RESUMO
Metastatic tumors to the heart usually involve right sided chambers. We report a rare case of malignant phyllodes tumor of breast with metastatic involvement of left atrium occurring through direct invasion from mediastinal micro-metastasis and presenting as a left atrial mass causing arrhythmia.
Assuntos
Neoplasias da Mama/patologia , Átrios do Coração/patologia , Neoplasias Cardíacas/secundário , Neoplasias Cardíacas/cirurgia , Tumor Filoide/secundário , Biópsia por Agulha , Neoplasias da Mama/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ecocardiografia Doppler , Feminino , Neoplasias Cardíacas/diagnóstico , Humanos , Imuno-Histoquímica , Excisão de Linfonodo/métodos , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Tumor Filoide/cirurgia , Doenças Raras , Medição de Risco , Resultado do TratamentoRESUMO
Thyroid lymphoma is a rare disease entity of elderly females. Chronic lymphocytic thyroiditis is said to be the precursor of thyroid lymphoma, suggesting a role of chronic antigen stimulation in the development of the disease. We present a case of male with lymphocytic thyroiditis who presented with painless progressive neck enlargement and pathology revealed features of high grade lymphoma. Staging and posttreatment (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) was performed. This report reemphasizes the role of (18)F-FDG PET/CT in the diagnosis, staging, and assessment of therapy response in patients with extranodal lymphoma, including the primary thyroid lymphoma.
RESUMO
Primary penile lymphoma is an extremely rare neoplasm. We present a case of 63-year-old man with painless diffuse pe- nile swelling and retention of urine. Biopsy from the penile swelling demonstrated CD20+ diffuse large B-cell lymphoma. Staging was performed using ï¬uorine-18-ï¬uorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and revealed a FDG avid penile mass with enlarged and FDG avid multiple inguinal and aortocaval lymph nodes. A follow-up FDG PET-CT scan after eight cycles of combination chemotherapy showed complete remission of the dis- ease. Thus, FDG PET-CT should be integrated in management protocols of rare primary penile lymphoma.
Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/patologia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Fluordesoxiglucose F18 , Seguimentos , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Penianas/tratamento farmacológico , Pênis/diagnóstico por imagem , Compostos Radiofarmacêuticos , Resultado do TratamentoRESUMO
Distant soft tissue metastasis and the simultaneous presence of iodine concentrating and nonconcentrating lesions in papillary thyroid cancer are extremely rare. The concerned patient, a histopathologically proven case of papillary thyroid cancer with nodal metastases treated with total thyroidectomy, bilateral cervical nodal dissection, and radioablation, subsequently developed lung, muscle, and liver metastasis. Triggered by increased thyroglobulin, the iodine-131 whole body scan and 200 mci iodine-131 post-therapy scan showed a left gluteus maximus lesion and a liver lesion. Fludeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scan intended to find additional lesions revealed iodine and FDG nonconcentrating bilateral pulmonary nodules and a single FDG avid hepatic and two muscle metastases. Although FDG concentration in metastatic pulmonary nodules is generally low, the CT characteristics were classical for metastatic lesion. A follow-up FDG PET-CT study six months after 200 mci iodine-131 radioablation showed treatment response in muscle and liver lesions but not lungs.
RESUMO
Authors describe a very rare case of mature teratoma with malignant transformation, preoperatively suggested by FDG PET/CT study. So the role of CT component in elucidating three embryonal components and hypermetabolism evident on PET part suggesting possible malignant transformation makes PET/CT a valuable modality in evaluation of these rare tumors.
RESUMO
Authors describe diagnostic dilemma of differentiating pyelonephritis with lymphomatous involvement of kidney in a known case of lymphoma. FDG uptake pattern was non-discriminatory and pyelonephritis diagnosed retrospectively on follow up study. Authors emphasize the importance of recognition of features and subtle clues of infection evident on CT component of PET-CT.
RESUMO
Spontaneous perforation of the biliary ducts is a rare disorder in infants. Early diagnosis of this entity is important because it can be treated surgically. We report on a 4-month-old child presenting with jaundice and progressive abdominal distention present since birth. Hepatobiliary scintigraphy, which was done to rule out any obstructive pathology, showed a biliary leak from the porta hepatis region leading to biliary ascites and bilateral hydroceles. Surgical exploration and intraoperative cholangiogram confirmed cystic duct perforation. Cholecystectomy and inguinal herniorrhaphy were performed. Follow-up hepatobiliary scintigraphy demonstrated complete resolution of the bile leak and hydroceles.
Assuntos
Doenças dos Ductos Biliares/diagnóstico por imagem , Icterícia/diagnóstico por imagem , Doenças dos Ductos Biliares/complicações , Doença Crônica , Feminino , Humanos , Lactente , Icterícia/etiologia , Cintilografia , Doenças Raras , Ruptura Espontânea/diagnóstico por imagemRESUMO
Cholecystectomy is one of the most commonly performed abdominal surgeries in which bile duct injury and bile leaks are the most important complications. Imaging plays an important role in the prompt diagnosis and management of bile leaks. The more common sites of bile leak are the gallbladder bed, subhepatic, in a bilioma, right paracolic gutter, or diffusely in the peritoneal cavity. Bile leak into the lesser sac (LS) is uncommon but is a special entity posing difficult problems in management. We have described in this study the clinical presentation, imaging findings, and management of 6 patients with biliary leakage into the LS postcholecystectomy. The clinical presentation of this condition was varied, ranging from patients with asymptomatic or with vague complaints resulting in difficulties in clinical suspicion or symptomatic but minimal enough not to be detected by ultrasonogram. Hepatobiliary scintigraphy played an important role in the diagnosis and management, and all patients required definitive therapeutic drainage procedures. Any persistent focal radiotracer activity in the anatomy of the LS, increasing with time and not diffusing into the general peritoneal cavity is diagnostic of bile leak into the LS.