Hemangiomatose neonatal difusa : caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Tab.1: Composition of salt crusts and host rocks

Gypsum and calcite crusts were found on many outcrops of the metamorphic basement and on moraines in Dronning Maud Land. For the first time the copper mineral connellite was found in such crusts. Salt crust and efflorescences indicate an important role of chemical weathering even in a cold and arid climate such as the Antarctic interior. Findings of salt efflorescenees few centimetres beneath the rock surface suggest the contribution of salt crystallization to the formation of the typical Antarctic cavernous or honeycomb weathering features.

The Bioeroding Sponge Aka paratypica, a Modern Tracemaking Analogue for the Paleozoic Ichnogenus Entobia devonica

Many attempts have been made by ichnologists to match bioerosion traces to their respective tracemakers. This task has been considered difficult, especially for fossil samples. The present study demonstrates that the Australian bioeroding sponge Aka paratypica can generate a cavity similar to the ichnospecies Entobia devonica. The modern sponge and its cavity are redescribed and compared to the fossil boring. A. paratypica has white fistules and soft, mucoid endosomal tissue. Spicules are stout oxeas with often telescoped or mucronate tips. Observed borings of A. paratypica are rounded and cavernous, with canals and apertures radiating from the chambers in all directions. It was noted that the internal openings of such canals are covered with porous nodules, which may act as sieves against larger particles or intruding endofauna. No obvious microsculpturing was observed in the erosion scars. A. paratypica borings are analogous to ancient E. devonica borings, which to date were only known from the fossil record.

Masson’s tumor: a soft tissue tumor simulating a tendon cyst. Case report

Introduction. Intravascular papillary endothelial hyperplasia (Masson's hemangioma or Masson’s tumor) is a benign vascular disease with an exuberant endothelial proliferation in normal blood vessels. Although relatively uncommon, its correct diagnosis is important because it can clinically be like both benign lesions and malignant neoplasms. We present a case of intravascular proliferative endothelial hyperplasia simulating a tendon cyst both clinically and on ultrasound. Case report. A 74-year old Caucasian female presented with a 4-month history of soreness and swelling in the fourth finger of the right hand. Ultrasound showed an oval mass with fluid content, referred to a tendon cyst. A wide surgical excision was subsequently performed. The final histological diagnosis was Masson’s tumor. Discussion. The pathogenesis of intravascular papillary endothelial hyperplasia is still unclear but the exuberant endothelial cell proliferation might be stimulated by an autocrine loop of endothelial basic fibroblast growth factor (bFGF) secretion. There are three types of papillary endothelial hyperplasia: primary, or intravascular; secondary, or mixed; and extravascular. The main differential diagnosis is against pyogenic granuloma, Kaposi sarcoma, hemangioma, and angiosarcoma. Conclusions. Masson's tumor can be like both benign lesions and malignant neoplasms clinically and on ultrasound. For this reason, the right diagnosis can be made only by histology, which reveals a papillary growth composed of hyperplastic endothelial cells supported by delicate fibrous stalks entirely confined within the vascular lumen.

Hydrothermale Dolomitisierung im Kauffunger Kalkstein (Paläozoikum - W-Sudeten, Polen

Within the Kauffung Limestone dolomite bodies related to volcanic contacts occure and are interpreted as a post-Variscan, hydrothermal volcanogenic formation. Two genetic dolomite types are discernible: a pervasive replacement saddle dolomite and a cavity filling saddle dolomite cement. Micro texture and oxygen isotopy of both dolomite types refer to heightened temperatures of formation. The ocurrence of the dolomite in contact to cross-cutting rhyolithic dikes points to a close petrogenetic relation. Dolomite bodies and rhyolithic injections in contrast to the rock wall are characterized by a distinctive cavernous texture, so that a prekinematic genesis is excluded. The formation of replacement saddle dolomite and saddle dolomite cement altogether are considered as a concomitant phenomenon of the Permo-Carboniferous volcanism widespread in the Bober-Katzbach Mountains.

Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

BACKGROUND: in 21st century, endoscopic study of the small intestine has undergone a revolution with capsule endoscopy and balloon-assisted enteroscopy. The difficulties and morbidity associated with intraoperative enteroscopy, the gold-standard in the 20th century, made this technique to be relegated to a second level. AIMS: evaluate the actual role and assess the diagnostic and therapeutic value of intraoperative enteroscopy in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: we conducted a retrospective study of 19 patients (11 males; mean age: 66.5 ± 15.3 years) submitted to 21 IOE procedures for obscure GI bleeding. Capsule endoscopy and double balloon enteroscopy had been performed in 10 and 5 patients, respectively. RESULTS: with intraoperative enteroscopy a small bowel bleeding lesion was identified in 79% of patients and a gastrointestinal bleeding lesion in 94%. Small bowel findings included: angiodysplasia (n = 6), ulcers (n = 4), small bowel Dieulafoy´s lesion (n = 2), bleeding from anastomotic vessels (n = 1), multiple cavernous hemangiomas (n = 1) and bleeding ectopic jejunal varices (n = 1). Agreement between capsule endoscopy and intraoperative enteroscopy was 70%. Endoscopic and/or surgical treatment was used in 77.8% of the patients with a positive finding on intraoperative enteroscopy, with a rebleeding rate of 21.4% in a mean 21-month follow-up period. Procedure-related mortality and postoperative complications have been 5 and 21%, respectively. CONCLUSIONS: intraoperative enteroscopy remains a valuable tool in selected patients with obscure GI bleeding, achieving a high diagnostic yield and allowing an endoscopic and/or surgical treatment in most of them. However, as an invasive procedure with relevant mortality and morbidity, a precise indication for its use is indispensable.