A tomografia computadorizada na avaliação do comprometimento abdominal na paracoccidioidomicose

Abstract

A tomografia computadorizada foi utilizada para avaliar o comprometimento abdominal em 25 doentes deparacoccidioidomicose. Existiam lesões intra-abdominais em, respectivamente, 75%e23% dos doentes com asformas aguda ("juvenil") e crônica ( do adulto '). A alteração mais freqüente foi o aumento dos gânglios linfáticos abdominais (12/25 casos); outras lesões foram: calcificação de gânglios linfáticos em 4 casos; obstrução das vias biliares em 5 doentes ictéricos; abscessos ou calcificação esplénica em 3 casos; 2 doentes mostraram lesões incomuns: aumento e irrgularidade do pâncreas em um e múltiplos abscessos nos músculos psoas em outro. Conclui-se que a tomografia computadorizada é procedimento útil na avaliação da disseminação da paracoccidioidomicose ao abdome e no diagnóstico de suas complicações abdominais.

Intestinal paracoccidioidomycosis simulating colon cancer

“…The intestinal form seems to be more common in the southeastern and central-western regions of Brazil 7 . There is a scarcity of intestinal findings in abdominal CT scans 5 . The main alterations in the intestinal tract are found in the small and large intestines, and in segments rich in lymphoid tissue, such as terminal ileum, appendix and right hemi-colon 1 2 4 .…”

The contribution of ultrasonography and computed tomography in the evaluation of abdominal involvement in paracoccidioidomycosis

“…These affected up to 48% of patients submitted to the necroscopic study, and adrenal insufficiency may be identified in 48.7% of paracoccidioidomycosis patients. [36][37][38][39][40][41] The adrenal hypo function is not always possible to be diagnosed. The adrenals are increased in size in the acute form, with hypo dense center, and lesions may calcify with chronicity.…”

“…The adrenals are increased in size in the acute form, with hypo dense center, and lesions may calcify with chronicity. [36][37][38][39][40][41][42] The kidneys were increased in echogenicity suggesting glomerular or tubular damage, which is associated to the use of amphotericin B. 5,9,11,16,17 The splenomegaly was observed in approximately one third of patients, even moderate (16 cm), with homogeneous texture, which may contain focal lesions.…”

“…Therefore, imaging methods are important to the overall diagnosis of PCM involvement and evaluation of its evolution for early diagnoses of recurrences. 19,21,32,36,39,40,44,[51][52][53][54][55] The differential diagnosis of PCM mainly consists of tuberculosis and lymphoma and other deep mycoses. Lymphomegaly in tuberculosis and PCM may have central necrosis and calcification.…”

Paracoccidioidomycosis disease (Lutz-Splendore-Almeida disease): Additional workup, differential diagnosis, cure control

“…1-7.18 tines, liver, spleen, kidney -and the deep lymphatic system (Figures 6 and 7). [73][74][75][76][77][78][79][80][81][82][83][84] Anatomical alterations in the adrenal can be defined by ultrasound or computed tomography (Figure 8). [64][65][66]75,76 FO involvement of the central nervous system can be identified by computed tomography, being characterized by rounded injury, of variable location, without signs of neoformation or bone destruction, with small amount of perifocal edema, discreet and compressive effect, and contrast buildup (circinate lesion) in a ring shape (Figure 9).…”