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Anatomia Patológica
Pereira, F; Cunha, L; Campos, P; Gaspar, A; Manso, RT; Soto, K
Systemic lupus erythematosus (SLE) is an autoimmune disease which can involve almost any organ, making
its difficult therapeutic approach. Immune complex deposition can often activate complement, accounting for
many of SLE clinical manifestations and laboratory findings.
We present a case of a patient who presented with acute pancreatitis and acute kidney injury as onset manifestations
of SLE, later developing neurological manifestations, who was successfully treated with rituximab,
plasma exchange and steroids as induction therapy. Persistently low C3 level led to a genetic analysis of the
complement system components. We found three polymorphisms in the alternative pathway of complement
regulators (complement factor H c2669 G>T, p.Ser890Ile and c3019...
Cassis, J; Sousa, H; Manso, RT; Ramos, S; Machado, D
IgA nephropathy has many clinical presentations, of which nephrotic syndrome is possibly the rarest. Recently,
the association of IgA nephropathy with minimal change disease was better described with patients having
complete response to steroid therapy and no progression to CKD. We report a similar case in a young male presenting with nephrotic syndrome.
Ferreira, M
N/A
Alves, AJ; Ferreira, MA; Gallego-Poveda, J; Matos, A; Costa-Silva, A; Nobre, A; Lopez-Beltran, A
Intravenous leiomyomatosis (IVL) is an extremely rare variant of leiomyoma in which nodular masses of tumor grow within venous channels. Rarely, the tumor can reach the vena cava and right heart. We present a case of a 45-year-old woman, admitted with rapidly evolving exertional dyspnea. Cardiac ultrasonography revealed a "mass in the right chambers". She was submitted to right atriotomy plus tumorectomy, with intraoperative consultation requested. Grossly, the tumor was polypoid, firm, with a smooth surface. The frozen section showed a lesion composed of tortuous vessels and some areas with a fibrillar eosinophil extracellular matrix and others with spindle cells,...
Barbosa, S; Sequeira, M; Castro, S; Manso, R; Klut, C; Trancas, B; Santos, NB; Maia, T
INTRODUCTION:
Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013).
MATERIAL AND METHODS:
Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included.
RESULTS:
Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients...
Barbosa, S; Sequeira, M; Castro, S; Manso, RT; Klut, C; Trancas, B; Santos, NB; Maia, T
INTRODUCTION:
Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013).
MATERIAL AND METHODS:
Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis. Patients transferred to other wards during their admission were not included.
RESULTS:
Circulatory system diseases were the most prevalent causes of death, occurring in 2/3 of patients...
Lopes, S; Furtado, A; Oliveira, R; Cebola, A; Graça, B; Coelho, M; Ferrito, F; Gomes, FC
Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.
Peres, J; Cruz, S; Oliveira, R; Santos, L; Valverde, A
A 68-year-old Caucasian female was admitted to the emergency department with a progressive history of behavioural symptoms and anxiety followed by visual and auditory hallucinations, forgetfulness, and impaired gait in the previous 3 months. On examination she was psychotic and had a postural and rest tremor of the upper limbs, cogwheel rigidity of the four limbs, retropulsion on standing position, and inability to walk. During the following 2 weeks she developed xerostomia and unilateral parotiditis that improved with steroids. A simultaneous improvement of the cognitive abilities allowed for the detection of sensory ataxia of the lower limbs. Sensory ganglionopathy was...
Ferreira, J; Gasparinho, MG; Fonseca, R
BACKGROUND:
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic tumor that was once believed to be derived from natural killer cells and is now recognized as originating from precursors of plasmacytoid dendritic cells. It generally involves the skin and has an aggressive clinical course. Due to its highly malignant behavior, a fast and accurate diagnosis of this condition is of the utmost importance.
METHODS:
Six cytology specimens from 5 patients diagnosed with BPDCN were reviewed as well as their clinical records. Findings were compared with 3 previously published cases.
RESULTS:
Two exfoliative cytology specimens (cerebrospinal fluid) and 4 fine-needle aspiration specimens (3 lymph...
Santiago, I; Rodrigues, E; Germano, A; Costa, A; Manso, R; Gomes, A; Leichsenring, C; Geraldes, V
Neoadjuvant chemotherapy in potentially resectable high-risk Stage II and Stage III colon cancer has demonstrated promising results in the PRODIGE 22-ECKINOXE Phase II trial. Identification of adverse morphologic features, namely T3 with >5 mm extramural extension/T4 stages and/or N2, is fundamental and requires accurate noninvasive imaging. Our aim was to assess the value of optimized preoperative MDCT to stratify potentially resectable colon cancer patients for neoadjuvant therapy.
METHODS:
this is an observational prospective cross-sectional radiologic-pathologic agreement study. All patients with colon cancer referred to our Institution's Radiology department for preoperative MDCT staging between 01-10-2013 and 11-02-2015 underwent independent reading based on axial...
Santiago, I; Rodrigues, E; Germano, A; Costa, A; Manso, RT; Gomes, A; Leichsenring, C; Geraldes, V
Neoadjuvant chemotherapy in potentially resectable high-risk Stage II and Stage III colon cancer has demonstrated promising results in the PRODIGE 22-ECKINOXE Phase II trial. Identification of adverse morphologic features, namely T3 with >5 mm extramural extension/T4 stages and/or N2, is fundamental and requires accurate noninvasive imaging. Our aim was to assess the value of optimized preoperative MDCT to stratify potentially resectable colon cancer patients for neoadjuvant therapy.
METHODS:
this is an observational prospective cross-sectional radiologic-pathologic agreement study. All patients with colon cancer referred to our Institution's Radiology department for preoperative MDCT staging between 01-10-2013 and 11-02-2015 underwent independent reading based on axial...
Ferreira, M
Paula, F; Amaral, M; Oliveira, Alves; Alves, J
A crise de retenção esplénica é uma complicação, frequentemente, fatal da drepanocitose. É rara em adultos, pela elevada
incidência de autoesplenectomia durante a infância. Heterozigóticos com traços de drepanocitose e de beta-talassémia têm
fenótipos menos graves, podendo manter um baço funcional até à idade adulta. Descrevemos um caso de crise de retenção
esplénica num homem de 19 anos, com concentração mínima de hemoglobina de 2,9g/dL, que resolveu após esplenectomia
emergente. Os poucos casos descritos na literatura acarretam uma mortalidade elevada. Um diagnóstico rápido e actuação
imediata são necessários para garantir a sobrevivência. É apresentada uma revisão da fisiopatologia e da...
Gonçalves, L; Ferreira, M
O programa “Saúde para Todos – Especialidades” é um
programa de cooperação na área da saúde ancorado em São
Tomé e Príncipe (STP), desenvolvido e sustentado pelo Instituto
Marquês de Valle Flôr (IMVF) com o apoio principal
da Cooperação Portuguesa (através do Camões – Instituto
da Cooperação e da Língua) e da Fundação Calouste Gulbenkian
e em parceria com o Ministério da Saúde da República Democrática de São Tomé e Príncipe.
Dores, J; Graça, B; Manso, R; Gomes, FC
Introduc¸ão: Até ao fim dos anos 80 defendia-se que qualquer nódulo testicular suspeito devia ser
excisado com orquidectomia radical. No entanto, com o aumento do diagnóstico incidental de
massas testiculares, a maior acuidade dos exames extemporâneos e a evidência das vantagens
potenciais da orquidectomia parcial, questionou-se se seria necessário sacrificar, sempre, todo
o testículo, mesmo na presenc¸a de um testículo contralateral normal.
Caso clínico: Apresentamos o caso de um doente de 23 anos, com o diagnóstico de um nódulo
testicular com 7,5 mm, não palpável, assintomático e marcadores tumorais negativos. Foi submetido
a orquidectomia parcial guiada por ecografia e exame extemporâneo, no entanto,
por suspeita anatomopatológica de provável...
Dores, J; Graça, B; Manso, RT; Gomes, FC
Introduc¸ão: Até ao fim dos anos 80 defendia-se que qualquer nódulo testicular suspeito devia ser
excisado com orquidectomia radical. No entanto, com o aumento do diagnóstico incidental de
massas testiculares, a maior acuidade dos exames extemporâneos e a evidência das vantagens
potenciais da orquidectomia parcial, questionou-se se seria necessário sacrificar, sempre, todo
o testículo, mesmo na presenc¸a de um testículo contralateral normal.
Caso clínico: Apresentamos o caso de um doente de 23 anos, com o diagnóstico de um nódulo
testicular com 7,5 mm, não palpável, assintomático e marcadores tumorais negativos. Foi submetido
a orquidectomia parcial guiada por ecografia e exame extemporâneo, no entanto,
por suspeita anatomopatológica de provável...
Germano, A; Gasparinho, MG
Rosado, E; Germano, A; Costa, A; Theias, R; Gomes, A; Leichsenring, C; Santiago, I
PURPOSE: Neoadjuvant chemotherapy (NACT) in potencially-resectable locally advanced colon cancer (LACC) is likely to prove superiority compared to standard treatment in the phase III FOXTROT Collaborative Group Trial. Thus, identification of LACC, defined as T3≥5 mm or T4, is fundamental and requires accurate noninvasive imaging. The value of optimized preoperative MDCT for that purpose is being assessed.
METHODS AND MATERIALS: Observational, cross-sectional, prospective study including all patients with colon cancer refered to our Institution´s Radiology Department for preoperative staging between the 1st of October 2013 and the 6th of August 2014. Independent reading of optimized MDCT acquisitions using MPR was...
Rosado, E; Germano, A; Costa, A; Manso, RT; Gomes, A; Leichsenring, C; Santiago, I
PURPOSE: Neoadjuvant chemotherapy (NACT) in potencially-resectable locally advanced colon cancer (LACC) is likely to prove superiority compared to standard treatment in the phase III FOXTROT Collaborative Group Trial. Thus, identification of LACC, defined as T3≥5 mm or T4, is fundamental and requires accurate noninvasive imaging. The value of optimized preoperative MDCT for that purpose is being assessed.
METHODS AND MATERIALS: Observational, cross-sectional, prospective study including all patients with colon cancer refered to our Institution´s Radiology Department for preoperative staging between the 1st of October 2013 and the 6th of August 2014. Independent reading of optimized MDCT acquisitions using MPR was...
Nunes, V; Santiago, I; Marinho, R; Pires, D; Theias, R; Gomes, A; Pignatelli, N
INTRODUCTION:
Rare adenosquamous carcinomas have no defined standard approach given their low incidence. They present with nonspecific imaging characteristics and are described as having worse prognosis than other lung malignancies, with greater likelihood of local invasion and early metastasis.
PRESENTATION OF CASE:
Male caucasian patient, 43 years, 26 pack-year smoking history, presented with watery diarrhea, early emesis and loss of 25% body weight (20kg) in four weeks. Colonoscopy identified a left colonic mass. Abdominal CT/ultrasound showed a large fistulous lesion between the 4th portion of the duodenum and left colon. CT showed a solid mass in the right upper lung lobe. Endoscopy and...