RESUMEN
OBJECTIVES: The aim of this study was to assess the usefulness of 18-fluorodeoxyglucose positron emission tomography (PET) scanning for the evaluation of metastases (nodal and distant) in patients with carcinoma of the cervix. METHODS: A retrospective review was performed of 13 patients with carcinoma of the cervix who had a 18-fluorodeoxyglucose PET scan as part of their workup (10 during initial workup, 3 at time of relapse). Ten patients also underwent a fine needle aspiration (FNA) under imaging guidance for verification. RESULTS: All 10 patients with positive sites identified by PET scan who underwent an FNA were positive for cancer. In 3 situations PET identified sites where other imaging studies were negative. CONCLUSIONS: PET scanning is a useful imaging tool in the evaluation of patients with carcinoma of the cervix. This review supports other limited published data in this regard and suggests that further prospective studies are needed.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/secundario , Neoplasias del Cuello Uterino/diagnóstico por imagen , Adulto , Biopsia con Aguja , Carcinoma de Células Escamosas/patología , Femenino , Fluorodesoxiglucosa F18 , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/metabolismo , Metástasis Linfática , Persona de Mediana Edad , Metástasis de la Neoplasia , Radiofármacos , Estudios Retrospectivos , Tomografía Computarizada de Emisión , Neoplasias del Cuello Uterino/patologíaRESUMEN
Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases.
Asunto(s)
Radioisótopos de Yodo , Pulmón/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen , Adulto , Diagnóstico Diferencial , Reacciones Falso Positivas , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Cintigrafía , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patologíaRESUMEN
Three patients with primary breast sarcoma showed intense F-18 FDG breast uptake on the whole-body scan. In two patients the uptake was irregular and associated with cold foci that corresponded to hypodense lesions noted on the chest CT; these represented areas of pathologically demonstrated tumor necrosis. There was also intense FDG uptake in pulmonary, axillary, and supraclavicular lymph node metastases. All lesions were confirmed by CT scan of the chest. Thus F-18 FDG positron emission tomographic scanning accurately staged the tumors in these two patients, and it documented local recurrence in the third patient. Histopathologic examination showed evidence of a high-grade sarcoma, a primary rhabdomyosarcoma, and a malignant cystosarcoma phyllodes of the breast. Similar to breast carcinoma, F-18 FDG whole-body positron emission tomographic imaging could be useful in diagnosing and staging primary breast sarcomas.
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Neoplasias de la Mama/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Radiofármacos , Sarcoma/diagnóstico por imagen , Tomografía Computarizada de Emisión , Adolescente , Adulto , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Metástasis Linfática , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Tumor Filoide/diagnóstico por imagen , Rabdomiosarcoma Alveolar/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: To evaluate the justification of routine removal of ipsilateral adrenal gland as part of radical nephrectomy for renal cell carcinoma (RCC). METHODS: The medical records, pathologic specimens, and computed tomographic (CT) scans of 77 patients who underwent radical nephrectomy and ipsilateral adrenalectomy for RCC were reviewed. Comparison was made between radiologic analysis and pathologic findings regarding involvement of the adrenal gland. RESULTS: The size of the renal tumor varied between 3.5 and 19 cm (mean 8.5). The upper pole was involved in 45%, the lower pole in 28%, and the midpole in 18% of the patients, and in 9% the whole kidney was involved by the tumor. Histologic findings showed that 72 (94%) of the 77 adrenal glands were normal and 70 of these were normal on CT as well. Two adrenal glands involved by metastases showed heterogeneous contrast entrancement on CT. The benign lesions of three adrenal glands were also picked up as abnormal on CT. In 2 patients adrenal glands could not be visualized on CT because of a paucity of retroperitoneal fat. CONCLUSIONS: Adrenalectomy with nephrectomy may not be performed in patients with RCC in whom CT demonstrates normal adrenal glands. In patients with adrenal abnormality on CT, magnetic resonance imaging can separate metastases from incidental benign adrenal adenoma, further reducing the number of patients requiring removal of the adrenal gland.
Asunto(s)
Adrenalectomía , Carcinoma de Células Renales/cirugía , Neoplasias Renales/cirugía , Nefrectomía , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/patología , Estudios de Factibilidad , Femenino , Humanos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Radiografía , Estudios RetrospectivosRESUMEN
A 60-year-old female underwent transurethral resection of superficial grade 2 transitional cell carcinoma (TCC) of the urinary bladder. Six months later, intravesical Mitomycin C instillation was given following two superficial recurrences. A further recurrence of TCC grade I was resected transurethrally 39 months later. Forty-eight months after the original diagnosis the patient developed an abdominal mass, which turned out to be TCC grade 3 involving the left ovary. She underwent laparotomy which showed a left ovarian mass. Total abdominal hysterectomy, bilateral oophorectomy and partial omentectomy were carried out. She developed pelvic metastases 3 months later and died.
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Carcinoma de Células Transicionales/secundario , Neoplasias Ováricas/secundario , Carcinoma de Células Transicionales/diagnóstico por imagen , Resultado Fatal , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Neoplasias de la Vejiga Urinaria/patologíaAsunto(s)
Enfermedades Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Tuberculosis/diagnóstico , Adulto , Biopsia con Aguja , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pancreáticas/diagnóstico por imagen , Enfermedades Pancreáticas/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Radiografía , Tuberculosis/diagnóstico por imagen , Tuberculosis/patologíaRESUMEN
Idiopathic retroperitoneal fibrosis (IRF) may cause ureteric obstruction with renal damage. Ureterolysis with intraperitonealization of the ureter is commonly used as primary treatment. We gave corticosteroids for two years to six patients, four males and two females, between 40 and 56 years of age. one of the patients is in his tenth month of treatment and another in the fourth month. Between 4 and 74 months (mean 40.4 months) after initiation of treatment, kidney function had improved, or was preserved in previously functioning renal units, and the patients were free from symptoms. We conclude that steroids may be used as primary treatment of IRF after histological or cytological diagnosis to exclude retroperitoneal malignancy. Steroids should also be part of the treatment strategy in patients with a more aggressive disease who may need surgery. Patients with IRF should be followed for the rest of their lives after discontinuation of steroid therapy.
RESUMEN
PURPOSE: To compare the yield and complications of ultrasound-guided gun-biopsy and manual Tru-Cut techniques in percutaneous renal biopsy. MATERIAL AND METHODS: A total of 448 biopsies were reviewed. They comprised 124 manual and 131 gun-biopsies in native kidneys, and 111 manual and 82 gun-biopsies in transplant kidneys. The gun-biopsies were performed under real-time ultrasound (US) guidance. The manual technique used US mainly for marking the position of the kidney. RESULTS: There was a significantly higher diagnostic yield and fewer complications in the gun-biopsy group. A total of 8 major complications were found, all in the manual group. CONCLUSION: Provided that the operator is experienced in US scanning, a switch from the manual technique to real-time US-guided gun-biopsy will result in the improvement of diagnostic accuracy together with a reduced risk of complications.
Asunto(s)
Biopsia con Aguja/métodos , Trasplante de Riñón/patología , Riñón/patología , Ultrasonografía Intervencional , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Fístula Arteriovenosa/etiología , Biopsia con Aguja/efectos adversos , Transfusión Sanguínea , Niño , Preescolar , Femenino , Hematoma/etiología , Hematuria/etiología , Humanos , Lactante , Riñón/diagnóstico por imagen , Riñón/cirugía , Glomérulos Renales/patología , Trasplante de Riñón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea , Factores de Riesgo , Irrigación Terapéutica , Ultrasonografía Intervencional/efectos adversos , Vejiga Urinaria/lesionesRESUMEN
The case of a 28-year-old female patient with portal vein thrombosis mimicking tumour and causing obstructive jaundice is presented. The cavernous-transformed enlarged portal vein, explaining the mass-like lesion in the hepatic hilum on ultrasonography, compressed the extrahepatic bile ducts and caused obstructive jaundice. Endoscopic retrograde cholangiography demonstrated multiple nodular extrinsic indentations of the extrahepatic bile ducts with moderately dilated intrahepatic bile ducts.
Asunto(s)
Colestasis Extrahepática/etiología , Vena Porta , Trombosis/complicaciones , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico , Trombosis/diagnósticoRESUMEN
Juvenile nephronophthisis (NPH) and medullary cystic kidney disease are an important cause of chronic renal failure in children and young adults. Medullary cysts are regarded as the hallmark of this condition. The diagnostic techniques that were used previously were not conclusive in most cases to demonstrate medullary cysts. We studied the role of thin-section (1.5-mm) computed tomography (CT) scan as an optimal imaging diagnostic technique. Three children who were admitted to our hospital consecutive with a clinical diagnosis of NPH were included. We found that the thin-section CT scan demonstrates the medullary cysts in all patients. We recommend CT scan as the investigation of choice in patients with clinical features suggestive of nephronophthisis-cystic renal medulla complex.
Asunto(s)
Enfermedades Renales Quísticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Niño , Consanguinidad , Femenino , Humanos , Enfermedades Renales Quísticas/complicaciones , Enfermedades Renales Quísticas/genética , Fallo Renal Crónico/etiología , Médula Renal/diagnóstico por imagen , MasculinoRESUMEN
A retrospective study of chest radiographs in patients with brucellosis was undertaken at King Khalid University Hospital, Riyadh. The commonest presenting symptoms were fever, back and joint pains, excessive sweating, headache, and cough. Different chest radiographic abnormalities were detected, including soft miliary mottling, parenchymal nodules, consolidation, chronic diffuse changes, hilar or paratracheal lymphadenopathy and pneumothorax. Soft miliary mottling and pneumothorax have not been described before. The high incidence of lung abnormalities is most probably due to the chronicity of the disease in the present series.