array:24 [
  "pii" => "S2173511509700922"
  "issn" => "21735115"
  "doi" => "10.1016/S2173-5115(09)70092-2"
  "estado" => "S300"
  "fechaPublicacion" => "2009-01-01"
  "aid" => "70092"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2009"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "cor"
  "cita" => "Rev Port Pneumol. 2009;15:93-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3944
    "formatos" => array:3 [
      "EPUB" => 215
      "HTML" => 1896
      "PDF" => 1833
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173511509700934"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(09)70093-4"
    "estado" => "S300"
    "fechaPublicacion" => "2009-01-01"
    "aid" => "70093"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2009;15:101-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3234
      "formatos" => array:3 [
        "EPUB" => 234
        "HTML" => 1877
        "PDF" => 1123
      ]
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Carcinoma adenóide quístico recorrente. Revisão a propósito de um caso clínico"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "101"
          "paginaFinal" => "107"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Recurrent adenoid cystic carcinoma. Review based on a case report"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nicole Murinello, M Emília Vitorino, Cristina Matos, José Manuel Correia, Manuela Lima, Pedro Baptista, José Sena Lino, Fernando Nogueira"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Nicole"
              "apellidos" => "Murinello"
            ]
            1 => array:2 [
              "nombre" => "M"
              "apellidos" => "Emília Vitorino"
            ]
            2 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Matos"
            ]
            3 => array:2 [
              "nombre" => "José"
              "apellidos" => "Manuel Correia"
            ]
            4 => array:2 [
              "nombre" => "Manuela"
              "apellidos" => "Lima"
            ]
            5 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Baptista"
            ]
            6 => array:2 [
              "nombre" => "José"
              "apellidos" => "Sena Lino"
            ]
            7 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Nogueira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509700934?idApp=UINPBA00004E"
    "url" => "/21735115/0000001500000001/v1_201305151504/S2173511509700934/v1_201305151504/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173511509700910"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(09)70091-0"
    "estado" => "S300"
    "fechaPublicacion" => "2009-01-01"
    "aid" => "70091"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Pneumol. 2009;15:89-92"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3772
      "formatos" => array:3 [
        "EPUB" => 224
        "HTML" => 1959
        "PDF" => 1589
      ]
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Tuberculose do lobo pulmonar inferior"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "89"
          "paginaFinal" => "92"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Lower lung field tuberculosis"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "José Roberto Silva, Adelino Carragoso, Isabel Gil, Simões Torres, Orlando Gaspar"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "José"
              "apellidos" => "Roberto Silva"
            ]
            1 => array:2 [
              "nombre" => "Adelino"
              "apellidos" => "Carragoso"
            ]
            2 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Gil"
            ]
            3 => array:2 [
              "nombre" => "Simões"
              "apellidos" => "Torres"
            ]
            4 => array:2 [
              "nombre" => "Orlando"
              "apellidos" => "Gaspar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509700910?idApp=UINPBA00004E"
    "url" => "/21735115/0000001500000001/v1_201305151504/S2173511509700910/v1_201305151504/pt/main.assets"
  ]
  "pt" => array:14 [
    "idiomaDefecto" => true
    "titulo" => "Adenocarcinoma do pulmão em doente com esclerodermia: Um caso clínico"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "93"
        "paginaFinal" => "99"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "João Bento, Gabriela Fernandes, Maria Alice Barbosa, Adriana Magalhães, Ana Rosa Santos, Venceslau Hespanhol"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "João"
            "apellidos" => "Bento"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Gabriela"
            "apellidos" => "Fernandes"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Maria"
            "apellidos" => "Alice Barbosa"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Adriana"
            "apellidos" => "Magalh&#227;es"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ana"
            "apellidos" => "Rosa Santos"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Venceslau"
            "apellidos" => "Hespanhol"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">4</span>"
                "identificador" => "aff0020"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Interno Complementar de Pneumologia"
            "etiqueta" => "<span class="elsevierStyleSup">1</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Assistente Hospitalar de Pneumologia"
            "etiqueta" => "<span class="elsevierStyleSup">2</span>"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Assistente Hospitalar Graduado de Pneumologia"
            "etiqueta" => "<span class="elsevierStyleSup">3</span>"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Chefe de Servi&#231;o de Pneumologia"
            "etiqueta" => "<span class="elsevierStyleSup">4</span>"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Servi&#231;o de Pneumologia&#44; Hospital de S&#227;o Jo&#227;o&#44; EPE&#44; Porto"
            "etiqueta" => "<span class="elsevierStyleSup">5</span>"
            "identificador" => "aff0025"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Lung adenocarcinoma associated with systemic sclerosis&#58; A case report"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2008-04-21"
    "fechaAceptado" => "2008-09-12"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec159916"
          "palabras" => array:4 [
            0 => "Esclerodermia"
            1 => "cancro"
            2 => "pulm&#227;o"
            3 => "fibrose"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec159915"
          "palabras" => array:4 [
            0 => "Systemic sclerosis"
            1 => "cancer"
            2 => "lung"
            3 => "fibrosis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A esclerodermia &#233; uma doen&#231;a do tecido conjuntivo de etiologia desconhecida&#44; que tem sido associada a um risco acrescido de malignidade&#46; O cancro do pulm&#227;o &#233; a neoplasia mais frequente&#44; nestes doentes&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Apresenta-se o caso cl&#237;nico de uma mulher de 42 anos&#44; n&#227;o fumadora&#44; com esclerodermia&#44; que desenvolveu agravamento progressivo do seu estado geral e derrame pleural com caracter&#237;sticas de exsudado&#44; sem evid&#234;ncia de infec&#231;&#227;o ou malignidade&#46; A TAC tor&#225;cica mostrou zonas de fibrose&#44; a broncofibroscopia&#44; os lavados br&#244;nquico e broncoalveolar foram normais&#46; Foi exclu&#237;da neoplasia extrapulmonar&#46; Na pleuroscopia&#44; observaram-se forma&#231;&#245;es nodulares&#44; cujas bi&#243;psias revelaram tratar-se de adenocarcinoma pulmonar&#46; Iniciou quimioterapia&#44; desenvolvendo ao 48&#46;&#176; dia neutropenia febril e s&#233;psis&#44; vindo a morrer 12 dias depois&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Salientamos este caso pela rela&#231;&#227;o&#44; apesar de rara&#44; entre a esclerodermia e o cancro do pulm&#227;o e pela import&#226;ncia de uma vigil&#226;ncia pulmonar cuidadosa&#44; em indiv&#237;duos com esta doen&#231;a reumatol&#243;gica&#44; pelo risco acrescido de neoplasia&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Systemic sclerosis &#40;scleroderma&#41; is a connective tissue disorder of unknown aetiology characterised by immune abnormalities&#44; which has been related to an increased risk of malignancy&#46; Lung cancer is the most prevalent among these patients&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We present a clinical case of a 42 years old non smoker female with systemic sclerosis&#46; She presented progressive general health status worsening and an exudative pleural effusion&#44; with no evidence of infection or malignancy&#46; Chest high resolution computed tomography revealed pulmonary fibrosis&#46; Bronchoscopy&#44; bronchial and bronchoalveolar lavage were normal&#46; Extrapulmonary malignancies were excluded&#46; Pleural nodularities were found on pleuroscopy and the biopsy was compatible with lung adenocarcinoma&#46; Chemotherapy was then started&#44; which complicated with febrile neutropenia&#44; sepsis and patient death 12 days after&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The purpose of this case report is to bring attention to the relationship&#44; although rare&#44; between systemic sclerosis and lung cancer&#44; stressing the importance of adequate pulmonary surveillance in these patients&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:13 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and prevalence of systemic sclerosis&#58; a systematic literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Chifflot"
                            1 => "B&#46; Fautrel"
                            2 => "C&#46; Sordet"
                            3 => "E&#46; Chatelus"
                            4 => "J&#46; Sibilia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2007.05.003"
                      "Revista" => array:7 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2008"
                        "volumen" => "37"
                        "numero" => "4"
                        "paginaInicial" => "223"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17692364"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality and causes of death in a Swedish s&#233;ries of systemic sclerosis patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Hesselstrand"
                            1 => "A&#46; Scheja"
                            2 => "A&#46; Akesson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "1998"
                        "volumen" => "57"
                        "paginaInicial" => "682"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9924211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary involvement in diffuse cutaneous systemic sclerosis&#58; broncheoalveolar fluid granulocytosis predicts progreesion of fibrosing alveolitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Christian Witt"
                            1 => "Adrian C&#46; Borges"
                            2 => "Mathias John"
                            3 => "Ingo Fietze"
                            4 => "Gert Baumann"
                            5 => "Andreas Krause"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "1999"
                        "volumen" => "58"
                        "paginaInicial" => "635"
                        "paginaFinal" => "640"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10491363"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of cancer in patients with scleroderma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;E&#46; Pearson"
                            1 => "A&#46;J&#46; Silman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2003"
                        "volumen" => "62"
                        "paginaInicial" => "697"
                        "paginaFinal" => "699"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12860720"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of cancer in patients with scleroderma&#58; a population based cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;L&#46; Hill"
                            1 => "A&#46;-M&#46; Nguyen"
                            2 => "D&#46; Roder"
                            3 => "P&#46; Roberts-Thomson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2003"
                        "volumen" => "62"
                        "paginaInicial" => "728"
                        "paginaFinal" => "731"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12860727"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Small cell lung cancer associated with systemic sclerosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "N&#46; Kanaji"
                            1 => "J&#46; Fujita"
                            2 => "S&#46; Bandoh"
                            3 => "T&#46; Fukumoto"
                            4 => "M&#46; Ishikawa"
                            5 => "R&#46; Haba"
                            6 => "T&#46; Ishii"
                            7 => "A&#46; Kubo"
                            8 => "T&#46; Ishida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Internal Medicine"
                        "fecha" => "2005"
                        "volumen" => "44"
                        "paginaInicial" => "315"
                        "paginaFinal" => "318"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15897643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of malignancy with diseases causing interstitial pulmonary changes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Bouros"
                            1 => "K&#46; Hatzakis"
                            2 => "H&#46; Labrakis"
                            3 => "K&#46; Zeibecoglou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2002"
                        "volumen" => "121"
                        "paginaInicial" => "1278"
                        "paginaFinal" => "1289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11948064"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary fibrosis and terminal bronchiolar &#40;&#8220;alveolar-cell&#8221;&#46; carcinoma in scleroderma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Zatuchni"
                            1 => "W&#46;N&#46; Campbell"
                            2 => "C&#46;J&#46;D&#46; Zarafonetis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1953"
                        "volumen" => "6"
                        "paginaInicial" => "1147"
                        "paginaFinal" => "1158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13106829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malignancy and autoimmunity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Bernatsky"
                            1 => "R&#46; Ramsey-Goldman"
                            2 => "A&#46; Clarke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.bor.0000209423.39033.94"
                      "Revista" => array:7 [
                        "tituloSerie" => "Curr Opin Rheumatol"
                        "fecha" => "2006"
                        "volumen" => "18"
                        "numero" => "2"
                        "paginaInicial" => "129"
                        "paginaFinal" => "134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16462517"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer in systemic sclerosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Abu-Shakra"
                            1 => "F&#46; Guillemin"
                            2 => "P&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1993"
                        "volumen" => "36"
                        "paginaInicial" => "460"
                        "paginaFinal" => "464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8457221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scleroderma and malignancy&#58; an epidemiological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;K&#46; Rosenthal"
                            1 => "J&#46;K&#46; McLaughlin"
                            2 => "M&#46;S&#46; Linet"
                            3 => "I&#46; Persson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "1993"
                        "volumen" => "52"
                        "paginaInicial" => "531"
                        "paginaFinal" => "533"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8346981"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of cancer among patients with systemic sclerosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;K&#46; Rosenthal"
                            1 => "J&#46;K&#46; McLaughlin"
                            2 => "G&#46; Gridley"
                            3 => "O&#46; Nyr&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1995"
                        "volumen" => "76"
                        "paginaInicial" => "910"
                        "paginaFinal" => "914"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8625197"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung cancer and scleroderma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;K&#46; Winkelmann"
                            1 => "D&#46;B&#46; Flach"
                            2 => "K&#46;K&#46; Unni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol Res"
                        "fecha" => "1988"
                        "volumen" => "280"
                        "numero" => "Suppl"
                        "paginaInicial" => "S15"
                        "paginaFinal" => "S18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2841907"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/21735115/0000001500000001/v1_201305151504/S2173511509700922/v1_201305151504/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9550"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case Report&#47;Caso Cl&#237;nico"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001500000001/v1_201305151504/S2173511509700922/v1_201305151504/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509700922?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 15. Issue 1.
Pages 93-99 (January - February 2009)
Share
Share
Download PDF
More article options
Vol. 15. Issue 1.
Pages 93-99 (January - February 2009)
Full text access
Adenocarcinoma do pulmão em doente com esclerodermia: Um caso clínico
Lung adenocarcinoma associated with systemic sclerosis: A case report
Visits
898
João Bento1,5, Gabriela Fernandes2,5, Maria Alice Barbosa3,5, Adriana Magalhães3,5, Ana Rosa Santos3,5, Venceslau Hespanhol4,5
1 Interno Complementar de Pneumologia
2 Assistente Hospitalar de Pneumologia
3 Assistente Hospitalar Graduado de Pneumologia
4 Chefe de Serviço de Pneumologia
5 Serviço de Pneumologia, Hospital de São João, EPE, Porto
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Resumo

A esclerodermia é uma doença do tecido conjuntivo de etiologia desconhecida, que tem sido associada a um risco acrescido de malignidade. O cancro do pulmão é a neoplasia mais frequente, nestes doentes.

Apresenta-se o caso clínico de uma mulher de 42 anos, não fumadora, com esclerodermia, que desenvolveu agravamento progressivo do seu estado geral e derrame pleural com características de exsudado, sem evidência de infecção ou malignidade. A TAC torácica mostrou zonas de fibrose, a broncofibroscopia, os lavados brônquico e broncoalveolar foram normais. Foi excluída neoplasia extrapulmonar. Na pleuroscopia, observaram-se formações nodulares, cujas biópsias revelaram tratar-se de adenocarcinoma pulmonar. Iniciou quimioterapia, desenvolvendo ao 48.° dia neutropenia febril e sépsis, vindo a morrer 12 dias depois.

Salientamos este caso pela relação, apesar de rara, entre a esclerodermia e o cancro do pulmão e pela importância de uma vigilância pulmonar cuidadosa, em indivíduos com esta doença reumatológica, pelo risco acrescido de neoplasia.

Palavras-chave:
Esclerodermia
cancro
pulmão
fibrose
Abstract

Systemic sclerosis (scleroderma) is a connective tissue disorder of unknown aetiology characterised by immune abnormalities, which has been related to an increased risk of malignancy. Lung cancer is the most prevalent among these patients.

We present a clinical case of a 42 years old non smoker female with systemic sclerosis. She presented progressive general health status worsening and an exudative pleural effusion, with no evidence of infection or malignancy. Chest high resolution computed tomography revealed pulmonary fibrosis. Bronchoscopy, bronchial and bronchoalveolar lavage were normal. Extrapulmonary malignancies were excluded. Pleural nodularities were found on pleuroscopy and the biopsy was compatible with lung adenocarcinoma. Chemotherapy was then started, which complicated with febrile neutropenia, sepsis and patient death 12 days after.

The purpose of this case report is to bring attention to the relationship, although rare, between systemic sclerosis and lung cancer, stressing the importance of adequate pulmonary surveillance in these patients.

Key-words:
Systemic sclerosis
cancer
lung
fibrosis
Full text is only aviable in PDF
Bibliografia
[1.]
H. Chifflot, B. Fautrel, C. Sordet, E. Chatelus, J. Sibilia.
Incidence and prevalence of systemic sclerosis: a systematic literature review.
Semin Arthritis Rheum, 37 (2008), pp. 223-235
[2.]
R. Hesselstrand, A. Scheja, A. Akesson.
Mortality and causes of death in a Swedish séries of systemic sclerosis patients.
Ann Rheum Dis, 57 (1998), pp. 682-686
[3.]
Christian Witt, Adrian C. Borges, Mathias John, Ingo Fietze, Gert Baumann, Andreas Krause.
Pulmonary involvement in diffuse cutaneous systemic sclerosis: broncheoalveolar fluid granulocytosis predicts progreesion of fibrosing alveolitis.
Ann Rheum Dis, 58 (1999), pp. 635-640
[4.]
J.E. Pearson, A.J. Silman.
Risk of cancer in patients with scleroderma.
Ann Rheum Dis, 62 (2003), pp. 697-699
[5.]
C.L. Hill, A.-M. Nguyen, D. Roder, P. Roberts-Thomson.
Risk of cancer in patients with scleroderma: a population based cohort study.
Ann Rheum Dis, 62 (2003), pp. 728-731
[6.]
N. Kanaji, J. Fujita, S. Bandoh, T. Fukumoto, M. Ishikawa, R. Haba, T. Ishii, A. Kubo, T. Ishida.
Small cell lung cancer associated with systemic sclerosis.
Internal Medicine, 44 (2005), pp. 315-318
[7.]
D. Bouros, K. Hatzakis, H. Labrakis, K. Zeibecoglou.
Association of malignancy with diseases causing interstitial pulmonary changes.
Chest, 121 (2002), pp. 1278-1289
[8.]
J. Zatuchni, W.N. Campbell, C.J.D. Zarafonetis.
Pulmonary fibrosis and terminal bronchiolar (“alveolar-cell”. carcinoma in scleroderma.
Cancer, 6 (1953), pp. 1147-1158
[9.]
S. Bernatsky, R. Ramsey-Goldman, A. Clarke.
Malignancy and autoimmunity.
Curr Opin Rheumatol, 18 (2006), pp. 129-134
[10.]
M. Abu-Shakra, F. Guillemin, P. Lee.
Cancer in systemic sclerosis.
Arthritis Rheum, 36 (1993), pp. 460-464
[11.]
A.K. Rosenthal, J.K. McLaughlin, M.S. Linet, I. Persson.
Scleroderma and malignancy: an epidemiological study.
Ann Rheum Dis, 52 (1993), pp. 531-533
[12.]
A.K. Rosenthal, J.K. McLaughlin, G. Gridley, O. Nyrén.
Incidence of cancer among patients with systemic sclerosis.
Cancer, 76 (1995), pp. 910-914
[13.]
R.K. Winkelmann, D.B. Flach, K.K. Unni.
Lung cancer and scleroderma.
Arch Dermatol Res, 280 (1988), pp. S15-S18
Copyright © 2009. Sociedade Portuguesa de Pneumologia
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?