Background: Breast hematomas are common after traumas, surgeries, or contusions. They are rarely spontaneous, but they can occur spontaneously in patients with hematologic disease or with coagulation disorders. Material and methods:The authors report a clinical case of a 48-year-old female with a 27-year history of paroxysmal nocturnal hemoglobinuria who underwent mammography screening because of a painless palpable moveable node in the upper inner quadrant of the right breast.Results: Mammography showed a partially defined heterogeneous node of 35 mm without microcalcifications in the upper inner quadrant of the right breast which, associated with the clinical features, seemed to be an hematoma. Further mammography and ultrasound after 45 days showed retrocession of the lesion, and another mammography obtained after 60 days was normal. Seventy-five days after the first episode, the patient complained of another node with a skin bruise in the upper outer quadrant of the same breast, which seemed to be a recurrent hematoma. Two months later the mammography obtained was normal.Conclusion: Breast hematoma must be thought of as a differential diagnosis for a breast node, regardless of previous trauma or hematologic disorders.
OBJETIVO: Descrever os achados de tomografia computadorizada de alta resolução de pacientes com esclerose sistêmica pulmonar, independentemente dos sintomas respiratórios. MATERIAIS E MÉTODOS: Foram revisados 73 exames de tomografia computadorizada de alta resolução de 44 pacientes com diagnós-tico de esclerodermia estabelecido através de critérios clínicos e laboratoriais. Os exames foram revisados por dois radiologistas, que estabeleceram os achados por consenso. RESULTADOS: Em 91,8% (n = 67) dos exames observaram-se alterações. Os principais achados foram lesões de padrão reticular (90,4%), opacidades em vidro-fosco (63%), bronquiectasias e bronquiolectasias de tração (56,2%), dilatação esofagiana (46,6%), faveolamento (28,8%) e sinais de hipertensão pulmonar (15,6%). Na maioria dos casos as lesões eram bilaterais (89%) e simétricas (58,5%). Quanto à localização, houve predomínio de lesões basais (91,2%) e periféricas (92,2%). CONCLUSÃO: A esclerose sistêmica progressiva acarreta fibrose pulmonar na maioria dos pacientes, caracterizada principalmente por lesão reticular basal e periférica. Unitermos: Tomografia computadorizada de alta resolução; Esclerose sistêmica pulmonar; Padrão reticular.Progressive systemic sclerosis: high-resolution computed tomography findings. OBJECTIVE: To describe the high-resolution computed tomography findings in the lung of patients with systemic sclerosis, independently of the respiratory symptoms. MATERIALS AND METHODS: Seventy-three high-resolution computed tomography scans of 44 patients with clinical diagnosis of systemic sclerosis were reviewed and defined by the consensus of two radiologists. RESULTS: Abnormalities were seen in 91.8% (n = 67) of the scans. The most frequent findings were reticular pattern (90.4%), ground-glass opacities (63%), traction bronchiectasis and bronchiolectasis (56.2%), esophageal dilatation (46.6%), honeycombing pattern (28.8%) and signs of pulmonary hypertension (15.6%). In most cases the lesions were bilateral (89%) and symmetrical (58.5%). The lesions were predominantly located in the basal (91.2%) and peripheral (92.2%) regions. CONCLUSION: In the majority of the patients, progressive systemic sclerosis can cause pulmonary fibrosis mainly characterized by reticular pattern with basal and peripheral distribution on highresolution computed tomography. Key words: High-resolution computed tomography; Progressive systemic sclerosis; Reticular pattern. Resumo Artigo OriginalA esclerose sistêmica progressiva é caracterizada por um processo auto-imune de etiologia desconhecida que resulta em vasculopatia fibrótica e acúmulo difuso de proteínas na matriz extracelular. No envolvimento pulmonar há inflamação e fibrose do interstício, alvéolos e tecido peribrôn-quico. A vasculopatia pode ocasionar hipertensão pulmonar mesmo na ausência de fibrose significativa (2) . As complicações pulmonares suplantaram o envolvimento renal como causa mais comum de morte, sendo consideradas fator prognóstico adverso da esclerodermia . Semelhantemente a outras doenças ...
Rev. Bras. Cir. Plást. 2011; 26(4): 675-9 675Abdominoplasty after gastroplasty: evaluation of 100 cases operated on by the "fish" technique Abdominoplasty after gastroplasty: evaluation of 100 cases operated on by the "fish" technique Dermolipectomia abdominal pós-gastroplastia: avaliação de 100 casos operados pela técnica do "peixinho" ABSTRACT Background: Morbid obesity is a worldwide endemic disease. Its growing incidence makes it a public health problem. Bariatric surgery is an alternative weight loss method with the objective of controlling obesity-associated diseases and improving quality of life. The sur gical treatment of the deformities resulting from significant weight loss is a new challenge for plastic surgeons. This paper presents a new technique for abdominoplasty in formerly obese patients with a midline abdominal scar resulting from gastroplasty. Methods: A total of 28 men and 72 women who underwent abdominoplasty after gastroplasty by the "fish" technique described in this study were analyzed. Results: The results obtained with the te chnique presented were satisfactory, resulting in a new body contour and a low complication rate. Conclusions: Abdominoplasty with markings forming a fish shape is successful for the removal of excess abdominal skin in patients who underwent bariatric surgery.Keywords: Surgery, plastic/methods. Abdomen/surgery. Gastroplasty. Bariatric surgery. RESUMO Introdução:A obesidade classe III é uma doença endêmica em todo o mundo. Trata-se de problema de saúde pública em decorrência de sua incidência progressiva. A cirurgia bariátrica oferece alternativa de redução ponderal, visando ao melhor controle das doenças que têm a obesidade como fator de risco e à melhoria da qualidade de vida. O tratamento cirúrgico das deformidades secundárias a grandes emagrecimentos é um novo desafio ao cirurgião plástico. O objetivo deste trabalho é apresentar uma nova técnica para abdominoplastia do paciente ex-obeso, portador de cicatriz abdominal mediana decorrente de gastroplastia. Méto-do: Foram analisados 28 homens e 72 mulheres, submetidos a dermolipectomia abdominal pós-gastroplastia, segundo a técnica do "peixinho", apresentada neste trabalho. Resultados: A técnica apresentada demonstrou-se satisfatória, resultando em novo contorno corporal, com baixo índice de complicações. Conclusões: A abdominoplastia com marcação em peixe é mais uma opção no arsenal do cirurgião plástico para tratamento do excedente cutâneo do abdome de pacientes submetidos a cirurgia bariátrica. 676Lage RR et al.
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