RESUMEN
Scrotal scintigraphy has become a relatively uncommon examination in many nuclear medicine departments. However, scrotal perfusion is visualized during three-phase bone imaging of the pelvis and hips. The authors present a compilation of three cases of hip pain secondary to unsuspected scrotal pathology documented on routine three-phase bone scintigraphy, discussing this topic for the first time in the literature. A short review of the pathophysiology of referred hip pain, differential diagnosis, and imaging alternatives emphasize the unique contribution of nuclear imaging.
Asunto(s)
Articulación de la Cadera/diagnóstico por imagen , Dolor/diagnóstico por imagen , Huesos Pélvicos/diagnóstico por imagen , Escroto/diagnóstico por imagen , Adolescente , Anciano , Niño , Diagnóstico Diferencial , Epididimitis/complicaciones , Epididimitis/diagnóstico por imagen , Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Humanos , Masculino , Orquitis/complicaciones , Orquitis/diagnóstico por imagen , Dolor/etiología , Dolor/fisiopatología , Prostatitis/complicaciones , Prostatitis/diagnóstico por imagen , Cintigrafía , Enfermedades Testiculares/complicaciones , Enfermedades Testiculares/diagnóstico por imagen , Anomalía Torsional/complicaciones , Anomalía Torsional/diagnóstico por imagenRESUMEN
In this case, a distinctive amyloid tumor of the breast clinically simulated carcinoma, although the patient related onset to trauma. Hepatosplenomegaly, elevated globulins, and anemia led to identification of large amounts of monoclonal IgG-kappa production. The patient died of renal failure within several months despite chemotherapy. The matrix of the breast tumor was tinctorially characteristic of amyloid light chain (AL) protein. The mass contained islands of plasma cells that morphologically suggested local production of amyloid matrix. Moreover, plasma cell and matrix immunohistochemically displayed reactivity of IgG-kappa protein, indicating a clonal plasma cell infiltrate. Pseudo-acinar arrangement of plasma cells may be misinterpreted as epithelial cells in needle biopsy specimens. The notion that some amyloidomas may represent in situ production of protein by clonal immunocytes ("secretory immunocytomas") should be further studied.
Asunto(s)
Amiloidosis/patología , Enfermedades de la Mama/patología , Calcinosis/patología , Anciano , Carcinoma/diagnóstico , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Inmunoglobulina G/análisis , Cadenas Ligeras de Inmunoglobulina/análisis , Cadenas kappa de Inmunoglobulina/análisis , Células Plasmáticas/patología , Insuficiencia Renal/patologíaRESUMEN
Insertion of a permanent dual chamber pacemaker by the Seldinger technique usually requires two needle punctures of the vein or the use of a large introducer, thus increasing the risks associated with this procedure. We describe a modified technique using a relatively small introducer and a single subclavian vein puncture that we have found to be safe and simple to perform.