摘要:

Hurthle cell carcinoma of the thyroid is a rare type of thyroid neoplasm. The most common clinical presentation is a single palpable thyroid nodule. The neoplasm typically presents as a nonfunctioning or cold nodule on a Tc-99m sodium pertechnetate or radioiodine thyroid scan. We report a case of Hurthle cell carcinoma of the thyroid in a woman presenting with thyrotoxicosis. The Tc-99m thyroid scan was also interesting in that the nodule was a hot or hyperfunctioning area, resulting in a rare scintigraphic finding in a rare tumor. Clinicopathologic aspects and related issues are further discussed.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

We report the case of a 40-year-old man with radiographically silent pulmonary metastases of papillary thyroid cancer discovered during I-131 scintigraphy following total thyroidectomy performed 10 years after unilateral lobectomy. The residual lobe was histologically normal. After a dose of 11.1 GBq (300 mCi), there was no I-131 uptake in the thyroid bed and lung metastases, and serum thyroglobulin became undetectable. Conservative therapy could be associated with a delay in the possibility of diagnosing and treating extrathyroidal metastases.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Talc pleurodesis is a technique used in the treatment of patients with persistent pleural effusions or pneumothorax not amenable to other treatment. These are commonly seen in patients with malignant thoracic neoplasms. Radiographic abnormalities resulting from prior talc pleurodesis could be confused with progression of the underlying neoplastic process. Positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) might be unable to distinguish between malignant and benign inflammatory processes. This report demonstrates the use of combined positron emission tomography/computed tomography (PET/CT) in a patient with a history of both malignant neoplasm and a prior talc pleurodesis. Fusion of PET and CT studies could add information that CT and PET alone cannot. This could alter the diagnostic and therapeutic course for patients with a history of both thoracic neoplasm and talc pleurodesis.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sarcomas are a heterogeneous group of tumors comprising approximately 1% of all malignancies. Definitive treatment of sarcoma is surgical resection. However, after surgical removal, 40% to 60% of the patients will develop local or distant recurrence. Therefore, the early detection and treatment of recurrence is an important part of modern sarcoma therapy. Positron emission tomography with fluorine-18-deoxyglucose (FDG-PET) has been highly successful in detecting and staging a variety of malignancies. However, its use in the management of patients with sarcoma is less defined. The purpose of our study was to assess the potential roles of FDG-PET in the detection of local recurrence and distant metastases. In this retrospective study, the images of 33 FDG-PET scans, reports of 29 computed tomography (CT) scans, and 8 magnetic resonance imaging (MRI) scans from 28 patients were compared with surgical pathology or clinical follow up for at least 6 months. FDG-PET detected all 25 cases of local and distant recurrences with 100% sensitivity. CT was able to detect 18 of the 22 possible cases of recurrent disease, whereas MRI was able to detect 5 of 7 cases of recurrent disease. PET was particularly useful in patients with extensive histories of surgery and radiation therapy, precisely the setting in which CT and MRI have the lowest specificity and sensitivity. In conclusion, FDG-PET was a sensitive test to detect local and distant recurrences of sarcoma and this warrants further investigation.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

An inferior wall false aneurysm (pseudoaneurysm) was diagnosed in a 77-year-old male by single photon emission computed tomography (SPECT) radionuclide ventriculography (RNV). This immediately followed routine planar RNV because the latter did not lead to definitive characterization of the type of aneurysm and did not ideally characterize the location and size of the aneurysm. RNV was followed by false-negative first-pass radionuclide ventriculography, routine echocardiography, and gated magnetic resonance imaging of the heart (cardiac MRI). A definitive diagnosis of a false aneurysm is found at surgery and pathology; however, the patient declined surgery and has done well for 1.5 years after these imaging studies. The first-pass study is limited with relatively small pseudoaneurysms, like in this case. Echocardiography is noninvasive and can show wall motion and aneurysm size. Cardiac MRI is the most expensive noninvasive study but, in addition to revealing the diameters of the neck and body of the aneurysm, MRI is able to characterize the surrounding myocardium. This case report suggests the critical information needed for a confident, noninvasive diagnosis of false aneurysm can be obtained with SPECT RNV. The location of the aneurysm is easily determined, and the relative diameters of the neck to the body of the aneurysm can be easily seen. SPECT RNV is superior to planar RNV and first-pass radionuclide ventriculography in making a diagnosis of false aneurysm. Although RNV might be unable to directly demonstrate the perfusion and thickness of the myocardium, it has an advantage over MRI in terms of ejection fraction (EF) and cost.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Diffuse pulmonary microvascular arteriovenous communication developed in an 8-year-old girl with a patent ductus venosus. Tc-99m macroaggregated albumin (MAA) pulmonary perfusion scintigraphy with total-body imaging demonstrated multiple lung perfusion deficits and abnormal tracer uptake in systemic organs with hepatic radioactivity greater than the kidneys, suggesting the presence of right-to-left shunt and abnormal hepatic hemodynamics. I-123 iodoamphetamine transrectal portal scintigraphy revealed a large portosystemic venous shunt. The follow-up Tc-99m MAA perfusion scans after banding of the patent ductus venosus revealed partial improvement of the perfusion deficits and right-to-left shunt, indicating the possible reversibility of this pulmonary shunt complication.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Hemangioma is the most common benign liver tumor. Hepatic blood pool imaging is an effective technique with a specificity approaching 100%. Typically, hemangiomas are completely filled on hepatic blood pool imaging. However, incomplete fill-in can be seen in larger hemangiomas complicated with thrombosis, fibrosis, or bleeding. We report a hepatic cavernous hemangioma with atypical peripheral rim activity.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 37-year-old woman with non-Hodgkin lymphoma had a F-18 fluorodeoxyglucose positron emission tomography (FDG PET) scan which showed 2 foci of pelvic uptake initially thought to represent iliac nodes. However, a computed tomography scan demonstrated no pelvic nodes in the regions of uptake. Using excreted ureteral FDG activity as a landmark, the foci of uptake were identified as intraperitoneal and localized to the ovaries. Although ureteral activity is often a confounding factor during PET image interpretation, it can be used to demarcate intraperitoneal (eg, ovary) from extraperitoneal (eg, iliac node) pelvic structures to arrive at the correct interpretation.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A 45-year-old man had chronic osteomyelitis in the right tibia since 1996 and developed severe shoulder pain recently. Bone scintigraphy was performed to exclude additional osteomyelitis originating from the primary site. Because of the bone scan results, the presence of osteomyelitis in the sternoclavicular region turned out to be very unlikely. To exclude malignancy, fluorodeoxyglucose positron emission tomography was performed. Further examination showed that the patient had palmoplantar pustulosis. This pattern led to the diagnosis of SAPHO syndrome, which is characterized by synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis. In this case the positron emission tomographic scan, in addition to bone scintigraphy, showed that in SAPHO syndrome certain areas are active (right ankle region) whereas the activity of the disease in other parts of the body has burned out (thoracic lesions).

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A case of asymmetric moderately increased fluorodeoxyglucose (FDG) uptake into muscle is shown. A 57-year-old right-handed man with non-Hodgkin lymphoma underwent a FDG positron emission tomographic (PET) scan to assess response to chemotherapy. Two days before the PET scan, the patient had spent several hours digging in his garden. He was relatively inactive during the 48 hours before the PET study. Marked skeletal FDG uptake is generally reported in subjects who have exercised before or after the injection of FDG. The authors present a case of increased muscle FDG uptake 48 hours after cessation of strenuous muscle activity.

ISSN:0363-9762    

出版商:OVID    

年代:2003

数据来源: OVID