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Resolution of Thoracic and Abdominal Lymphangioleiomyomas in a Patient With Lymphangioleiomyomatosis Treated With Sirolimus
Resolución de los linfangioleiomiomas torácicos y abdominales en una paciente con linfangioleiomiomatosis tratada con sirolimus
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TAC abdominal (B) donde se aprecia una tumoración de 6,8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3,9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5,1<span class="elsevierStyleHsp" style=""></span>cm de aspecto quístico retroperitoneal, de localización paraaórtica izquierda que se extiende hasta la pelvis, compatible con un linfangioleiomioma abdominal. TAC toraco-abdominal al año (C y D) donde se observa una resolución prácticamente completa de las lesiones descritas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Cabeza Osorio, María Ángeles Ruiz Cobos, Álvaro Casanova Espinosa" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Cabeza Osorio" ] 1 => array:2 [ "nombre" => "María Ángeles" "apellidos" => "Ruiz Cobos" ] 2 => array:2 [ "nombre" => "Álvaro" "apellidos" => "Casanova Espinosa" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916300416" "doi" => "10.1016/j.arbr.2016.04.002" "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/S1579212916300416?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001027?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000006/v1_201605260144/S0300289615001027/v1_201605260144/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212916300313" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.03.025" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1156" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2016;52:331" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1860 "formatos" => array:3 [ "EPUB" => 134 "HTML" => 1206 "PDF" => 520 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "An Example of Difficulty in Diagnosing and Treating Lung Sarcoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "331" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ilustramos la dificultad en el diagnóstico y tratamiento del sarcoma pulmonar" ] ] "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" => 679 "Ancho" => 1501 "Tamanyo" => 98073 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest X-ray: left paracardiac mass. (B) Positron emission tomography; left lower mass with marked increase in glucidic metabolism, in contact with the posterior pleura, paravertebral space and oblique fissure.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Quintana Cortés, Patricia Cruz Castellanos, Javier de Castro Carpeño" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Quintana Cortés" ] 1 => array:2 [ "nombre" => "Patricia" "apellidos" => "Cruz Castellanos" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "de Castro Carpeño" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289615001052" "doi" => "10.1016/j.arbres.2015.03.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001052?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300313?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000006/v1_201605260126/S1579212916300313/v1_201605260126/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212916300246" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.03.018" "estado" => "S300" "fechaPublicacion" => "2016-06-01" "aid" => "1298" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Arch Bronconeumol. 2016;52:321-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 10935 "formatos" => array:3 [ "EPUB" => 176 "HTML" => 9420 "PDF" => 1339 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Farmer's Lung Disease. 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BAL: bronchoalveolar lavage; DIPD: diffuse interstitial pulmonary disease; FLD: farmer's lung disease; TBB: transbronchial biopsy. *Respiratory function improvement >20% of FVC, FEV1 and/or DLco. <span class="elsevierStyleItalic">Source</span>: adapted from the algorithm proposed for the diagnosis of HP by Morell et al.<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">28</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Esteban Cano-Jiménez, Adelaida Acuña, María Isabel Botana, Teresa Hermida, María Guadalupe González, Virginia Leiro, Irene Martín, Sonia Paredes, Pilar Sanjuán" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Esteban" "apellidos" => "Cano-Jiménez" ] 1 => array:2 [ "nombre" => "Adelaida" "apellidos" => "Acuña" ] 2 => array:2 [ "nombre" => "María Isabel" "apellidos" => "Botana" ] 3 => array:2 [ "nombre" => "Teresa" "apellidos" => "Hermida" ] 4 => array:2 [ "nombre" => "María Guadalupe" "apellidos" => "González" ] 5 => array:2 [ "nombre" => "Virginia" "apellidos" => "Leiro" ] 6 => array:2 [ "nombre" => "Irene" "apellidos" => "Martín" ] 7 => array:2 [ "nombre" => "Sonia" "apellidos" => "Paredes" ] 8 => array:2 [ "nombre" => "Pilar" "apellidos" => "Sanjuán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616000089" "doi" => "10.1016/j.arbres.2015.12.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000089?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300246?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000006/v1_201605260126/S1579212916300246/v1_201605260126/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Resolution of Thoracic and Abdominal Lymphangioleiomyomas in a Patient With Lymphangioleiomyomatosis Treated With Sirolimus" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "329" "paginaFinal" => "330" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luis Cabeza, María Ángeles Ruiz-Cobos, Álvaro Casanova" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Luis" "apellidos" => "Cabeza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "María Ángeles" "apellidos" => "Ruiz-Cobos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Álvaro" "apellidos" => "Casanova" "email" => array:1 [ 0 => "acasanova1977@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario del Henares, Coslada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario del Henares, Coslada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resolución de los linfangioleiomiomas torácicos y abdominales en una paciente con linfangioleiomiomatosis tratada con sirolimus" ] ] "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" => 1039 "Ancho" => 1500 "Tamanyo" => 201372 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed axial tomography (CAT) (A) showing a right paravertebral cystic lesion 3.2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>cm, consistent with retrocrural lymphangioleiomyoma. Abdominal CAT (B) showing tumor 6.8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5.1<span class="elsevierStyleHsp" style=""></span>cm of retroperitoneal cystic appearance, located in the left para-aortic region, extending to the pelvis, consistent with abdominal lymphangioleiomyoma. Chest-abdominal CAT one year later (C and D) showing practically complete resolution of lesions.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 53-year-old woman was diagnosed with lymphangioleiomyomatosis (LAM) in 2010, presenting diffuse pulmonary involvement with multiple fine walled cysts, right retrocrural cystic lymphangioleiomyomas, and multiple retroperitoneal tumors of cystic appearance, consistent with abdominal lymphangioleiomyomas, the largest being 6.8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5.1 in diameter (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> A and B). Lung function on diagnosis showed forced vital capacity (FVC) 3300<span class="elsevierStyleHsp" style=""></span>ml (98%), forced expiratory volume in 1 second (FEV<span class="elsevierStyleInf">1</span>) 2370<span class="elsevierStyleHsp" style=""></span>ml (82%) and an FEV<span class="elsevierStyleInf">1</span>/FVC ratio 69%. Carbon monoxide diffusing capacity (DLCO) was 89%. She reported symptoms of dyspnea on heavy exertion and intermittent episodes of predominantly catamenial chest and abdominal pain. After 2 years of follow-up, lung function had significantly worsened, with FEV<span class="elsevierStyleInf">1</span> 2040<span class="elsevierStyleHsp" style=""></span>ml (71%) and DLCO 72%, increased basal dyspnea, and catamenial symptoms persisted. In view of her clinical and functional progression, treatment was started with the mammalian target of rapamycin (m-TOR) inhibitor sirolimus at a dose of 2<span class="elsevierStyleHsp" style=""></span>mg/day.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> One year after beginning treatment, a follow-up radiological examination showed practically complete resolution of the thoracic and abdominal lymphangioleiomyomas<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D). Clinical improvement and stabilized lung function were observed, with FEV<span class="elsevierStyleInf">1</span> 1980<span class="elsevierStyleHsp" style=""></span>ml (70%) and DLCO 82%. This image shows the beneficial effect of sirolimus in reducing the size of the thoracic and abdominal lymphangioleiomyomas, and in stabilizing lung function in patients with LAM.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cabeza Osorio L, Ruiz Cobos MÁ, Casanova Espinosa Á. Resolución de los linfangioleiomiomas torácicos y abdominales en una paciente con linfangioleiomiomatosis tratada con sirolimus. Arch Bronconeumol. 2016;52:329–330.</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" => 1039 "Ancho" => 1500 "Tamanyo" => 201372 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed axial tomography (CAT) (A) showing a right paravertebral cystic lesion 3.2<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>cm, consistent with retrocrural lymphangioleiomyoma. Abdominal CAT (B) showing tumor 6.8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5.1<span class="elsevierStyleHsp" style=""></span>cm of retroperitoneal cystic appearance, located in the left para-aortic region, extending to the pelvis, consistent with abdominal lymphangioleiomyoma. Chest-abdominal CAT one year later (C and D) showing practically complete resolution of lesions.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of sirolimus in lymphangioleiomyomatosis" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "National Institutes of Health Rare Lung Diseases Consortium; MILES Trial Group" "etal" => true "autores" => array:6 [ 0 => "F.X. McCormack" 1 => "Y. Inoue" 2 => "J. Moss" 3 => "L.G. Singer" 4 => "C. Strange" 5 => "K. Nakata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1100391" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2011" "volumen" => "364" "paginaInicial" => "1595" "paginaFinal" => "1606" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21410393" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Everolimus treatment of abdominal lymphangioleiomyoma in five women with sporadic lymphangioleiomyomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.M. Mohammadieh" 1 => "S.D. Bowler" 2 => "E.J. Silverstone" 3 => "A.R. Glanville" 4 => "D.H. Yates" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med J Aust" "fecha" => "2013" "volumen" => "199" "paginaInicial" => "121" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23879512" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005200000006/v1_201605260126/S1579212916300416/v1_201605260126/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005200000006/v1_201605260126/S1579212916300416/v1_201605260126/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300416?idApp=UINPBA00003Z" ]
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| 2019 May | 27 | 15 | 42 |
| 2019 April | 54 | 17 | 71 |
| 2019 March | 35 | 19 | 54 |
| 2019 February | 42 | 14 | 56 |
| 2019 January | 29 | 16 | 45 |
| 2018 December | 43 | 18 | 61 |
| 2018 November | 50 | 20 | 70 |
| 2018 October | 54 | 29 | 83 |
| 2018 September | 34 | 16 | 50 |
| 2018 May | 15 | 0 | 15 |
| 2018 April | 40 | 7 | 47 |
| 2018 March | 37 | 2 | 39 |
| 2018 February | 32 | 9 | 41 |
| 2018 January | 115 | 9 | 124 |
| 2017 December | 64 | 3 | 67 |
| 2017 November | 17 | 9 | 26 |
| 2017 October | 24 | 5 | 29 |
| 2017 September | 18 | 6 | 24 |
| 2017 August | 16 | 6 | 22 |
| 2017 July | 20 | 5 | 25 |
| 2017 June | 32 | 19 | 51 |
| 2017 May | 38 | 10 | 48 |
| 2017 April | 27 | 10 | 37 |
| 2017 March | 14 | 9 | 23 |
| 2017 February | 16 | 10 | 26 |
| 2017 January | 15 | 5 | 20 |
| 2016 December | 28 | 16 | 44 |
| 2016 November | 42 | 30 | 72 |
| 2016 October | 47 | 34 | 81 |
| 2016 September | 24 | 3 | 27 |
Show all
