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Diagnóstico inicial en metástasis ganglionar con patrón de carcinoma neuroendocrino de células grandes. Descripción de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "252" "paginaFinal" => "256" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Initial diagnosis of small cell carcinoma of prostate in a nodal metastasis of large cell neuroendocrine carcinoma. A case report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1516 "Ancho" => 1500 "Tamanyo" => 653132 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Estudio inmunohistoquímico del cilindro prostático. A)<span class="elsevierStyleHsp" style=""></span>Células tumorales con inmunotinción positiva con PSA (×200). B)<span class="elsevierStyleHsp" style=""></span>Inmunorreacción con racemasa (×200). C)<span class="elsevierStyleHsp" style=""></span>El componente de carcinoma de células pequeñas es positivo con sinaptofisina, siendo negativa en el componente de adenocarcinoma acinar convencional (×100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Haydee de la Hoz-Herazo, Laura Macías-García, Antonio Robles-Frías, María Jesús Pareja-Megía, Rafael Martinez-García, Juan López-Garrido" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Haydee" "apellidos" => "de la Hoz-Herazo" ] 1 => array:2 [ "nombre" => "Laura" "apellidos" => "Macías-García" ] 2 => array:2 [ "nombre" => "Antonio" "apellidos" => "Robles-Frías" ] 3 => array:2 [ "nombre" => "María Jesús" "apellidos" => "Pareja-Megía" ] 4 => array:2 [ "nombre" => "Rafael" "apellidos" => "Martinez-García" ] 5 => array:2 [ "nombre" => "Juan" "apellidos" => "López-Garrido" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699885513000068?idApp=UINPBA00004N" "url" => "/16998855/0000004600000004/v1_201310300857/S1699885513000068/v1_201310300857/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1699885513000081" "issn" => "16998855" "doi" => "10.1016/j.patol.2012.12.006" "estado" => "S300" "fechaPublicacion" => "2013-10-01" "aid" => "226" "copyright" => "SEAP y SEC" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Esp Patol. 2013;46:242-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1770 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 1405 "PDF" => 359 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo breve</span>" "titulo" => "Carcinoma de glándulas anales: criterios diagnósticos. Descripción de un caso y revisión de la literatura" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "242" "paginaFinal" => "246" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The diagnostic criteria of anal gland carcinoma: a case report and review of the literature" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1142 "Ancho" => 1582 "Tamanyo" => 423223 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Adenocarcinoma de glándulas anales. En esta visión es posible observar el patrón de crecimiento predominantemente profundo de la lesión, conformado por múltiples estructuras tubulares que forman pseudolóbulos separados por tabiques fibrosos. También pueden identificarse áreas de patrón desordenado y de aspecto infiltrativo entre los haces de la muscular propia (HE, 100×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolina Martínez-Ciarpaglini, Estefanía Zorraquino, Samuel Navarro" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Carolina" "apellidos" => "Martínez-Ciarpaglini" ] 1 => array:2 [ "nombre" => "Estefanía" "apellidos" => "Zorraquino" ] 2 => array:2 [ "nombre" => "Samuel" "apellidos" => "Navarro" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699885513000081?idApp=UINPBA00004N" "url" => "/16998855/0000004600000004/v1_201310300857/S1699885513000081/v1_201310300857/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>" "titulo" => "AIDS-related gastric cryptosporidiosis simulating malignancy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "247" "paginaFinal" => "251" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Fernando Val-Bernal, Marta Mayorga, Ainara Azueta, Joaquín Cabezas, José Luis Lozano, Fidel Fernández" "autores" => array:6 [ 0 => array:4 [ "nombre" => "José Fernando" "apellidos" => "Val-Bernal" "email" => array:2 [ 0 => "apavbj@humv.es" 1 => "valbernal@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Marta" "apellidos" => "Mayorga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Ainara" "apellidos" => "Azueta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Joaquín" "apellidos" => "Cabezas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "José Luis" "apellidos" => "Lozano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Fidel" "apellidos" => "Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Digestive Endoscopy Unit, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Internal Medicine, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cryptosporidiosis gástrica relacionada con el SIDA simulando un tumor maligno" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1280 "Ancho" => 950 "Tamanyo" => 248602 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Gastric antral cryptosporidiosis. Abundant cryptosporidia are present attached to the apical border of the epithelial cells.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cryptosporidium organisms in AIDS syndrome most frequently colonize the small intestine, but the entire gastrointestinal tract, the esophagus, the gallbladder, biliary ducts, the pancreas<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and the respiratory tract may be involved.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Gastric involvement in AIDS-associated cryptosporidiosis has been infrequently reported.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> Furthermore, as far as we are aware gastric cryptosporidiosis simulating malignancy has not been described.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 56-year-old HIV-positive male patient presented with severe immunosuppression after antiretroviral treatment dropout. He was diagnosed as Pneumocystis jiroveci pneumonia which responded to the treatment with trimethoprim-sulfamethoxazole. The following days he complained of progressive severe diarrhea (up to 15 stools a day), loss of appetite and loss of weight. Later on, the patient presented perioral ulcerative lesions and difficulty of swallowing. A colonoscopy showed the presence of cryptosporidium in the biopsies taken from the colonic mucosa. In the course of his process, 5 days later, he presented epigastric discomfort, nausea and vomiting. The abdominal CT with contrast showed an important concentric thickening of the gastric antrum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Upper gastrointestinal endoscopic evaluation revealed lack of distensibility of the gastric wall and marked thickening, stiffness, distortion, and erosions of mucosal folds involving the antrum region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The mucosa was erythematous and friable extending through the pylorus and duodenum. This endoscopy was clinically reported as gastric malignancy suggestive of lymphoma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histological examination of antral biopsies revealed gastric pits greatly extended because of increase in the number of epithelial cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). These long pits had a sinuous course (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). In the lamina propria of the mucosa mild-to-moderate diffuse infiltration of lymphoid cells, plasma cells, neutrophils and eosinophils and mild edema was observed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). Numerous small, uniform round, basophilic organisms measuring about 2<span class="elsevierStyleHsp" style=""></span>μm in size were found attached to the apical surface of the foveolar epithelium and in the lumen of this structure (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">They showed a patchy distribution. These organisms were stained with Giemsa. Epithelial necrosis in occasional pits was observed. The spheric structures were identified as cryptosporidium oocysts. Helicobacter pylori was not present.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Taking into account the former endoscopy appearance a new upper gastrointestinal endoscopy was performed 6 days later. This confirmed the same findings in the antrum; and similar organisms were observed in the antral biopsies. A sample of the esophagus showed intranuclear inclusions of cytomegalovirus in the vascular endothelial cells of the lamina propria (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Since the 1996 advent of highly active antiretroviral therapy for the treatment of AIDS, the incidence of most opportunistic infections in industrialized countries has dramatically declined but certainly has not disappeared.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Cryptosporidium gastropathy is uncommonly reported. Coelho et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> detected gastric cryptosporidiosis in two out of 60 (3.3%) patients with AIDS systematically submitted to biopsies of the gastric mucosa.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Gastric involvement in cryptosporidiosis is considered to be secondary to the retrograde spread from the small intestine.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The location is mostly in the antrum due to its proximity to the duodenum. On the other hand, in that gastric area the environment is less acidic than in the corpus and consists of neutral mucus-secreting cells that allow parasite colonization and subsequent development.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In a series of 16 patients with AIDS who showed cryptosporidium by histologic examination of gastric biopsies only three (18.7%) had vomiting and only one (6.2%) reported epigastric pain.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Vomiting and epigastric pain has been observed in patients with extensive parasitized gastric mucosa<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> as occurred in our patient.</p><p id="par0050" class="elsevierStylePara elsevierViewall">On the other hand, Rivasi et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> in a series of eight patients did not found significant mucosal abnormalities in half of the individuals by endoscopic examination while hyperemia and edema was observed in the other half. Therefore, the lack of an endoscopic appearance suggestive of gastric cryptosporidial infection makes the diagnosis difficult. Furthermore, no clear correlation has been found between endoscopic and histologic findings, since histologic examination may reveal a high parasite burden in cases with normal endoscopic appearances.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Berk et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> in a barium study of the stomach and small intestine in 16 AIDS patients with cryptosporidiosis observed that the stomach was normal in appearance in all but two patients. These cases showed rigidity and lack of distensibility, but no mucosal hyperplasia.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Thickened antral folds with narrowing in that area have been occasionally reported by endoscopy in gastric cryptosporidiosis.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a> Even this fact has been consistent with the diagnosis of partial gastric outlet obstruction.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a> This process has also been observed in animals.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,15</span></a> However, to the best of our knowledge a prominent hyperplasia of the antral mucosa simulating malignancy has not been reported.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Cryptosporidium is a parasitic protozoan unique among the coccidian because it lies attached to the apical border of the epithelial cells. This superficial position differs from that the other coccidian. Thus, Microsporidia spores are located supranuclearly in the apical cytoplasm and Isospora belly occupies a subnuclear basal cytoplasmic position. Cyclospora like cryptosporidium can be present in the cell surface. That organism is similar in appearance but it is much larger (8–10<span class="elsevierStyleHsp" style=""></span>μm). Cryptosporidia are small, uniform, dotlike organisms that attach to the surface epithelium. Small size and uniformity distinguish them from struded mucin droplets or cellular debris.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Although affliction of the entire gastrointestinal tract with Cryptosporidium has been described, localization to the stomach is uncommon. Non-Hodgkin lymphoma and superficial spreading carcinoma are recognized causes of gastric thickening in endoscopy, but cryptosporidiosis is a rare cause reported in this study. This type of lesion should be included in the differential diagnosis of AIDS patients with lesions simulating gastric malignancy.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Protection of human and animal subjects</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Confidentiality of data</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres287779" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec271260" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres287778" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec271261" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Right to privacy and informed consent" ] ] ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-02-21" "fechaAceptado" => "2013-03-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec271260" "palabras" => array:4 [ 0 => "AIDS" 1 => "Lymphoma" 2 => "Malignant tumour" 3 => "Stomach" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec271261" "palabras" => array:5 [ 0 => "Criptosporidiosis" 1 => "Estómago" 2 => "Linfoma" 3 => "SIDA" 4 => "Tumor maligno" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cryptosporidium localization to the stomach is uncommon. We report a case of a 56-year-old, HIV-positive, male patient with severe immunosuppression after antiretroviral treatment dropout who presented with epigastric discomfort, nausea and vomiting. The abdominal CT with contrast showed an important concentric thickening of the gastric antrum wall. Upper gastrointestinal endoscopic evaluation revealed lack of distensibility of the gastric wall and marked thickening, stiffness, distortion, and erosions of mucosal folds involving the antrum region. The endoscopy was clinically reported as gastric malignancy suggestive of lymphoma. The histopathologic diagnosis was cryptosporidiosis. To our knowledge, gastric cryptosporidiosis simulating malignancy has not been previously described. This type of lesion should be included in the differential diagnosis of AIDS patients with lesions simulating gastric malignancy.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La localización del Cryptosporidium en el estómago es infrecuente. Se presenta el caso de un paciente de 56 años de edad, VIH-positivo, con inmunosupresión severa, después de abandonar el tratamiento anti-retroviral, que presentó malestar epigástrico, náuseas y vómitos. La TC abdominal con contraste mostró un engrosamiento concéntrico importante del antro gástrico. La evaluación endoscópica gastrointestinal reveló falta de distensibilidad de la pared gástrica y marcado engrosamiento, junto con rigidez, distorsión y erosión de los pliegues de la mucosa del antro. El estudio endoscópico fue informado como proceso maligno sugestivo de linfoma. El diagnóstico histopatológico fue de criptosporidiosis. De acuerdo con nuestro conocimiento, la criptosporidiosis gástrica simulando un tumor maligno no ha sido descrita. Este tipo de lesión se debe incluir en el diagnóstico diferencial de pacientes VIH+ con lesiones que sugieran malignidad gástrica.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 602 "Ancho" => 1500 "Tamanyo" => 139797 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Abdominal CT scan showing thickening of the gastric antrum. (B) Upper gastrointestinal endoscopy showing markedly thickened antral mucosa. The mucosa is erythematous and friable.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1026 "Ancho" => 1498 "Tamanyo" => 414347 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Gastric antral cryptosporidiosis. (A) The length of the gastric pits is greatly extended due to the increase in the number of epithelial cells. Moderate degree of inflammatory cells in the lamina propria can be seen. (B) Enlarged gastric pits show a sinuous course. Cryptosporidia show a patchy distribution.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1280 "Ancho" => 950 "Tamanyo" => 248602 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Gastric antral cryptosporidiosis. Abundant cryptosporidia are present attached to the apical border of the epithelial cells.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1013 "Ancho" => 1500 "Tamanyo" => 388937 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cytomegalovirus infection of the esophagus. 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Brief report
AIDS-related gastric cryptosporidiosis simulating malignancy
Cryptosporidiosis gástrica relacionada con el SIDA simulando un tumor maligno
José Fernando Val-Bernala,
, Marta Mayorgaa, Ainara Azuetaa, Joaquín Cabezasb, José Luis Lozanoc, Fidel Fernándeza
Autor para correspondencia
a Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain
b Digestive Endoscopy Unit, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain
c Department of Internal Medicine, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria and IFIMAV, Santander, Spain