "volumen" => "232" "paginaInicial" => "554" "paginaFinal" => "559" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15215543" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005600000007/v2_202007230732/S0300289619303023/v2_202007230732/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005600000007/v2_202007230732/S0300289619303023/v2_202007230732/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289619303023?idApp=UINPBA00003Z" ]
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