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"documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;157:157" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Paraesophageal hernia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "157" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hernia de hiato paraesofágica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 639 "Ancho" => 1625 "Tamanyo" => 125072 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A computed tomographic scan showed a retrocardiac mass containing air and liquid, right middle lobe atelectasis and pleural effusion.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zi-Shan Lin, Xue-Jing Chen, Zhe Jin" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Zi-Shan" "apellidos" => "Lin" ] 1 => array:2 [ "nombre" => "Xue-Jing" "apellidos" => "Chen" ] 2 => array:2 [ "nombre" => "Zhe" "apellidos" => "Jin" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020621003521" "doi" => "10.1016/j.medcle.2020.06.042" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621003521?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320305455?idApp=UINPBA00004N" "url" => "/00257753/0000015700000003/v3_202112201214/S0025775320305455/v3_202112201214/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Perirenal infiltration: Key point in Erdheim-Chester disease diagnosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "158" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alejandra García Baizan, Paula Pereira Bouzas, Rosa Bouzas Sierra" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alejandra" "apellidos" => "García Baizan" ] 1 => array:4 [ "nombre" => "Paula" "apellidos" => "Pereira Bouzas" "email" => array:1 [ 0 => "ppereira@iib.uam.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Rosa" "apellidos" => "Bouzas Sierra" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Radiology, Hospital Universitario de Vigo (CHUVI), Vigo, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infiltración perirrenal: signo clave en el diagnóstico de la enfermedad de Erdheim-Chester" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 638 "Ancho" => 850 "Tamanyo" => 68501 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 45-year-old man presents 1.55<span class="elsevierStyleHsp" style=""></span>mg/dL levels of creatinine in a routine analysis. The first step was to conduct an ultrasound scan, at the health centre, that revealed a bilateral hydronephrosis with no apparent cause. Next, a multidetector computed tomography (MDCT) showed big kidneys with blur and increased density of perirenal and renal sinus fat (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), sign known as “hairy kidney”. These findings are typical of Erdheim-Chester Disease (ECD).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Perirenal fat biopsy with a diffuse infiltration by histiocytes and isolated Touton giant cells validated the diagnosis. BRAF V600E mutation was confirmed.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The bone marrow biopsy confirms dotted CD68+ foamy histiocytes.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Interstitial lung disease and symmetric long bone uptake in 99mTc bone scan was also noted, with predominance in femur and tibia (not shown). PET-TC confirmed diffuse hypermetabolic perirenal and renal disease. Pulmonary CT showed ground-glass opacities in upper lobes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patient initiated a treatment with Vemurafenib. PET-TC conducted after 16 weeks showed metabolic response in retroperitoneum.</p><p id="par0030" class="elsevierStylePara elsevierViewall">ECD is a non-Langerhans cell histiocytic neoplasm, a rare multisystemic disease with complex manifestations and often a delayed or overlooked diagnosis. The “hairy kidney” is a sign of extra bone manifestation of ECD and could be the first key for diagnosis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 638 "Ancho" => 850 "Tamanyo" => 68501 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015700000003/v3_202112201214/S0025775320305200/v3_202112201214/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015700000003/v3_202112201214/S0025775320305200/v3_202112201214/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320305200?idApp=UINPBA00004N" ]
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