RESUMEN
Two patients with dissimilar but advanced malignancies and lower extremity swelling underwent bilateral lower extremity radionuclide venograms, several months apart. Both patients' scintigrams showed multiple collaterals in the abdomen and pelvis, consistent with inferior vena cava obstruction, and hepatic uptake in a diffuse pattern. One patient also had multiple bilateral pulmonary emboli on a lung scan. Although diffuse hepatic uptake has been mentioned before with inferior vena cava obstruction, it has usually been incidental to focal hepatic uptake near the porta hepatis. The case results in this study demonstrated that inferior vena cava obstruction can manifest itself solely as diffuse hepatic uptake on nuclear venograms. The authors believe that either pattern can be corroborative of inferior vena cava obstruction on a nuclear venogram.
Asunto(s)
Hígado/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Vena Cava Inferior/diagnóstico por imagen , Anciano , Neoplasias de la Mama/patología , Circulación Colateral , Constricción Patológica/diagnóstico por imagen , Femenino , Humanos , Neoplasias Renales/patología , Pierna/irrigación sanguínea , Masculino , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico por imagen , Cintigrafía , Agregado de Albúmina Marcado con Tecnecio Tc 99mRESUMEN
To alleviate recurrent pericardial effusion secondary to systemic lupus erythematosus, pericardio-peritoneal window was performed. Subsequently, end stage renal disease developed and the patient required peritoneal dialysis. Patency of the pericardio-peritoneal window was demonstrated by intraperitoneal injection of Tc-99m SC through a Tenckhoff catheter, which prompted special counsel to the patient in order to prevent infectious pericarditis potentially complicating peritoneal dialysis induced-peritonitis.
Asunto(s)
Derrame Pericárdico/diagnóstico por imagen , Técnicas de Ventana Pericárdica , Diálisis Peritoneal , Adulto , Humanos , Fallo Renal Crónico/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Masculino , Derrame Pericárdico/complicaciones , Cintigrafía , RecurrenciaRESUMEN
A woman with Graves' disease and unsuspected coexisting thyroid cancer is presented. Although rare, this association has to be considered. It has been noticed that thyroid cancer is more common in hyperthyroid than euthyroid persons. Thus, thyroid scintigraphy is very important in the initial workup of Graves' disease. It helps determine whether medical or surgical therapy is more appropriate in a particular patient.
Asunto(s)
Carcinoma Papilar/complicaciones , Enfermedad de Graves/complicaciones , Enfermedad de Graves/diagnóstico por imagen , Radioisótopos de Yodo , Neoplasias de la Tiroides/complicaciones , Carcinoma Papilar/diagnóstico por imagen , Carcinoma Papilar/cirugía , Femenino , Humanos , Persona de Mediana Edad , Cintigrafía , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , TiroidectomíaRESUMEN
A neck mass in the right carotid triangle of a 28-year-old woman was found to be the only thyroid tissue she possessed. Resection of the mass led to clinical and biochemical hypothyroidism. A possible explanation for the unlikely occurrence of lateral aberrant thyroid tissue and absence of a thyroid gland in the usual location is offered. It is suggested that patients with midline or low lateral neck masses undergo isotopic scanning of the thyroid gland before any iodinated contrast materials are administered or surgery performed.
Asunto(s)
Arterias Carótidas/diagnóstico por imagen , Coristoma/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Glándula Tiroides , Adulto , Arterias Carótidas/patología , Coristoma/patología , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , CintigrafíaRESUMEN
Tc-99m labeled RBC imaging is becoming increasingly useful in detecting gastrointestinal (GI) bleeding sites. A patient is presented who had massive GI bleeding from an unsuspected gastric leiomyoma in whom a Tc-99m sulfur colloid GI bleed image was negative. The Tc-99m labeled RBC imaging done on the day after sulfur colloid imaging revealed increased gastric activity due to active bleeding from an intragastric leiomyoma. Tc-99m labeled RBC imaging helped in early detection of the bleeding site resulting in its successful treatment. This experience also reinforces the assertion that Tc-99m labeled RBC imaging may be more helpful than Tc-99m sulfur colloid imaging in patients with upper GI or intermittent bleeding.
Asunto(s)
Eritrocitos , Hemorragia Gastrointestinal/diagnóstico por imagen , Leiomioma/complicaciones , Neoplasias Gástricas/complicaciones , Tecnecio , Anciano , Hemorragia Gastrointestinal/etiología , Humanos , Masculino , CintigrafíaRESUMEN
Imaging with Tc-99m labeled red blood cells (RBC) is increasingly being used in the detection of acute gastro-intestinal bleeding, especially in patients with intermittent bleeding. A patient is presented in whom the labeled RBC scan was helpful in the incidental discovery of a previously unsuspected probable angiosarcoma of the right femur and adjacent soft tissues of the right hip due to the "blood pool" or "blush effect" of the labeled cells. The labeled RBC scan also identified extravasation due to active gastrointestinal bleeding from a previously unknown angiosarcoma of the ascending colon. Thus, the Tc-99m labeled RBC scan was useful in simultaneously detecting extravasation and blood pool effect at two remote tumor sites in the same patient.