Mujer de 45 años, en seguimiento por bocio multinodular, que presenta un cuadro de rápido crecimiento del tamaño de la glándula tiroidea, asociando disfonía, disfagia para líquidos y disnea al adoptar decúbito. En la TC cervical se apreció una gran masa tiroidea (12×13×8,5cm) que desplazaba y comprimía faringe y esófago, con disminución marcada de la luz traqueal (6mm); asimismo presentaba el «signo del donut» al envolver la masa por completo la tráquea separándola del esófago (fig. 1), característico del linfoma tiroideo. Tras biopsia tiroidea, se diagnosticó de linfoma no Hodgkin difuso de células B grandes.
array:24 [ "pii" => "S0009739X12003107" "issn" => "0009739X" "doi" => "10.1016/j.ciresp.2012.07.018" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "971" "copyright" => "AEC" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Cir Esp. 2013;91:e31" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4112 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 3597 "PDF" => 504 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2173507713001889" "issn" => "21735077" "doi" => "10.1016/j.cireng.2013.10.031" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "971" "copyright" => "AEC" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Cir Esp. 2013;91:e31" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2245 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 1811 "PDF" => 419 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the Month</span>" "titulo" => "Doughnut Sign in Thyroid Lymphoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e31" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Signo del donut en el linfoma tiroideo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 795 "Ancho" => 1150 "Tamanyo" => 83419 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Luis Muñoz de Nova, Ana Rodríguez Sánchez, Joaquín Gómez Ramírez, Eduardo Larrañaga Barrera" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José Luis" "apellidos" => "Muñoz de Nova" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Rodríguez Sánchez" ] 2 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Gómez Ramírez" ] 3 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Larrañaga Barrera" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X12003107" "doi" => "10.1016/j.ciresp.2012.07.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X12003107?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507713001889?idApp=UINPBA00004N" "url" => "/21735077/0000009100000006/v1_201312060036/S2173507713001889/v1_201312060036/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0009739X12002813" "issn" => "0009739X" "doi" => "10.1016/j.ciresp.2012.07.015" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "966" "copyright" => "AEC" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Cir Esp. 2013;91:e33" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4099 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 3575 "PDF" => 513 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">La imagen del mes</span>" "titulo" => "Nevus cerebriforme gigante" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e33" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Giant cerebriform nevus" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 693 "Ancho" => 900 "Tamanyo" => 83462 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Oscar Duménigo Arias, Yudisley Guerrero Osorio, Yamila Valiente Hernández" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Oscar" "apellidos" => "Duménigo Arias" ] 1 => array:2 [ "nombre" => "Yudisley" "apellidos" => "Guerrero Osorio" ] 2 => array:2 [ "nombre" => "Yamila" "apellidos" => "Valiente Hernández" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173507713001877" "doi" => "10.1016/j.cireng.2013.10.030" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507713001877?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X12002813?idApp=UINPBA00004N" "url" => "/0009739X/0000009100000006/v1_201306181545/S0009739X12002813/v1_201306181545/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0009739X12002667" "issn" => "0009739X" "doi" => "10.1016/j.ciresp.2012.05.026" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "951" "copyright" => "AEC" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Cir Esp. 2013;91:389" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2964 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 2427 "PDF" => 522 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">La imagen del mes</span>" "titulo" => "Herniación hepática tras neumonectomía extrapleural por mesotelioma" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "389" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Liver herniation after extrapleural pneumonectomy due to a mesothelioma" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 678 "Ancho" => 1297 "Tamanyo" => 84341 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Emilio Peña, Montserrat Blanco, José Ignacio Rivas-Polo, Jhon Christian Durán" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Emilio" "apellidos" => "Peña" ] 1 => array:2 [ "nombre" => "Montserrat" "apellidos" => "Blanco" ] 2 => array:2 [ "nombre" => "José Ignacio" "apellidos" => "Rivas-Polo" ] 3 => array:2 [ "nombre" => "Jhon Christian" "apellidos" => "Durán" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173507713001865" "doi" => "10.1016/j.cireng.2013.10.029" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507713001865?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X12002667?idApp=UINPBA00004N" "url" => "/0009739X/0000009100000006/v1_201306181545/S0009739X12002667/v1_201306181545/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">La imagen del mes</span>" "titulo" => "Signo del donut en el linfoma tiroideo" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e31" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Luis Muñoz de Nova, Ana Rodríguez Sánchez, Joaquín Gómez Ramírez, Eduardo Larrañaga Barrera" "autores" => array:4 [ 0 => array:4 [ "nombre" => "José Luis" "apellidos" => "Muñoz de Nova" "email" => array:1 [ 0 => "pepedenova@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Rodríguez Sánchez" ] 2 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Gómez Ramírez" ] 3 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Larrañaga Barrera" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de la Princesa, Madrid, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Autor para correspondencia</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Doughnut sign in thyroid lymphoma" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 795 "Ancho" => 1150 "Tamanyo" => 77542 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 45 años, en seguimiento por bocio multinodular, que presenta un cuadro de rápido crecimiento del tamaño de la glándula tiroidea, asociando disfonía, disfagia para líquidos y disnea al adoptar decúbito. En la TC cervical se apreció una gran masa tiroidea (12<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>8,5<span class="elsevierStyleHsp" style=""></span>cm) que desplazaba y comprimía faringe y esófago, con disminución marcada de la luz traqueal (6<span class="elsevierStyleHsp" style=""></span>mm); asimismo presentaba el «signo del donut» al envolver la masa por completo la tráquea separándola del esófago (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>), característico del linfoma tiroideo. Tras biopsia tiroidea, se diagnosticó de linfoma no Hodgkin difuso de células B grandes.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 795 "Ancho" => 1150 "Tamanyo" => 77542 ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/0009739X/0000009100000006/v1_201306181545/S0009739X12003107/v1_201306181545/es/main.assets" "Apartado" => array:4 [ "identificador" => "5762" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "La imagen del mes" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0009739X/0000009100000006/v1_201306181545/S0009739X12003107/v1_201306181545/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X12003107?idApp=UINPBA00004N" ]