Clinical Image
Malignant Melanoma Metastasis in the Form of Nonsolid Nodules: Diagnosis by Percutaneous Lung Biopsy
Metástasis de melanoma maligno en forma de nódulos no sólidos: diagnóstico mediante biopsia pulmonar percutánea
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Enmarcado por una circunferencia, puede observarse el nódulo no sólido que se biopsió. Imágenes microscópicas a ×250 de la biopsia pulmonar (B y C) en las que se observa infiltración de células neoplásicas por el intersticio en la tinción de hematoxilina-eosina (B), y se aprecia la diferenciación melanocítica mediante positividad para proteína S-100 (C).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ivan Vollmer, José Ramírez, Marcelo Sánchez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ivan" "apellidos" => "Vollmer" ] 1 => array:2 [ "nombre" => "José" "apellidos" => "Ramírez" ] 2 => array:2 [ "nombre" => "Marcelo" "apellidos" => "Sánchez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916301069" "doi" => "10.1016/j.arbr.2016.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => 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"HTML" => 1181 "PDF" => 458 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Twin Cavities: An Unusual Radiological Finding in Pulmonary Tuberculosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "432" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cavernas gemelas, una curiosa imagen radiográfica en tuberculosis 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" => 926 "Ancho" => 993 "Tamanyo" => 77383 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara 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"https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916301070?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000008/v1_201607230336/S1579212916301070/v1_201607230336/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Malignant Melanoma Metastasis in the Form of Nonsolid Nodules: Diagnosis by Percutaneous Lung Biopsy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "433" "paginaFinal" => "434" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ivan Vollmer, José Ramírez, Marcelo Sánchez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ivan" "apellidos" => "Vollmer" "email" => array:1 [ 0 => "vollmer@clinic.ub.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" => "José" "apellidos" => "Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Marcelo" "apellidos" => "Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico (CDIC), Hospital Clínic, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica (CDB), Hospital Clínic, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis de melanoma maligno en forma de nódulos no sólidos: diagnóstico mediante biopsia pulmonar percutánea" ] ] "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" => 727 "Ancho" => 1505 "Tamanyo" => 293917 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography image (A) showing multiple nonsolid nodules (arrows) in the right lung. The nonsolid nodule that was biopsied is indicated within the red circle. Microscopic images (250×) of the lung biopsy (B and C), showing interstitial infiltration by the cancer cells on hematoxylin–eosin staining (B). S100 protein positivity indicates melanocytic differentiation (C).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 20-year old patient with a diagnosis of malignant melanoma in the presternal region (Clark level III, Breslow 3.56), treated with excisional biopsy and subsequent widening of surgical margins and sentinel node detection.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was monitored by computed tomography (CT), which, 15 months after surgery, revealed multiple nonsolid nodules on both lungs. A follow-up CT in 3 months was recommended, and this scan revealed persistent nodular lesions, increased in size and density (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). In view of the clinical suspicion of lung metastasis, a CT-guided percutaneous biopsy was performed, which confirmed the diagnosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Although most persistent nonsolid lesions are lesions within the lung adenocarcinoma spectrum, the differential diagnosis must include metastases from gastrointestinal cancers, melanoma, and renal carcinoma.</p><p id="par0020" class="elsevierStylePara elsevierViewall">There are only 2 reports in the literature of melanoma lung metastasis in the form of nonsolid nodules which required surgical biopsy for confirmation.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> In our case, percutaneous biopsy showed typical melanoma cell growth, with infiltration of the alveolar septa and preservation of air spaces (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C), conferring the appearance of a nonsolid nodule on CT.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vollmer I, Ramírez J, Sánchez M. Metástasis de melanoma maligno en forma de nódulos no sólidos: diagnóstico mediante biopsia pulmonar percutánea. Arch Bronconeumol. 2016;52:433–434.</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" => 727 "Ancho" => 1505 "Tamanyo" => 293917 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography image (A) showing multiple nonsolid nodules (arrows) in the right lung. The nonsolid nodule that was biopsied is indicated within the red circle. Microscopic images (250×) of the lung biopsy (B and C), showing interstitial infiltration by the cancer cells on hematoxylin–eosin staining (B). S100 protein positivity indicates melanocytic differentiation (C).</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" => "Multiple ground-glass opacity in metastasis of malignant melanoma diagnosed by lung biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Okita" 1 => "M. Yamashita" 2 => "M. Nakata" 3 => "N. Teramoto" 4 => "A. Bessho" 5 => "H. Mogami" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.athoracsur.2003.12.104" "Revista" => array:4 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2005" "volumen" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15854988" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ground-glass nodules found in two patients with malignant melanomas: different growth rate and different histology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.J. Kang" 1 => "M.A. Kim" 2 => "C.M. Park" 3 => "C.H. Lee" 4 => "J.M. Goo" 5 => "H.J. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinimag.2009.10.036" "Revista" => array:6 [ "tituloSerie" => "Clin Imaging" "fecha" => "2010" "volumen" => "34" "paginaInicial" => "396" "paginaFinal" => "399" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20813308" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005200000008/v1_201607230336/S1579212916301069/v1_201607230336/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/15792129/0000005200000008/v1_201607230336/S1579212916301069/v1_201607230336/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916301069?idApp=UINPBA00003Z" ]
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