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El cáncer de mama es el más frecuente en las mujeres y representa la segunda causa de muerte entre las féminas. Resulta fundamental la prevención mediante los programas de pesquizaje. El diagnóstico por imagen de este tumor ha evolucionado en los últimos años. En mamografía, se han incorporado las técnicas digitales, los aparatos de ultrasonidos son de mejor calidad y la resonancia magnética ha adquirido mayor protagonismo entre todos los algoritmos diagnósticos, no obstante, la mamografía sigue representando el examen de elección para la detección de este tipo de neoplasia en la población general. El objetivo del presente artículo es describir los aspectos imagenológicos de importancia que contribuyen al diagnóstico del cáncer de mama, para ello se realizó una revisión de la bibliografia, en diferentes bases de datos con el descriptor de estudios por imágenes en el cáncer de mama.

Breast cancer is the most common in women and represents the second leading cause of death. Prevention through screening programs is essential. Imaging of this tumor has evolved in recent years. In mammography, digital techniques have been incorporated, ultrasound machines are of better quality and magnetic resonance imaging has acquired greater prominence among all diagnostic algorithms, however, mammography continues to represent the test of choice for the detection of this type of neoplasia in the general population. The aim of this article is to describe the important imaging aspects that contribute to the diagnosis of breast cancer, for this, a review of the literature was carried out in different databases with the descriptor of imaging studies in breast cancer.

El Mycoplasma pneumoniae es causa frecuente de infecciones del tracto respiratorio superior e inferior en niños y adultos jóvenes, atribuyéndosele hasta un 40 % de los casos de neumonía adquirida en la comunidad. La neumonía por bacterias atípicas ha sido tema de discusión desde su descripción. El diagnóstico de la neumonía adquirida en la comunidad es fundamentalmente clínico. La radiografía de tórax es el patrón oro para confirmarlo, pero no se recomienda de forma rutinaria. En casos graves es necesaria la obtención de imágenes tomográficas. El objetivo de este trabajo es presentar el caso de un paciente con neumonía causada por Mycoplasma pneumoniae adquirida en la comunidad que fue atendido en el Hospital de Cienfuegos. Se trata de un hombre de color de piel blanca, de 51 años de edad, de procedencia urbana, sin hábitos tóxicos, con antecedentes patológicos personales de hipertensión arterial desde hacía tres años, con tratamiento regular; diabetes mellitus tipo 2, con control glucémico mediante dieta, además antecedentes referidos de insuficiencia venosa, el cual se ingresa en el hospital por el diagnóstico de neumonía atípica. Evolucionó hacia la gravedad, pero el adecuado empleo e interpretación de los elementos clínicos e imagenológicos permitió llegar al diagnóstico de neumonía por Mycoplasma pneumoniae, adquirida en la comunidad. Se logró una atención médica adecuada y la recuperación del paciente.

Diastematomyelia is a division of the medullar cord, in a variable length, by a bony, fibrous or extradural bone septum. This form of dysraphia is associated with other spinal malformations. The case of a 29-years-old patient with a two-year history of progressive medial low back pain with irradiation to both lower extremities, treated at the Neurology Service of the Dr. Gustavo Aldereguía Lima University General Hospital, in Cienfuegos, is reported. On physical examination, she presented flaccid paraparesis, amyotrophy of the left lower limb, and painful tactile hypoesthesia in the lower limbs. Nuclear magnetic resonance and computerized axial tomography showed diastematomyelia associated with tethered cord. As it is an uncommon Dysraphia disorder that can occur in any age group and can be associated with tethered cord with other spinal dysraphias, the presentation of the case was decided. It is assumed that in a young patient with low back pain and progressive motor deficit we may be dealing with a case of diastematomyelia, tethered cord or both.

Metaplastic Tumors of the mammary gland are infrequent. The diagnosis should be based on studies of hematoxylin and eosin, confirmed by inmunohistochemical markers. It is a type of malignant neoplasm which includes a group of uncommon heterogeneous entities characterized by mixing a high grade invasive ductal epithelial component with a squamous or sarcomatoid component which adopts a variable phenotype. Its prognosis is worse than conventional carcinomas and is related to the tumor size, histological type, and grade of mesenquimatic component. For these reasons a case of a 63 year old patient who was diagnosed with this infrequent breast tumor that was diagnosed by inmunohistochemical techniques.

Los linfomas primarios del sistema nervioso central son una variedad poco común de linfoma no Hodgkin extranodal, que pueden afectar cerebro, médula espinal, ojos, meninges y nervios craneales. Se presenta el caso de una paciente de 51 años de edad, que acude a consulta por cefalea y se comprobó papiledema causado por lesión encefálica que requirió tratamiento quirúrgico. El estudio histológico permitió diagnosticar linfoma no hodgkiniano de alto grado de malignidad, de células B, CD20 positivo, con patrón tipo Burkitt periférico. La paciente recibió inmuno-quimioterapia y radioterapia, con evolución favorable. Por ser este tipo de tumor poco común y de comportamiento agresivo se decidió la presentación del caso.

Los feocromocitomas son tumores relativamente raros. Constituyen lesiones hipervascularizadas que, en un 90% de los casos, producen hipertensión arterial. Generalmente reportadas como lesiones sólidas, debido a su hipervascularización, pueden presentar áreas con degeneración quística focal o parcial. Sin embargo, aunque infrecuentes, se han reportado feocromocitomas con degeneración quística total o subtotal y son denominados feocromocitomas quísticos. Por tales razones se decidió la publicación del caso de un paciente masculino que falleció en el Hospital Gustavo Aldereguía Lima, a los 65 años de edad, con historia personal de hipertensión arterial de 10 años de evolución, artritis gotosa desde hacía cinco años y diabetes mellitus, todas bajo tratamiento regular. Acudió a consulta por cefalea universal y náuseas. Estudios imagenológicos evidenciaron una masa tumoral en glándula suprarrenal derecha. Durante su ingreso presentó edema pulmonar severo no cardiogénico que le causó la muerte. El estudio necrósico confirmó que presentaba un feocromocitoma quístico.

Pheocromocytomas are relatively unusual tumors. They are vascularized lesions that, in the 90% of the cases produce arterial hypertension. Generally reported as solid lesions due to hyper-vascularization. They may present areas with focal or partial cystic degeneration. Although infrequent, however, pheochromocytomas with total of subtotal cystic degeneration has been reported and are called cystic Pheochromocytomas. Due to these reasons it was decided to publish the case of a male patient who died at the Gustavo Aldereguía Lima Hospital, aged 65 with a ten year personal history of arterial hypertension, gout arthritis and nausea. He came to the hospital complaining of universal cephalea and nausea. Imaging studies showed a tumorous mass in the suprarenal right gland. During admission he presented a non-cardiogenic severe pulmonary edema which caused his death. The necropsy study confirmed a cystic pheochromocytoma.

Primary Lymphomas of the Central Nervous System are an uncommon variety of non- Hodgkin extra node which may affect the brain, spinal cord, eyes, meninges and cranial nerves. It is presented a case of a 51-year-old patient who came to the doctor complaining of headache and papilledema caused by an encephalic lesion was corroborated which required surgical treatment. Histological study allowed diagnosing a non-hodking lymphoma of a high malignancy, B cells, positive CD20, with a type of peripheral Burkitt pattern. The patient received immunochemo-therapy and radiotherapy, with a favorable evolution. Because it is an uncommon and aggressive tumor it was decided to present the case.

Breast Invasive micro-papillary carcinoma is an aggressive and infrequent variant of breast cancer characterized by large lymphotropism and high frequency of lymph node metastases, regardless tumor size. It presents an unfavorable clinical prognosis, imaging studies do not show significant differences with the usual breast carcinomas and the immunohistochemical biomarkers expression is variable. For these reasons the case of a 52-year-old female patient is presented. She came with a hard and slightly mobile nodular mass in the upper left quadrant of the left breast. In the biopsy report it was classified as an invasive micropapillary carcinoma with lymphovascular infiltration and metastasis in eight of ten examined lymph nodes. Immunohistochemistry techniques were also performed.

Primary invasive breast papillary carcinomas are rare, accounting for approximately 1% of all malignant tumors in that organ and are characterized by occurring in postmenopausal women aged 64 to 67 years on average. We present the case of an 84 year old woman with a breast nodule whose biopsy revealed an invasive papillary carcinoma; In spite of not manifesting telorrhea and nor its location was the habitual one. It is considered a relevant case and of interest for health professionals since this uncommon mammary neoplasm is in our country and few cases have been published.

Inflammatory breast carcinoma is a rare and aggressive type of breast cancer. It is distinguished from other breast carcinomas due to its clinical presentation, aggressiveness, and poor prognosis. We present the case of a female patient with a history of controlled hypertension. She sought medical attention because of redness in the right breast accompanied by partial retraction of the nipple. On physical examination, redness covering more than half of the breast, thickened skin, and palpable axillary lymph nodes were found. A mammogram revealed an asymmetric density in the right breast. She underwent a right axillary ultrasound that showed various lymphadenopathies. Conventional imaging methods remain valuable tools for the accurate diagnosis of inflammatory breast carcinoma.

Parejo al aumento de las exploraciones radiológicas ha ocurrido el escubrimiento de quistes renales que, en ocasiones, no cumplen los criterios de benignidad o malignidad. Dentro de esta lesiones se encuentran los quistes hiperdensos, los cuales constituyen un reto para todos los responsables del diagnóstico y tratamiento de estos pacientes. Por tales razones se decidió la presentación del caso de una paciente de 23 años de edad, con antecedentes de sicklemia, que acudió al cuerpo de guardia del Hospital General Universitario Dr. Gustavo Aldereguía Lima, por sufrir dolor lumbar en lado izquierdo, de tipo cólico, que no se aliviaba con analgésicos. Mediante estudio por tomografía axial computadoriada, simple y con contraste endovenoso, se le diagnosticó un quiste renal hiperdenso tipo II, según la clasificación de Bosniak.

La incidencia de polimastia en la población general oscila de 0,4 al 6 %. Las mamas accesorias son frecuentemente consideradas como un problema meramente cosmético; sin embargo, en esas estructuras, como en cualquier otro tejido mamario, pueden surgir alteraciones variadas, tanto benignas como malignas. Se presenta el caso de una paciente que durante el embarazo presentó una masa en ambas regiones axilares, no dolorosa. Su médico de familia lo interpretó como adenopatías. Durante el puerperio inmediato se constató mayor aumento de tamaño en las regiones axilares, evidente al examen físico, así como dolor, por lo cual se decidió realizar mamografía y ultrasonido. Se diagnosticó como mama supernumeraria bilateral y ectasia ductal izquierda.

Background: Cancer of the colon is the second cause of death due to cancer worldwide, alter lung cancer in males and breast cancer in females. It is not possible to confirm the patient’s diagnosis without the result of image tests such as barium enema, ultrasound cytology or biopsy of the lesion. Objective: To characterize cancer of the colon through images. Methods: Descriptive study which included all the patients discharged from “Dr. Gustavo Aldereguía Lima” General Hospital with a confirming diagnosis of cancer of the colon. The variables under study were: sex, age, past and family history of the disease, its way of presentation, location, image findings and histological diagnosis. Shi square was used for a 95 % exactitude where pResults: Cancer of the colon was more frequently detected in the age group of 50 to 59 years of age in both sexes meanwhile in the age group 70 to 79 years of age the disease affected males. It was mainly associated to idiopathic ulcerative colitis and to family history of cancer of the colon and cholecystectomy. Suggestive symptoms were predominant in the findings. The most frequent location was in the left part of the colon. There was correlation between the results of the ultrasound and barium enema the X-rays.Conclusion: Ultrasound was of great usefulness, but barium enema is the test of choice in our environment for the diagnosis of cancer of the colon.

Background: In Cuba, as in all developed countries, cancer is the second cause of death and among it the different types of intracranial neoplasms present a morbidity of 2-3 %. Among the diagnostic methods that can be used computarized tomography (CT-Scan) and magnetic resonance image (MRI) are the techniques that define the patient’s diagnosis and treatment in this type of neoplasm. Objective: to characterize intracranial neoplasm. Methods: a retrospective descriptive study that included the discharged patients operated from central nervous system neoplasms was carried out at the University General Hospital “Dr. Gustavo Aldereguía Lima” from Cienfuegos province, from January 1st, 2003 to December 31st , 2007. All the patients had undergone a computarized tomography and had the histological post operatory diagnosis of primary or secondary neoplasms of the intracranial central nervous system. The variables under study were: sex, age, symptoms, location of the tumor, histological diagnosis, and tomography variables. Results: Neoplasms were predominant in males and in patients between 40 - 59 years of age. The most frequent symptom was headache, and its location in the frontal - parietal area. In 85, 7 % of the metastases a hypodense image was observed meanwhile in meningiomas a hyperdense image was seen. All tumors increased their density after contrast administration. The tomographic diagnosis coincided with the histological one in 85,7 % of gliomas, in 80 % of meningiomas and in 40 % of metastases. Conclusion: The computarized images of the cranium allow the inference of the histological type of intracranial neoplasms.

Diaphragmatic hernia constitutes an infrequent form of diaphragmatic disease and a high index of sospecha for its diagnosis. The lesions of the left side seem to be the most frequent according to the review of the medical literature. This is the case of a patient with a 15 year- history of right hemithorax due to car accident who presented to the internal medicine emergency service with weakness and shortness of breath . His skin and mucous membranes were pale and vesicular murmurs were abolished in the inferior two thirds of the right hemithorax. The patient was ordered a complete blood count (CBC), an antero-posterior chest x -ray, an abdominal ultrasound , a thoracic-abdominal ultrasound, a chest computerized axial tomography, respiratory function tests and a medulloculture. The computerized axial tomography revealed a right hemithorax filled with intestinal loops, liver and gallbladder. The patient was surgically treated realizing the presence of a right multivisceral diaphragmatic hernia which was corrected by hernioplasty with prothesis of the polypropylene. The patient recovered satisfactorily . For its uncommon presentation it has been published.

The influenza A (H1N1) has a wide radiological spectrum, difficult to differentiate from other epidemic respiratory diseases. One of the distinctive elements seems to be the quick evolution of the imagenologic lesions in the sick persons, as well as the slow resolution of these manifestations. The chest fillm is of vital importance to make a precise diagnosis, and it constitutes an indispensable tool for the identification of the cases according to the affection degree (light, moderate, and severe), besides contributing as an essential way to the classification of the patients according to a grade of uncertainty. Although as a confirmation complementary is not definitive, it is important in defining if a case is suspicious or probable.