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Epithelioid Hemangioendothelioma of the Superior Vena Cava Diagnosed With EBUS-TBNA
Hemangioendotelioma epitelioide de la vena cava superior diagnosticado con EBUS-TBNA
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B) TC tórax con contraste endovenoso (ventana mediastino). Consolidación parenquimatosa pulmonar con colección hipodensa de pared gruesa y realzada en relación con absceso de 6 cm (neumonía necrotizante) y derrame pleural. Lesión de morfología sacular, de 14 mm, en relación con pseudoaneurisma mucormicótico. C) Arteriografía diagnóstico-terapéutica. Lesión de morfología sacular en relación con pseudoaneurisma dependiente de la rama inferior del segmento medial del LID. D) Pseudoaneurisma de menor tamaño respecto a figura C y extravasación del contraste en relación con rotura. E) Embolización mediante dispositivo Amplatzer (flecha negra) y colocación de coils (flecha amarilla) en rama arterial del segmento inferomedial del LID. F) Pieza quirúrgica tras lobectomía inferior derecha. Se observa cavidad necrótica y dispositivo Amplatzer (flecha).</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">AP: Anatomía Patológica; LID: lóbulo inferior derecho; Rx: rayos x; TC: tomografía computarizada.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María del Mar García Gallardo, María Lucía Berma Gascón" "autores" => array:2 [ 0 => array:2 [ "nombre" => "María del Mar" "apellidos" => "García Gallardo" ] 1 => array:2 [ "nombre" => "María Lucía" "apellidos" => "Berma Gascón" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S157921292100389X" "doi" => "10.1016/j.arbr.2021.10.015" "estado" => "S200" "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/S157921292100389X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000934?idApp=UINPBA00003Z" "url" => "/03002896/0000005800000001/v1_202201130549/S0300289621000934/v1_202201130549/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289621004051" "issn" => "03002896" "doi" => "10.1016/j.arbres.2021.02.025" "estado" => "S300" "fechaPublicacion" => "2022-01-01" "aid" => "2965" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2022;58:T83" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => " Lung siliconoma, an etiology to consider" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "T83" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Siliconoma pulmonar, una etiología a tener en cuenta" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1134 "Ancho" => 2167 "Tamanyo" => 600149 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A–B<span class="elsevierStyleBold">)</span> Pre-operative CT image showing bilateral pulmonary nodules. A) Subpleural pulmonary nodule in the anterior segment of the right upper lobe. B) Left lower lobe pulmonary nodules. (C–F) Histologic images of the pulmonary nodule resected during surgery. C) Pulmonary parenchyma and bronchiole observed on the left, and on the right a nodule consisting of cells that appear light-colored at this magnification, with an incomplete lymphocytic rim (a foreign body granuloma variant). D) At higher magnification, these cells are seen to be histiocytic with a large “blank”, i.e. empty cytoplasm, because the silicone dissolves as it is processed, leaving a hollow space. E) Foreign body granuloma in the lung parenchyma near a vein. F) At higher magnification, the typical histiocytes and multinucleated giant cells are seen in more detail.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernando Cózar Bernal, Julia González Fernández, Juan Carlos Girón Arjona" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Fernando" "apellidos" => "Cózar Bernal" ] 1 => array:2 [ "nombre" => "Julia" "apellidos" => "González Fernández" ] 2 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Girón Arjona" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621004051?idApp=UINPBA00003Z" "url" => "/03002896/0000005800000001/v1_202201130549/S0300289621004051/v1_202201130549/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Epithelioid Hemangioendothelioma of the Superior Vena Cava Diagnosed With EBUS-TBNA" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "84" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ersin Günay, Sibel Günay, Betül Demirciler Yavas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ersin" "apellidos" => "Günay" "email" => array:1 [ 0 => "ersingunay@gmail.com" ] "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" => "Sibel" "apellidos" => "Günay" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Betül" "apellidos" => "Demirciler Yavas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Pulmonary Diseases, Yuksek Ihtisas University, Faculty of Medicine, VM Medical Park Hospital, Kecioren, Ankara, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pulmonary Diseases, Ankara City Hospital, Ankara, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Private Office of Pathology and Complimentary Medicine, Afyonkarahisar, Turkey" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemangioendotelioma epitelioide de la vena cava superior diagnosticado con EBUS-TBNA" ] ] "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" => 821 "Ancho" => 3175 "Tamanyo" => 459101 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography showed a right lower paratracheal lesion (A), endobronchial ultrasound revealed a well-circumscribed, round shaped, hypoechogenic lesion with the diameter of 11.6<span class="elsevierStyleHsp" style=""></span>mm compressing the vena cava superior (B), and immunohistochemical examination showed diffuse expression of CD34 (C).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 30-year-old female patient referred to our clinic because of the opacity located on the right lower paratracheal region, diagnosed on postero-anterior chest X-ray. She presented with complaints of chronic dry cough and weight loss. Thorax computed tomography revealed a lymphadenopathy with 20<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>mm in length on the right lower paratracheal region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). <span class="elsevierStyleSup">18</span>F-FDG (flourodeoxyglucose) PET-CT (Positron Emission Tomography-Computed Tomography) imaging revealed intense FDG-uptake value (SUVmax) with 8.7 on the lesion located at the region of 4R lymph node station (lower paratracheal region). We performed endobronchial ultrasound (EBUS) and transbronchial needle aspiration (TBNA). We visualized a well-circumscribed, round shaped, hypoechogenic lesion with the diameter of 11.6<span class="elsevierStyleHsp" style=""></span>mm that was compressing the vena cava superior (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). Immunohistochemistry examination revealed the mesenchymal tumour cells to be strongly positive for vimentin and CD34 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). Ki67 proliferation index was determined as 5%. No lymphoid cells were observed on microscopic examination. Patient was diagnosed with epithelioid hemangioendothelioma of the superior vena cava. Surgery was recommended to the patient, but she did not accept the operation.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Epithelioid hemangioendotheliomas usually originate from angioendothelial cells in different anatomical regions (such as the liver, lung, bone, etc.).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Clinical behaviour of this neoplasm is defined as intermediate between benign hemangiomas and malignant angiosarcomas.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> Involvement of the vena cava is a very rare site for primary tumour. To our knowledge, this is the first case report of epithelioid hemangioendothelioma of the vena cava superior that was diagnosed with EBUS-TBNA.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "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" => 821 "Ancho" => 3175 "Tamanyo" => 459101 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography showed a right lower paratracheal lesion (A), endobronchial ultrasound revealed a well-circumscribed, round shaped, hypoechogenic lesion with the diameter of 11.6<span class="elsevierStyleHsp" style=""></span>mm compressing the vena cava superior (B), and immunohistochemical examination showed diffuse expression of CD34 (C).</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" => "Epithelioid hemangioendothelioma of the superior vena cava: computed tomography demonstration and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.R. Ferretti" 1 => "C. Chiles" 2 => "R.D. Woodruff" 3 => "R.H. Choplin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Thorac Imaging" "fecha" => "1998" "volumen" => "13" "paginaInicial" => "45" "paginaFinal" => "48" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful excision of epithelioid hemangioendothelioma of the superior vena cava" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Ishibashi" 1 => "C. Takasaki" 2 => "T. Akashi" 3 => "K. Okubo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2020" "volumen" => "109" "paginaInicial" => "e271" "paginaFinal" => "e273" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005800000001/v1_202201130549/S0300289621000922/v1_202201130549/en/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/03002896/0000005800000001/v1_202201130549/S0300289621000922/v1_202201130549/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000922?idApp=UINPBA00003Z" ]
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