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Biomedical subjects

I Costa

Publications and source records attributed to I Costa.

34 records · Page 2Linked to original sources
PubMed1995

Diagnosis of lymphoma, leukemia, and metastatic tumor involvement of the cerebrospinal fluid by cytology and immunocytochemistry.

Fifty-five cerebrospinal fluid (CSF) specimens from 42 patients with suspected meningeal tumor involvement were reviewed. Cytology in conjunction with immunocytochemistry identified 26 CSF specimens as malignant. There were fifteen cases of lymphoma, four cases of leukemia, two cases of carcinoma, and two cases of melanoma. A monoclonal light chain expression was demonstrated in nine out of eleven B cell lymphomas. The three T-cell lymphomas all expressed pan T markers (CD 3) and two the T-helper antigen (CD 4). One patient had meningeal involvement of a true histiocytic lymphoma which was identified by its large atypical cells which were positive for alpha-1-anti-trypsin and muramidase. In four patients with a primary diagnosis of acute lymphoblastic leukemia, CSF involvement was confirmed by the demonstration of blasts with CD 10 (cALLA) or light chain restriction. Epithelial or melanocytic markers were demonstrated on the tumor cells in CSF from the remaining four patients. In 29 CSF specimens a diagnosis of reactive lymphocytosis was made using cytomorphology which mostly was characterized by macrophages mixed with small mature lymphoid cells. Immunologic evaluation showed that these mature cells were CD 10 negative T-cells and only few specimens contained polyclonal B-cells. The subsequent clinical course of these patients showed no evidence of CNS malignancy. It is concluded that cytology should be used in conjunction with immunocytochemistry to accurately evaluate CSF specimens from patients with possible malignant meningitis.

Adolescent↗
PubMed1995

Extratrigeminal ice-pick status.

We describe six patients with an identical type of headache, consisting of short episodes (lasting around 1 week) of daily attacks of ice-pick-like pain, recurring every minute in the same points of the scalp. In all of them, the pain was felt outside the cutaneous area of the trigeminal nerve (retroauricular, parietal, and occipital regions). All patients were examined in the emergency department of a general hospital over a period of 7 years because of these acute headaches. None of them had a history of migraine. Although this pain is identical to idiopathic stabbing headache, it differs from it by its temporal profile (in "status"), its posterior (extratrigeminal) location, and its lack of association with migraine. While the bouts were usually severe and recurred in two patients, all had a self-limited benign course and responded promptly to indomethacin.

Adult↗
PubMed1995

Headache associated with transient ischemic attacks.

Sixty (29%) of 205 consecutive patients with transient ischemic attacks registered in a hospital stroke data base had headache within 72 hours of onset. Headache was significantly more common in nonsmokers (odds ratio = 2.8; 95% confidence interval = 6.7 to 1.2). Headache was infrequent in patients with amaurosis fugax, and was not significantly associated with any other particular clinical presentation of transient ischemic attack. Headache was more common in vertebrobasilar (33%) than in carotid distribution (24%) episodes, and was not rare in transient ischemic attacks presenting as lacunar syndromes (29%). Headache was less frequent in patients whose computerized tomograms showed an infarct appropriate to the symptoms (odds ratio = 0.2; 95% confidence interval = 0.02 to 1.4). A diffuse headache was more common in patients with lacunar events than in patients with cortical attacks (odds ratio = 3.0; 95% confidence interval = 13 to 0.07). No other association was found between headache location and the presumed involved vascular territory. Headache in patients with transient ischemic attacks is poorly related/explained by the clinical characteristics of the ischemic event.

Aged↗
PubMed1994

[Aseptic adenitis in pyoderma gangrenosum].

INTRODUCTION: Extra-cutaneous manifestations of neutrophilic dermatosis are rare. Symptomatic cases are usually multiform and confusing. We report a case with an aseptic lymph node abscess associated with pyoderma gangrenosum. CASE REPORT: A 28-year-old woman with past history of pyoderma gangrenosum was seen for abdominal symptoms and fever related to an epigastric mass. Due to signs indicating abscess formation, surgery was performed and led to total regression of the symptomatology. Recurrence was evidenced 3 months later with skin lesions which were negative on bacteriological examinations. The diagnosis of lymph node manifestations of pyoderma gangrenosum was retained. General corticotherapy was very effective. Relapse occurred again 6 years later and was treated with thalidomide. DISCUSSION: Lymph node involvement has been described in Sneddon-Wilkinson's disease associated with pyoderma gangrenosum. In neutrophilic dermatosis, pulmonary manifestations appear to be the least exceptional of the extra-cutaneous lesions. The pathophysiology has not been elucidated although recent hypotheses suggest that G-CSF could be involved. Corticotherapy is remarkably effective in most cases but thalidomide could be an interesting alternative treatment.

Abdominal Pain↗
PubMedDate not supplied

Aspiration cytology of lung metastasis of monophasic synovial sarcoma. Report of a case.

BACKGROUND: Synovial sarcoma usually arises in the extremities of young adults and metastasizes in about 50% of the cases. Fine needle aspiration can reveal those metastases. CASE: A 65-year-old female presented with a solid mass in the left lung from which a fine needle aspirate was taken. Five years earlier her left foot was amputated because of a diagnosis of synovial sarcoma. Aspiration cytology from the lung revealed numerous groups of spindle cells with scant cytoplasm and ovoid nuclei with fine, homogeneous chromatin. Only vimentin was positive. Based on the clinical, cytologic and immunocytochemical studies, a metastasis from synovial sarcoma was considered to be the most accurate cytologic diagnosis. CONCLUSION: This case demonstrates the utility of aspiration cytology in the diagnosis of a metastatic tumor, especially in those organs in which a core or open biopsy might be too aggressive.

Aged↗
PubMedDate not supplied

[Epidermoid splenic cyst a in child. Report of a case].

The authors present a case of epidermoid splenic cyst in masculine patient of 13 years, that presented decrease of appetite, fever and alimentary vomits and tangible abdominal mass in the physical exam. Abdominal ultrasonography demonstrated expansible lesion in the topography of the spleen, and computerized tomography revealed intrinsic homogeneous lesion of the spleen, without communication with pancreas. To the laparotomy, cystic mass of great extension was observed, submitted total esplenectomy, being diagnosed in the histopatological exam epidermoid splenic cystic. In the follow-up patient developed with disappearance of the symptoms. The epidermoid splenic cyst are rare, they can be seen mainly in children and young adults, what proposes a congenital origin for this disease.

Adolescent↗
PubMedDate not supplied

[Sensitivity and specificity of stereotaxic core biopsy in the diagnosis of non palpable lesions of the breast].

BACKGROUND: Recently the stereotaxic core biopsy has been proposed as an alternative method for the initial evaluation of non palpable breast lesions. The authors verify the accuracy of core biopsy in diagnosis and discuss the applicability of tests used for nominal variables, like sensibility and specificity, to evaluate grading of quality such as benign, borderline and malignant. MATERIAL AND METHODS: Among 700 stereotaxic core biopsies of the breast the authors selected the first 567 cases, examined from May, 1993 to May, 1996 to check the accuracy of the histopathologic diagnosis. These cases were followed-up for a minimum of six months and a maximum of thirty months. For the evaluation, the diagnosis by core biopsies was compared with the findings of the surgical resection specimens for the malignant and atypical hyperplasia cases, and mammographic/clinical examinations for the cases not submitted to surgery. RESULTS: The sensibility and specificity were respectively 90.72% e 98.36% and the Spearman correlation test was 0.92. CONCLUSIONS: The stereotaxic core biopsy is an accurate method for the evaluation of breast non-palpable lesions. These results are similar to others in the literature.

Biopsy, Needle↗
PubMedDate not supplied

[Intravascular lymphomatosis: a rare etiology of recurrent cerebral ischemia].

INTRODUCTION: Intravascular lymphomatosis is a rarely seen clinicopathological condition. OBJECTIVE: To review the literature on cerebral ischemia and intravascular lymphomatosis. DEVELOPMENT: Intravascular lymphomatosis is usually caused by an uncommon type of non-Hodgkin lymphoma, usually of B cells, characterized by the localization of predominantly neoplastic cells within the small calibre blood vessels (arterioles, venules and capillaries). Therefore, it tends to cause multifocal vascular occlusions, with symptoms generally limited to the central nervous system, in the form of recurrent, multifocal cerebral infarcts--one in every 5,000 consecutive cases is usually of this aetiology--or rapidly progressive encephalopathy. Cerebral or meningeal biopsy, or biopsy of peripheral nerve, muscle, adrenal or lymphoid tissue, prostate or lung is usually diagnostic. The differential diagnosis is with vasculitis, multi-infarct dementia, occult neoplasia or infections. In spite of starting suitable treatment with chemotherapy or radiotherapy, the average survival from onset of symptoms is usually four months. CONCLUSION: Intravascular lymphomatosis should be taken into account in the differential diagnosis of repeated cerebral ischaemia of unusual aetiology.

Brain Ischemia↗
PubMedDate not supplied

[Unusual analytical interference caused by benzathine penicillin G].

Benzathine penicillin G is one of the antibiotics most often used in ENT practice. In spite of potential allergic or hypersensitivity complications, the restrictions for its administration are scant and its antibacterial spectrum often coincides with the pathogenic flora of the upper airways. A curious analytical interference secondary to its use was detected in two patients seen in our emergency unit. This phenomenon, not observed with other beta-lactamics or even other penicillins, consisted of a continuous false positive result in the urinary detection of amphetamine and its metabolites that lasted up to 50 days after the antibiotic was administered. This finding not only seems to be specific to the benzathine salt, but also to the enzymoimmunoanalysis used to detect drug abuse.

Amphetamines↗