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González-Sánchez C, Salvador-Egea MP, Glückmann-Maldonado E, Ríos A, Martín-Fernández J, Pérez-García JI, García-Lorenzo F, Flores-Pastor B, Gómez-Ramírez J, Ortega-Serrano J, Ros-López S, Villar-Del-Moral J, Morales-García D, Gutiérrez-Rodríguez MT, Domènech-Calvet J, Nuño-Vázquez-Garza JM, Franch-Arcas G. Diagnosis and treatment of primary thyroid lymphoma from a surgical perspective: a multi-institutional study. Langenbecks Arch Surg 2023; 408:206. [PMID: 37221304 DOI: 10.1007/s00423-023-02945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE Surgery of primary thyroid lymphoma (PTL) has been mostly limited to diagnostic work-up. This study aimed to further study its potential role. METHODS This was a retrospective study from a multi-institutional registry of PTL patients. Clinical, diagnostic work-up (fine needle aspiration, FNA; core needle biopsy, CoreNB), contribution of surgery (open surgical biopsy, OpenSB; thyroidectomy), histology subtype, and outcome data were evaluated. RESULTS Some 54 patients were studied. Diagnostic work-up included FNA in 47 patients, CoreNB in 11, and OpenSB in 21. CoreNB yielded the best sensitivity (90.9%). Thyroidectomy was performed in 14 patients with other diagnosis (incidental PTL), in 4 for diagnosis and in 4 for elective treatment of PTL. Incidental PTL was associated with not performed FNA nor CoreNB (OR 52.5; P = 0.008), mucosa-associated lymphoid tissue (MALT) subtype (OR 24.3; P = 0.012), and Hashimoto's thyroiditis (OR 11.1; P = 0.032). Lymphoma-related death (10 cases) mostly occurred within the first year after diagnosis and was associated with diffuse large B-cell (DLBC) subtype (OR 10.3; P = 0.018) and older patients (OR 1.08 for every 1-year increase; P = 0.010). There was a trend towards lower mortality rate in patients receiving thyroidectomy (2/22 versus 8/32, P = 0.172). CONCLUSION Incidental PTL accounts for most of thyroid surgery cases and are associated with incomplete diagnostic work-up, Hashimoto's thyroiditis and MALT subtype. CoreNB appears to be the best tool for diagnosis. Most of PTL deaths occurred during the first year after diagnosis and mostly related to systemic treatment. Age and DLBC subtype are poor prognostic factors.
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Affiliation(s)
- C González-Sánchez
- Department of Surgery, Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente, 88-132, 37007, Salamanca, Spain.
- Instituto de Investigación Biomédica de Salamanca IBSAL, Salamanca, Spain.
| | - M P Salvador-Egea
- Department of Surgery, Complejo Hospitalario de Navarra B, Pamplona, Spain
| | | | - A Ríos
- Department of Surgery, Hospital Clínico Universitario Arrixaca, Murcia, Spain
| | - J Martín-Fernández
- Department of Surgery, Complejo Hospitalario de Ciudad Real, Ciudad Real, Spain
| | - J I Pérez-García
- Department of Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - F García-Lorenzo
- Department of Surgery, Hospital Alvaro Cunqueiro de Vigo, Vigo, Spain
| | - B Flores-Pastor
- Department of Surgery, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - J Gómez-Ramírez
- Department of Surgery, Hospital Universitario La Paz, Madrid, Spain
| | - J Ortega-Serrano
- Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - S Ros-López
- Department of Surgery, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - J Villar-Del-Moral
- Department of Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria IBS de Granada, Granada, Spain
| | - D Morales-García
- Department of Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - J Domènech-Calvet
- Department of Surgery, Hospital Universitario Sant Joan de Reus, Reus, Spain
| | | | - G Franch-Arcas
- Department of Surgery, Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente, 88-132, 37007, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca IBSAL, Salamanca, Spain
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Soria-Aledo V, Flores-Pastor B, Carrasco-Prats M, Aguayo-Albasini JL. [Thromboembolic prophylaxis in major abdominopelvic surgery after introducing improvement measures]. ACTA ACUST UNITED AC 2013; 29:120-1. [PMID: 24361336 DOI: 10.1016/j.cali.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 11/13/2013] [Indexed: 10/25/2022]
Affiliation(s)
- V Soria-Aledo
- Servicio de Cirugía General, Hospital Morales Meseguer, Universidad de Murcia, Campus Mare Nostrum, Murcia, España.
| | - B Flores-Pastor
- Servicio de Cirugía General, Hospital Morales Meseguer, Universidad de Murcia, Campus Mare Nostrum, Murcia, España
| | - M Carrasco-Prats
- Servicio de Cirugía General, Hospital Santa Lucía, Cartagena, Murcia, España
| | - J L Aguayo-Albasini
- Servicio de Cirugía General, Hospital Morales Meseguer, Universidad de Murcia, Campus Mare Nostrum, Murcia, España
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Castillo-Bustos JA, Aguayo-Albasini JL, Flores-Pastor B. [Clinic recommendations according to the Grading of Recommendations, Assessment, Development and Evaluation system]. ACTA ACUST UNITED AC 2013; 61:61-3. [PMID: 23816367 DOI: 10.1016/j.redar.2013.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 05/02/2013] [Accepted: 05/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J A Castillo-Bustos
- Servicio de Anestesiología, Hospital General Universitario Morales Meseguer, Murcia, España.
| | - J L Aguayo-Albasini
- Servicio de Cirugía General, Hospital General Universitario Morales Meseguer, Murcia, España
| | - B Flores-Pastor
- Servicio de Cirugía General, Hospital General Universitario Morales Meseguer, Murcia, España
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Martínez-Gómez D, Campillo-Soto Á, Bataller-Peñafiel E, del Pozo P, Cases-Baldó MJ, Escribano-Jiménez M, Flores-Pastor B, Aguayo-Albasini JL. 308. Improvement in Pain Management in the Ambulatory Patient: Importance of Implementing a Protocol's Postoperative Pain. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Campillo-Soto A, Coll-Salinas A, Soria-Aledo V, Blanco-Barrio A, Flores-Pastor B, Candel-Arenas M, Aguayo-Albasini J. [Spontaneous pneumomediastinum: descriptive study of our experience with 36 cases]. Arch Bronconeumol 2005; 41:528-31. [PMID: 16194517 PMCID: PMC7129626 DOI: 10.1016/s1579-2129(06)60274-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Spontaneous pneumomediastinum is defined as a primary process characterized by the presence of air or gas in the mediastinum. We report all the cases of spontaneous pneumomediastinum diagnosed in our hospital between January 1996 and December 2004. We developed a protocol for data collection that included the following: medical history, triggers, signs, radiology, treatment, hospital stay, and complications. During this period we diagnosed 36 cases—25 men (69.4%) and 11 women (30.6%)—with a mean age of 36.8 years (range, 11-90 years) and a mean hospital stay of 8.56 days (range, 1-53 days). The most common clinical presentation was chest pain, either isolated (27%) or with associated dyspnea (19.4%). A triggering factor was identified for 14 patients (38.8%). There was no associated morbidity or mortality. In view of our findings, we concluded that spontaneous pneumomediastinum is an uncommon entity with considerable clinical variability and that correct diagnosis requires a high level of suspicion. Radiography provides the best evidence for diagnosis.
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Affiliation(s)
- A. Campillo-Soto
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
- Correspondence: Dr. A. Campillo-Soto. Avda. Marqués de los Vélez, s/n. 30008 Murcia. España
| | - A. Coll-Salinas
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
| | - V. Soria-Aledo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
| | - A. Blanco-Barrio
- Servicio de Radiodiagnóstico, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
| | - B. Flores-Pastor
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
| | - M. Candel-Arenas
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
| | - J.L. Aguayo-Albasini
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario J.M. Morales Meseguer, Murcia, Spain
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Martín-Lorenzo JG, Torralba-Martinez A, Lirón-Ruiz R, Flores-Pastor B, Miguel-Perelló J, Aguilar-Jimenez J, Aguayo-Albasini JL. Intestinal invagination in adults: preoperative diagnosis and management. Int J Colorectal Dis 2004; 19:68-72. [PMID: 12838363 DOI: 10.1007/s00384-003-0514-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2003] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Intestinal invagination in adults is an uncommon but potentially serious condition that is usually diagnosed during surgery by the presence of a mechanical obstructive syndrome. We report a series of adults with intestinal invagination and discuss preoperative diagnosis and surgical procedures. PATIENTS AND METHODS We analyzed the files of all the seven patients aged over 18 years with a postoperative diagnosis of intestinal invagination and treated at our center between 1996 and 2000. RESULTS Preoperative causal diagnosis was established in six cases by ultrasonography and computed tomography. All the patients received surgery, three as emergency and four programmed. The lesions causing the invagination were: three benign (Meckel's diverticulum, inflammatory pseudotumor, fibroid polyp) and one malignant (degenerative villous adenoma polyp) located in the terminal ileum, two malignant lesions in the cecum (both adenocarcinomas over a polyp), and in the remaining case a double lymphoma of the jejunum and ileum. The intussusceptions were ileoileal in three cases and ileocolic in four. We performed intestinal resection in six cases and one excision of Meckel's diverticulum. CONCLUSION Preoperative diagnosis of intussusception was possible in most cases. Sonography and computed tomography proved the most effective and useful preoperative diagnostic methods. In adults colonic invagination is almost always malignant while small bowel is almost always benign. Invagination in adults must be clarified by surgery, and intestinal resection is the procedure of choice.
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Affiliation(s)
- J G Martín-Lorenzo
- Department of General Surgery, Hospital General Universitario J.M. Morales Meseguer, C/Marqués de los Vélez s/n, 30008, Murcia, Spain.
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