RESUMO
SPECT/CT imaging can provide improved diagnostic information over traditional planar scintigraphy and SPECT, with more precise anatomic localization and observer confidence. We present 2 patients with polycystic liver disease (PCLD), both with constitutional symptoms and bacteremia. In WBC SPECT/CT images revealed increased WBC localization within a single liver cyst in each case, subsequently drained under imaging guidance. Cultures confirmed the presence of infection, allowing for appropriately directed antibiotic therapy and successful treatment outcomes. These cases illustrate the incremental value of In WBC SPECT/CT fusion imaging for the evaluation of bacteremia in complicated patients.
Assuntos
Cistos/diagnóstico por imagem , Leucócitos/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Cistos/sangue , Feminino , Humanos , Hepatopatias/sangue , Masculino , Imagem MultimodalRESUMO
Relatamos duas lesões pouco habituais e de difícil diagnóstico, nas quais o ecocardiograma transesofágico foi fundamental na avaliação mais detalhada da anatomia da valva mitral, permitindo o diagnóstico diferencial entre cisto sanguíneo e aneurisma roto da valva mitral, os quais, no exame inicial transtorácico, assumiam aspecto muito semelhante.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Abscesso/cirurgia , Abscesso/complicações , Cistos/sangue , Ecocardiografia Transesofagiana , Valva Mitral/cirurgia , Diagnóstico Diferencial , Espectroscopia de Ressonância Magnética/normas , Espectroscopia de Ressonância MagnéticaRESUMO
BACKGROUND: The finding of adnexal masses during pregnancy is an exceptional event. Its reported incidence is less than 5% and most cases resolve spontaneously as the pregnancy progresses. OBJECTIVE: Describe a case series of patients with adnexal mass and pregnancy. MATERIAL AND METHODS: We retrospectively reviewed the medical records of patients who had diagnosis of pregnancy and adnexal over a period of five years. RESULTS: The incidence was 0.22%. The mean age was 26 +/- 7.3 years, mean gestational age was 17 +/- 6.6 weeks. The diagnosis was established by ultrasound (USG) in 95% of cases, 48% had cystic characteristics, the mean diameter of the tumor was 99 +/- 42 mm. Cistectomy was performed during pregnancy or trans-cesarean section in 30% and 58% of patients respectably. The mean tumor size was 118 mm (range 2 a 40 mm), weight 1,370 g (range 10 a 5,800 g). The most frequent histological diagnosis were serous cyst (40%), mature teratoma (28%), mucinous (6%), malignancy (4%). There were not complications related to the surgical procedure. CONCLUSIONS: The USG constitute a safe method for the diagnosis, but the image method with the highest positive predictive value is the MRI. Tumor markers (CA-125, AFP, GCH-B,DHL, ACE), are not useful during pregnancy. If the tumor doesn't achieve surgical criteria the recommended follow up is clinical observation and USG. If surgery is decided, it should be performed between 16 a 23 weeks of pregnancy, and it's recommended to send the tumor to histological diagnosis, in case of malignancy the surgery will continue according to the tumor stage. The time and delivery route will be decided by the obstetrician.
Assuntos
Anexos Uterinos/patologia , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Neoplasias dos Genitais Femininos/cirurgia , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/cirurgia , Anexos Uterinos/diagnóstico por imagem , Anexos Uterinos/cirurgia , Doenças dos Anexos/sangue , Doenças dos Anexos/diagnóstico por imagem , Doenças dos Anexos/cirurgia , Adolescente , Adulto , Biomarcadores Tumorais/sangue , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Carcinoma/cirurgia , Cesárea , Cistadenoma/sangue , Cistadenoma/diagnóstico por imagem , Cistadenoma/cirurgia , Cistos/sangue , Cistos/diagnóstico por imagem , Cistos/cirurgia , Feminino , Neoplasias dos Genitais Femininos/sangue , Idade Gestacional , Humanos , Incidência , Achados Incidentais , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Complicações Neoplásicas na Gravidez/sangue , Estudos Retrospectivos , Teratoma/sangue , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
OBJECTIVE: Gross cystic disease (GCD) is the most common benign breast pathology. Although breast cysts are not considered pre-malignant lesions, an increased risk of breast cancer has been reported for patients with type I cysts (Na(+)/K(+)<3). Furthermore, an augmented IGF-I/IGF-binding protein-3 (IGFBP-3) ratio has been described in breast cancer patients. The objective was to evaluate serum IGF-I and binding protein concentrations of type I and type II cyst patients as compared with healthy women. METHODS: Twenty-four patients with type I cysts, 17 with type II cysts and 25 healthy women were evaluated. Serum IGF-I, IGFBP-3 and IGFBP-1 concentrations were measured by IRMA. RESULTS: IGF-I concentrations were significantly higher in sera from patients with type I cysts than in patients with type II cysts. A highly significant decrease of IGFBP-3, the major IGFBP, was found in patients with type I cysts with respect to healthy women, whereas no significant difference was evident between the different cyst types. The IGF-I/IGFBP-3 ratio, an estimate of biologically active IGF-I, was very significantly higher in patients with type I cysts than in both type II patients and healthy women. IGFBP-1 levels were significantly lower in patients with type I than in controls and type II cysts. The IGF-I/IGFBP-1 ratio was significantly higher in patients with type I cysts than in type II bearers and healthy women. Estrogen levels correlated with IGF-I in patients and controls. CONCLUSIONS: The enhanced levels of IGF-I/IGFBP-3 found in patients with type I cysts could eventually be associated with the increased risk of breast cancer described for this group.
Assuntos
Doenças Mamárias/sangue , Cistos/sangue , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Pré-Menopausa/sangue , Adulto , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Los quistes esplenicos son una entidad rara. En la literatura mundial hay recopilados alrededor de 600 casos. Este articulo describe el caso de una paciente con una masa quistica esplenica que se considera como un quiste secundario. Se discute la revision de la literatura respecto a clasificacion , etiologia, manifestaciones clinicas, diagnostico y tratamiento de la enfermedad