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Vol. 15. Issue 4.
Pages 713-720 (July - August 2009)
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Vol. 15. Issue 4.
Pages 713-720 (July - August 2009)
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Derrame pleural recidivante e polipose gástrica – Caso clínico
Relapsing pleural effusion and gastric polyposis – A case report
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E. Fragoso1,
Corresponding author
elsagcfragoso@gmail.com

Correspondência: Serviço de Pneumologia, Hospital de Santa Maria, CHLN, Av. Professor Egas Moniz, 1649-035 Lisboa, Portugal.
, I. Correia1, P. Campos2, M.J. Palhano3, R. Sotto-Mayor1
1 Serviço de Pneumologia (Director: Prof. Doutor A Bugalho de Almeida), Hospital de Santa Maria, CHLN, Lisboa, Portugal
2 Serviço de Imagiologia (Director: Dra. Isabel Távora), Hospital de Santa Maria, CHLN, Lisboa, Portugal
3 Serviço de Anatomia Patológica (Director: Prof. Doutor Afonso Fernandes), Hospital de Santa Maria, CHLN, Lisboa, Portugal
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Resumo

Os autores descrevem um caso de doença linfoproliferativa (DLP) com repercussão pleuropulmonar. Trata-se de um linfoma MALT primário do estômago com comportamento agressivo numa mulher de 86 anos internada no serviço de pneumologia do nosso hospital com derrame pleural como forma de apresentação clínica.

A pesquisa de Helicobacter pylori foi negativa, situação pouco frequente. A doença apresentou-se disseminada e sem qualquer resposta às múltiplas terapêuticas instituídas, o que não é frequente.

Abordam-se as formas de apresentação clínica desta patologia, aspectos diagnósticos e terapêuticos, fazendo-se uma discussão sobre as características particulares deste caso e cotejando-os com os dados existentes na literatura. Realça-se a importância de se incluir a DLP no diagnóstico diferencial dos derrames pleurais de etiologia em estudo.

Palavras-chave:
Linfoma não Hodgkin
linfoma MALT gástrico
Helicobacter pylori
derrame pleural
diagnóstico diferencial
polipose gástrica
Abstract

The authors present the case of a lymphoproliferative disorder (LPD) with pleuro-pulmonary involvement. It was a very aggressive primary gastric lymphoma of the MALT subtype, diagnosed in an 86-year-old woman admitted in Pulmonology ward at our Hospital with pleural effusion.

Helicobacter pylori search was negative, what is infrequent. The disease was already disseminated at the time of the diagnosis and did not respond to various treatment modalities, what is also an uncommon finding.

Clinical presentation, diagnosis and management of this disease are reviewed, pointing out its unique features and comparing the particular aspects of this case with the published literature. The authors stress that LPD is an important diagnosis to be held in mind in the case of a pleural effusion of unknown aetiology.

Key-words:
Non-Hodgkin's lymphoma
gastric MALT lymphoma
Helicobacter pylori
pleural effusion
differential diagnosis
gastric polyposis
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Copyright © 2009. Sociedade Portuguesa de Pneumologia
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