Detección de megauréter en gammagrafía renal: síndrome de Prune-Belly / Megaureter detection through renal scintigraphy scan: Prune-Belly syndrome

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Sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with operable breast cancer and positive axillary nodes at initial diagnosis

Objetivo. Valorar la utilidad de la biopsia selectiva del ganglio centinela (BGC) después de la quimioterapia neoadyuvante (QTN) en pacientes con cáncer de mama operable y axila positiva al diagnóstico. Material y métodos. Estudio prospectivo entre enero de 2008 y diciembre de 2012 en 52 pacientes, con una edad media de 50,7 años y con cáncer de mama infiltrante T1-3, N1, M0 (uno bilateral, 7 multifocales), tratadas con epirrubicina/ciclofosfamida, docetaxel y trastuzumab en HER-2/neu positivas. El estatus axilar se estableció por la exploración física, la ecografía axilar y la punción ecoguiada de ganglios sospechosos. El día antes de la cirugía se inyectó periareolarmente 74-111 MBq de 99mTc-nanocoloide de albúmina. En todas se realizó una cirugía mamaria, una BGC y una linfadenectomía axilar. El GC se analizó por cortes de congelación, hematoxilina-eosina, inmunohistoquímica u OSNA. Resultados. Tamaño medio del tumor: 3,5 cm. Tipo histológico: 81,1% carcinoma ductal infiltrante. Respuesta completa al tumor primario: clínica 43,4%, patológica 41,5%. Ninguna de las pacientes presentó adenopatías axilares palpables después del tratamiento. Respuesta completa patológica axilar: 42,2%. El porcentaje de identificación del GC fue de 84,9%. En 6 de las 8 pacientes sin migración del nanocoloide la axila resultó positiva en el estudio anatomopatológico. En el 95,5% de los casos el GC determinó correctamente el estatus axilar. La tasa de falsos negativos fue de 8,3%. En el 68,2% de los casos el GC fue el único afectado de la axila. El número medio de GC identificados fue de 1,9 y el de ganglios axilares extirpados fue de 13,2. Conclusión. La BGC post-QTN es una técnica segura y factible en pacientes con cáncer de mama operable T1-3, N1 y axila clínicamente negativa después del tratamiento (AU)

Aim. To evaluate the utility of the sentinel lymph node biopsy (SLNB) in patients with operable breast cancer and positive axillary nodes at initial diagnosis treated with neoadjuvant chemotherapy (NAC). Material and methods. A prospective study was performed from January 2008 to December 2012 in 52 women, mean age 50.7 years, with infiltrating breast carcinoma T1-3, N1, M0 (1 bilateral, 7 multifocal) treated with epirubicin/cyclophosphamide, docetaxel and trastuzumab in Her2/neu-positive patients. Axillary evaluation included physical examination, axillary ultrasound, and ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of 99mTc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB and complete axillary lymph node dissection (ALND). The SLNs were examined by frozen sections, hematoxylin-eosin staining, immunohistochemical analysis or one-step nucleic acid amplification assay (OSNA). Results. Mean tumor size: 3.5 cm. Histologic type: 81.1% invasive ductal carcinoma. Complete response of primary tumor was clinical 43.4%, pathological 41.5%. All patients were clinically node-negative after NAC. Pathological complete response of axillary node was 42.2%. SLN identification rate was 84.9%. Axilla was positive in the pathology study in 6 of 8 patients without nanocolloid migration. SLN accurately represented the axillary status in 95.5%. False negative rate was 8.3%. SLN was the only positive node in 68.2% of patients. Mean number of SLN removed was 1.9 and of nodes resected from the ALND 13.2. Conclusion. SLN biopsy after NAC is a feasible and accurate tool in patients with operable breast cancer T1-3, N1 and clinically node-negative after therapy (AU)

Sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with operable breast cancer and positive axillary nodes at initial diagnosis.

AIM: To evaluate the utility of the sentinel lymph node biopsy (SLNB) in patients with operable breast cancer and positive axillary nodes at initial diagnosis treated with neoadjuvant chemotherapy (NAC). MATERIAL AND METHODS: A prospective study was performed from January 2008 to December 2012 in 52 women, mean age 50.7 years, with infiltrating breast carcinoma T1-3, N1, M0 (1 bilateral, 7 multifocal) treated with epirubicin/cyclophosphamide, docetaxel and trastuzumab in Her2/neu-positive patients. Axillary evaluation included physical examination, axillary ultrasound, and ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of (99m)Tc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB and complete axillary lymph node dissection (ALND). The SLNs were examined by frozen sections, hematoxylin-eosin staining, immunohistochemical analysis or one-step nucleic acid amplification assay (OSNA). RESULTS: Mean tumor size: 3.5 cm. Histologic type: 81.1% invasive ductal carcinoma. Complete response of primary tumor was clinical 43.4%, pathological 41.5%. All patients were clinically node-negative after NAC. Pathological complete response of axillary node was 42.2%. SLN identification rate was 84.9%. Axilla was positive in the pathology study in 6 of 8 patients without nanocolloid migration. SLN accurately represented the axillary status in 95.5%. False negative rate was 8.3%. SLN was the only positive node in 68.2% of patients. Mean number of SLN removed was 1.9 and of nodes resected from the ALND 13.2. CONCLUSION: SLN biopsy after NAC is a feasible and accurate tool in patients with operable breast cancer T1-3, N1 and clinically node-negative after therapy.

Biopsia del ganglio centinela en pacientes con cáncer de mama operable tratadas con quimioterapia neoadyuvante / Sentinel lymph node biopsy in patients with operable breast cancer treated with neoadjuvant chemotherapy

Objetivo. Validar la biopsia selectiva del ganglio centinela (BGC) en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante. Materiales y métodos. Estudio prospectivo de enero de 2008 a enero de 2011, 88 pacientes con una edad media de 49,4 años, con cáncer de mama infiltrante T1-3, N0-1, M0, tratadas con epirrubicina/ciclofosfamida, docetaxel y trastuzumab en Her2/neu positivas. El estatus axilar se estableció por exploración física, ecografía axilar y punción ecoguiada de ganglios sospechosos. El día antes de la cirugía se inyectaron periareolarmente 74-111 MBq de 99mTc-nanocoloide de albúmina. En todas se realizó cirugía mamaria, BGC y linfadenectomía axilar. El ganglio centinela (GC) se analizó por cortes de congelación, hematoxilina-eosina, inmunohistoquímica u OSNA. Resultados. El tamaño medio del tumor fue de 3,5 cm. Según el tipo histológico, 69 se clasificaron como ductal infiltrante, 16 como lobulillar infiltrante y 3 como de otro tipo. Treinta y siete pacientes tenían axila clínica/ecográfica positiva al diagnóstico. La respuesta clínica del tumor primario fue: 38 completa, 45 parcial, 5 no respuesta. En todas las pacientes la axila fue clínica/ecográfica negativa después del tratamiento. En 25 casos hubo respuesta patológica completa en el tumor primario. El porcentaje de identificación del GC fue del 92,0%, 6 de las 7 pacientes sin migración eran axila clínica/ecográfica positiva al diagnóstico. En el 96,3% de los casos el GC determinó correctamente el estatus axilar. La tasa de falsos negativos fue del 8,3%. En el 69,4% de los casos el GC era el único afectado de la axila. El número medio de GC identificados fue 1,7 y el de ganglios axilares extirpados fue 13,2. Conclusión. La BGC es una técnica factible en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante, pudiendo evitar linfadenectomías innecesarias(AU)

Aim. To evaluate the accuracy of sentinel lymph node biopsy (SLNB) in operable breast cancer patients treated with neoadjuvant chemotherapy (NAC). Materials and methods. Between January 2008-2011, 88 women, mean age 49.4 years, with infiltrating breast carcinoma, were studied prospectively. Patients were T1-3, N0-1, M0. Prior to surgery, the patients received chemotherapy (epirubicin/cyclophosphamide, docetaxel), and trastuzumab in Her2/neu-positive patients. Axillary status was established by physical examination, ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of 99mTc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB, followed by complete axillary lymph node dissection (ALND). Sentinel lymph node (SLN) were examined by frozen sections, hematoxylin-eosin staining and immunohistochemical analysis or One Step Nucleic Acid Amplification (OSNA). Results. Mean tumor size: 3.5 cm. Histologic type: 69 invasive ductal, 16 invasive lobular and 3 others. Thirty seven patients had clinical/ultrasound node-positive at presentation. Clinical response of primary tumor to NAC: complete in 38, partial in 45, and stable disease in 5 patients. A pathological complete response was achieved in 25. All patients were clinically node-negative after NAC. SLN identification rate was 92.0%. Six of 7 patients in whom SLN was not found had clinical/ultrasound positive axilla before NAC. SLN accurately determined the axillary status in 96.5%. False negative rate was 8.3%. In 69.4% of patients, SLN was the only positive node. The mean number of SLN removed was 1.7 and nodes resected from the ALND were 13.2. Conclusion. SLN biopsy after NAC can predict the axillary status with a high accuracy in patients with breast cancer, avoiding unnecessary ALND(AU)

Sentinel lymph node biopsy in patients with operable breast cancer treated with neoadjuvant chemotherapy.

AIM: To evaluate the accuracy of sentinel lymph node biopsy (SLNB) in operable breast cancer patients treated with neoadjuvant chemotherapy (NAC). MATERIALS AND METHODS: Between January 2008-2011, 88 women, mean age 49.4 years, with infiltrating breast carcinoma, were studied prospectively. Patients were T1-3, N0-1, M0. Prior to surgery, the patients received chemotherapy (epirubicin/cyclophosphamide, docetaxel), and trastuzumab in Her2/neu-positive patients. Axillary status was established by physical examination, ultrasound-guided core needle biopsy of any suspicious lymph node. The day before surgery, 74-111 MBq of (99m)Tc-albumin nanocolloid was injected periareolarly. All patients underwent breast surgery, with SLNB, followed by complete axillary lymph node dissection (ALND). Sentinel lymph node (SLN) were examined by frozen sections, hematoxylin-eosin staining and immunohistochemical analysis or One Step Nucleic Acid Amplification (OSNA). RESULTS: Mean tumor size: 3.5 cm. Histologic type: 69 invasive ductal, 16 invasive lobular and 3 others. Thirty seven patients had clinical/ultrasound node-positive at presentation. Clinical response of primary tumor to NAC: complete in 38, partial in 45, and stable disease in 5 patients. A pathological complete response was achieved in 25. All patients were clinically node-negative after NAC. SLN identification rate was 92.0%. Six of 7 patients in whom SLN was not found had clinical/ultrasound positive axilla before NAC. SLN accurately determined the axillary status in 96.5%. False negative rate was 8.3%. In 69.4% of patients, SLN was the only positive node. The mean number of SLN removed was 1.7 and nodes resected from the ALND were 13.2. CONCLUSION: SLN biopsy after NAC can predict the axillary status with a high accuracy in patients with breast cancer, avoiding unnecessary ALND.

Displasia fibrosa ósea. Aportación de la Medicina Nuclear al diagnóstico de sospecha de degeneración sarcomatosa / Fibrous dysplasia of the bone. Contribution of Nuclear Medicine in the diagnosis of suspicion of sarcomatous degeneration

La displasia fibrosa (DF) es una enfermedad benigna del hueso relativamente frecuente, en la que existe un trastorno de la maduración del mesénquima óseo con sustitución del tejido lamelar de la cavidad medular de los huesos por un tejido fibroso anómalo. Su diagnóstico a menudo es un hallazgo casual al realizar estudios radiológicos o gammagráficos óseos por otros motivos ya que normalmente es asintomática. En ocasiones puede presentar complicaciones como deformidades, fracturas patológicas y excepcionalmente transformación maligna. El diagnóstico diferencial entre DF y neoplasia maligna puede ser complicado y llevar a un diagnóstico tardío de cuando ya existe degeneración sarcomatosa. En este contexto, la tomografía de positrones con 18F-fluorodesoxiglucosa (PET-FDG) puede ser de utilidad en el seguimiento de esta patología. Presentamos 2 casos de pacientes diagnosticadas de DF con sospecha de malignización de sus lesiones y a las que se les solicitaron estudios complementarios de medicina nuclear(AU)

Fibrous dysplasia (FD) is a relatively frequent benign disease of the bone in which there is a maturation disorder of the bone-forming mesenchyme where the lamellar bone marrow is replaced with abnormal fibrous tissue. Its diagnosis is often an accidental finding when X-ray studies or bone scans are performed for other reasons since it is usually asymptomatic. There may be complications such as deformities, pathological fractures and exceptionally malignant transformation. The differential diagnosis between malignancy and FD can be complicated and lead to late diagnosis when sarcomatous degeneration already exists. In this context, the positron tomography with 18F-fluorodeoxyglucose (FDG-PET) may be useful in the monitoring of this condition. We present two cases of patients diagnosed of FD with suspicion of malignization of their bone lesions who were referred to Nuclear Medicin(AU)

[Fibrous dysplasia of the bone. Contribution of nuclear medicine in the diagnosis of suspicion of sarcomatous degeneration]. / Displasia fibrosa ósea. Aportación de la Medicina Nuclear al diagnóstico de sospecha de degeneración sarcomatosa.

Fibrous dysplasia (FD) is a relatively frequent benign disease of the bone in which there is a maturation disorder of the bone-forming mesenchyme where the lamellar bone marrow is replaced with abnormal fibrous tissue. Its diagnosis is often an accidental finding when X-ray studies or bone scans are performed for other reasons since it is usually asymptomatic. There may be complications such as deformities, pathological fractures and exceptionally malignant transformation. The differential diagnosis between malignancy and FD can be complicated and lead to late diagnosis when sarcomatous degeneration already exists. In this context, the positron tomography with (18)F-fluorodeoxyglucose (FDG-PET) may be useful in the monitoring of this condition. We present two cases of patients diagnosed of FD with suspicion of malignization of their bone lesions who were referred to Nuclear Medicin.

[Diagnostic value of cardiac 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy in Lewy body disorders]. / Valor diagnóstico de la gammagrafía cardíaca con 123I-metaiodobenzilguanidina en las enfermedades con cuerpos de Lewy.

INTRODUCTION: Lewy body disorders such as Parkinson's disease (PD) and Lewy body dementia (LBD) are associated with cardiac sympathetic denervation, which can be visualized on 123I-MIBG scintigraphy. Our objectives were to study the diagnostic value of this technique in Lewy body disorders and its relationship with PD clinical variables. PATIENTS AND METHODS: We studied 90 patients: 51 with PD, 19 with LBD, 9 with multiple system atrophy (MSA) and 11 controls. Scintigraphy images were qualitatively evaluated and early and delayed heart-to-mediastinum ratios (HMR) were calculated. The main confounding factors (ischemic heart disease, diabetes, hypertension and drugs) were controlled by multivariate linear regression analysis. We investigated correlations between scintigraphy variables and PD variables. RESULTS: The delayed HMR, which showed better discriminative ability was 2.03 +/- 0.32 in controls, 1.37 +/- 0.30 in PD (p<0.001 vs controls), 1.47+/-0.45 in LBD (p=0.001 vs controls) and 1.69+/-0.28 in MSA (p=0.02 vs controls; p=0.004 vs PD). This ratio was influenced by PD/LBD diagnosis (beta= -0.638; p<0.001) and to a lesser degree, by ischemic heart disease (beta= -0.244; p=0.028). Optimal cut-off value between PD/LBD and controls was 1.71 (83% sensitivity and 82% specificity). Within the PD group, those with a family history of PD/LB showed higher delayed HMR values (1.65+/-0.34 vs 1.30+/-0.24 without history; p<0.001) and proportion with normal scintigraphy (56% vs 5%; p=0.001). CONCLUSIONS: Cardiac 123I-MIBG scintigraphy is useful in the diagnosis of Lewy body disorders, although its value in PD is conditioned by having a family history of PD.

[18F-fluorodeoxyglucose positron emission tomography in the evaluation of therapy response assessment in lymphomas. Systematic literature review and meta-analysis]. / Tomografía de positrones con 18F-fluorodesoxiglucosa en la valoración de la respuesta de los linfomas al tratamiento. Revisión sistemática de la literatura y metaanálisis.

This systematic review of literature analyze the utility of positron emission tomography (PET or PET-CT) with 18F-fluorodeoxyglucose, as a diagnostic tool in the assessment of response to chemotherapy and immunotherapy in lymphomas, in terms of diagnostic accuracy in prospective publications. A literature search was conducted in major databases and through manual review from the reference lists of articles that were recovered. The methodological quality of the selected items was evaluated using the QUADAS questionnaire. 9 publications were analyzed after the filtering process. The methodological quality of the same was broadly acceptable. In patients with LH, the negative predictive value of FDG-PET after 2-3 cycles of chemotherapy, was ranged between 93.4% (95% CI, 92.6-94.3) and 100% (95% CI, 99.3-100%), and after the treatment, the negative predictive value of PET-FDG, was between 94.3% (95% CI, 92.8-95.7) and 100% (95% CI, 97.1-100). In patients with residual masses and LH, the meta-analysis of results showed a sensitivity of 100% (95% CI, 0.753-1) and a specificity of 84% (95% CI, 0.699-0.934). PET-FDG seems to be a useful tool to evaluate the response to treatment of patients with lymphoma. However, it recommended further prospective studies and that possibly conducted in hybrid PET-CT scans, to determine its usefulness.

Valor diagnóstico de la gammagrafíacardíaca con 123I-metaiodobenzilguanidinaen las enfermedades con cuerpos de Lewy / Diagnostic value of cardiac 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy in Lewy body disorders

Introducción. Enfermedades con cuerpos de Lewy (ECL), como laenfermedad de Parkinson (EP) y la demencia con cuerpos de Lewy(DCL), asocian una denervación simpática cardíaca que puede evidenciarsemediante gammagrafía con 123I-metaiodobenzilguanidina(123I-MIBG). Nuestros objetivos fueron estudiar su valor diagnósticoen las ECL y su relación con variables clínicas de la EP.Pacientes y métodos. Estudiamos 90 pacientes: 51 con EP, 19 conDCL, 9 con atrofia multisistémica (AMS) y 11 controles. Se realizó valoracióncualitativa de la gammagrafía y se calcularon los índices corazón/mediastino (ICM) precoz y tardío. Los principales factores deconfusión (cardiopatía isquémica, diabetes, hipertensión y fármacos)se controlaron mediante regresión lineal multivariante. Efectuamoscorrelaciones entre las variables gammagráficas y del grupo con EP.Resultados. El ICM tardío, con mayor capacidad discriminativa,fue 2,03±0,32 en los controles, 1,37±0,30 en EP (p<0,001 vs controles),1,47±0,45 en DCL (p=0,001 vs controles) y 1,69±0,28 enAMS (p=0,02 vs controles; p=0,004 vs EP). En este índice influía eldiagnóstico de ECL (ß=–0,638; p<0,001) y en menor grado la cardiopatíaisquémica (ß=–0,244; p=0,028). Identificamos el valor 1,71como mejor punto de corte entre ECL y controles (sensibilidad 83%y especificidad 82%). Dentro del grupo con EP, aquellos con antecedentesfamiliares de EP mostraron mayores ICM tardío (1,65±0,34 vs1,30±0,24 sin antecedentes; p<0,001) y proporción de gammagrafíasnormales (56% vs 5%; p=0,001).Conclusiones. La gammagrafía cardíaca con 123I-MIBG es útilen el diagnóstico de ECL, si bien, en la EP su valor está condicionadopor el hecho de tener historia familiar de la enfermedad (AU)

Introduction. Lewy body disorders such as Parkinson’s disease(PD) and Lewy body dementia (LBD) are associated withcardiac sympathetic denervation, which can be visualized on123I-MIBG scintigraphy. Our objectives were to study the diagnosticvalue of this technique in Lewy body disorders and its relationshipwith PD clinical variables.Patients and methods. We studied 90 patients: 51 with PD,19 with LBD, 9 with multiple system atrophy (MSA) and 11 controls.Scintigraphy images were qualitatively evaluated and earlyand delayed heart-to-mediastinum ratios (HMR) were calculated.The main confounding factors (ischemic heart disease, diabetes,hypertension and drugs) were controlled by multivariate linearregression analysis. We investigated correlations between scintigraphyvariables and PD variables.Results. The delayed HMR, which showed better discriminativeability was 2.03 ± 0.32 in controls, 1.37 ± 0.30 in PD(p<0.001 vs controls), 1.47±0.45 in LBD (p=0.001 vs controls) and1.69±0.28 in MSA (p=0.02 vs controls; p=0.004 vs PD). This ratiowas influenced by PD/LBD diagnosis (ß=–0.638; p<0.001)and to a lesser degree, by ischemic heart disease (ß = –0.244;p=0.028). Optimal cut-off value between PD/LBD and controlswas 1.71 (83% sensitivity and 82% specificity). Within the PDgroup, those with a family history of PD/LB showed higher delayedHMR values (1.65±0.34 vs 1.30±0.24 without history; p<0.001)and proportion with normal scintigraphy (56% vs 5%; p=0.001).Conclusions. Cardiac 123I-MIBG scintigraphy is useful in thediagnosis of Lewy body disorders, although its value in PD isconditioned by having a family history of PD (AU)

Tomografía de positrones con 18F-fluorodesoxiglucosa en la valoración de la respuesta de los linfomas al tratamiento. Revisión sistemática de la literatura y metaanálisis / 18F-fluorodeoxyglucose positron emission tomography in the evaluation of therapy response assessment in lymphomas. Systematic literature review and meta-analysis

La presente revisión sistemática de la literatura pretende evaluar el rendimiento de la tomografía de positrones (PET o PET-TAC) de cuerpo entero con 18F-fluorodesoxiglucosa (FDG), como prueba diagnóstica, en la valoración de la respuesta a la quimioterapia y la inmunoterapia en los linfomas, en términos de validez y utilidad, para ello se utilizaron publicaciones de carácter prospectivo. Se realizó una búsqueda bibliográfica en las principales bases de datos disponibles y mediante revisión manual a partir de las listas de referencia de los artículos encontrados. La calidad metodológica de los artículos seleccionados se evaluó mediante el cuestionario QUADAS. Se analizaron 9 publicaciones tras el proceso de filtrado. La calidad metodológica de aquellos, en general, fue aceptable. En pacientes con linfoma de Hodgkin (LH) el valor predictivo negativo de la PET-FDG, después de 2-3 ciclos de quimioterapia, osciló entre el 93,4% (intervalo de confianza [IC] del 95%, 92,6-94,3) y el 100% (IC del 95%, 99,3-100%), y al finalizar el tratamiento el valor predictivo negativo de la PET-FDG osciló entre el 94,3% (IC del 95%, 92,8-95,7) y el 100% (IC del 95%, 97,1-100). En pacientes con LH y masas residuales el metaanálisis de resultados mostró una sensibilidad total del 100% (IC del 95%, 0,753-1) y una especificidad del 0,841% (IC del 95%, 0,699-0,934). La PET-FDG parece ser una herramienta útil en la valoración de la respuesta al tratamiento de pacientes con linfoma. No obstante, ha de recomendarse la realización de nuevos estudios de carácter prospectivo y que, a ser posible, sean con equipos híbridos PET-TAC para determinar su utilidad(AU)

This systematic review of literature analyze the utility of positron emission tomography (PET or PET-CT) with 18F-fluorodeoxyglucose, as a diagnostic tool in the assessment of response to chemotherapy and immunotherapy in lymphomas, in terms of diagnostic accuracy in prospective publications. A literature search was conducted in major databases and through manual review from the reference lists of articles that were recovered. The methodological quality of the selected items was evaluated using the QUADAS questionnaire. 9 publications were analyzed after the filtering process. The methodological quality of the same was broadly acceptable. In patients with LH, the negative predictive value of FDG-PET after 2-3 cycles of chemotherapy, was ranged between 93.4% (95% CI, 92.6-94.3) and 100% (95% CI, 99.3-100%), and after the treatment, the negative predictive value of PET-FDG, was between 94.3% (95% CI, 92.8-95.7) and 100% (95% CI, 97.1-100). In patients with residual masses and LH, the meta-analysis of results showed a sensitivity of 100% (95% CI, 0.753-1) and a specificity of 84% (95% CI, 0.699-0.934). PET-FDG seems to be a useful tool to evaluate the response to treatment of patients with lymphoma. However, it recommended further prospective studies and that possibly conducted in hybrid PET-CT scans, to determine its usefulness(AU)

[Usefulness of labelled red-cell scintigraphy in Blue Rubber-Bleb Nevus syndrome]. / Utilidad de la gammagrafía con hematíes marcados en el síndrome de Blue Rubber Bleb Nevus.

Blue Rubber Bleb Nevus syndrome is a rare disorder characterized by distinctive cutaneous and gastrointestinal venous malformations that usually cause episodes of occult gastrointestinal haemorrhage and iron deficiency anaemia. We describe an 8-year-old girl who had multiple cutaneous venous malformations since birth. She also suffered from several episodes of severe chronic iron deficiency anaemia and required blood transfusions. To evaluate the presence of gastrointestinal bleeding secondary to intestinal angiomatosis, we decided to perform 99mTc-labelled red blood cell scintigraphy, which confirmed cutaneous venous malformations and also showed gastrointestinal vascular lesions that suggested the diagnosis of Blue Rubber Bleb Nevus Syndrome.

Utilidad de la gammagrafía con hematíes marcados en el síndrome de Blue Rubber Bleb Nevus / Usefulness of labelled red cell scintigraphy in Blue Rubber Bleb Nevus syndrome

El síndrome de Blue Rubber Bleb Nevus (BRBNS) es una rara enfermedad que se caracteriza por múltiples malformaciones venosas (cutáneas y gastrointestinales) asociadas a episodios de sangrado gastrointestinal, generalmente oculto, y anemia ferropénica. Se presenta el caso de una niña de 8 años de edad que desde los primeros meses de vida presentó angiomas cutáneos y numerosos episodios de anemia ferropénica grave que requirió transfusiones en varias ocasiones. Ante la sospecha de angiomatosis intestinal por hemorragia digestiva, se le solicitó una gammagrafía con hematíes marcados con 99mTc, que evidenció las lesiones vasculares intestinales y, a su vez, confirmó las ya conocidas a nivel cutáneo, llegándose al diagnóstico de BRBNS (AU)

Blue Rubber Bleb Nevus syndrome is a rare disorder characterized by distinctive cutaneous and gastrointestinal venous malformations that usually cause episodes of occult gastrointestinal haemorrhage and iron deficiency anaemia. We describe an 8-year-old girl who had multiple cutaneous venous malformations since birth. She also suffered from several episodes of severe chronic iron deficiency anaemia and required blood transfusions. To evaluate the presence of gastrointestinal bleeding secondary to intestinal angiomatosis, we decided to perform 99mTc-labelled red blood cell scintigraphy, which confirmed cutaneous venous malformations and also showed gastrointestinal vascular lesions that suggested the diagnosis of Blue Rubber Bleb Nevus Syndrome (AU)

[The role of bone scintigraphy in two cases of hereditary multiple exostoses]. / Papel de la gammagrafía ósea en dos casos de exóstosis múltiple hereditaria.

We present the cases of two patients aged 18 and 40 years, with no previous personal history of interest. The only symptoms reported by the first patient in the previous year were episodes of pain and stiffness without inflammation in the right knee and third finger of the right hand. These episodes lasted two to three weeks. Our second patient presented numbness in the lower left limb over the previous year. The analytical study was normal. The patients were diagnosed with hereditary multiple exostoses, based on the clinical, radiological and scintigraphic findings. The bone scintigraphy enabled whole body images to be obtained in a single examination and may be used for the differential diagnosis of other osteoarticular conditions, as well as for the follow-up and assessment of the response to treatment.

Papel de la gammagrafía ósea en dos casos de exóstosis múltiple hereditaria / The role of bone scintigraphy in two cases of hereditary multiple exostoses

Se presentan los casos de dos pacientes de 18 y 40 años sin antecedentes personales de interés. Como única sintomatología, el primer paciente refería en el último año episodios de dolor y sensación de rigidez sin inflamación en la rodilla derecha y el tercer dedo de la mano derecha. Dichos episodios fueron de dos y tres semanas de evolución. Nuestro segundo paciente presentaba sensación de adormecimiento del miembro inferior izquierdo de 1 año de evolución. El estudio analítico fue normal. Se llegó al diagnóstico de exóstosis múltiple hereditaria basándose en los hallazgos clínicos, radiológicos y gammagráficos. La gammagrafía ósea permite obtener en una sola exploración imágenes de cuerpo entero y puede emplearse para el diagnóstico diferencial de otros procesos osteoarticulares, así como para el control evolutivo y la valoración de la respuesta al tratamiento

We present the cases of two patients aged 18 and 40 years, with no previous personal history of interest. The only symptoms reported by the first patient in the previous year were episodes of pain and stiffness without inflammation in the right knee and third finger of the right hand. These episodes lasted two to three weeks. Our second patient presented numbness in the lower left limb over the previous year. The analytical study was normal. The patients were diagnosed with hereditary multiple exostoses, based on the clinical, radiological and scintigraphic findings. The bone scintigraphy enabled whole body images to be obtained in a single examination and may be used for the differential diagnosis of other osteoarticular conditions, as well as for the follow-up and assessment of the response to treatment

Bazo accesorio detectado con gammagrafía abdominal con hematíes desnaturalizados marcados con 99mTc en niña de 8 años / No disponible

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Tomografía por emisión de positrones con 18F-fluordesoxiglucosa en pacientes con sarcoma uterino / Positron emision tomography with 18F-fluorodeoxyglucose in patients with uterine sarcoma

Objetivo. Describir nuestra experiencia con la tomografía por emisión de positrones con FDG-PET en pacientes con sarcoma uterino, tanto con sospecha de recurrencia como en estadificación tumoral tras hallazgo casual en la pieza de histerectomía. Material y métodos. Se revisaron retrospectivamente (abril 2002-enero 2006) los estudios de FDG-PET realizados a 10 pacientes diagnosticadas de sarcoma uterino, 7 por sospechade recurrencia y 3 por estudio de extensión. La edadmedia fue de 52,2 años. El tiempo de evolución desde el diagnóstico inicial oscilaba entre 1 mes y 15 años (mediana: 14 meses). Histológicamente, las lesiones correspondieron a 8 leiomiosarcomas y 2 carcinosarcomas. La estadificación según la clasificación FIGO de las pacientes fue: 5 casos en estadio I, 1 en estadio III y 4 en estadio IV. Resultados. En 4 de las 7 pacientes con sospecha de recurrencia existió discrepancia entre la información proporcionada por la tomografía por emisión de positrones (PET) y las técnicas de imagen convencionales. En tres casos de tomografía axial computarizada no concluyente la FDG-PET fue negativay las pacientes no presentaron evidencia de enfermedad. La PET resultó negativa en una paciente con metástasis pulmonares. En los 3 estudios de estadificación hubo concordancia entre los hallazgos de la FDG-PET y las técnicas de imagen convencionales. Existió confirmación histológica de las lesiones en 5 pacientes, con un seguimiento medio de 14 meses. Conclusión. La FDG-PET puede ser útil en el seguimiento de las pacientes con sarcoma uterino y cuando el tumor es un hallazgo casual en una histerectomía por otras causas

Objective. Describe our experience with 18F- fluorodeoxyglucose positron emission tomography (FDG-PET), in patients with uterine sarcomas, under suspicion of recurrence and in tumour staging after hysterectomy as an incidental pathology finding. Material and methods. A retrospective review, between april 2002 and january 2006, of FDG-PET performed in 10 patientswith clinical diagnosis of uterine sarcoma was made (7 patients under recurrence suspicion and three under initial staging). Mean age was 52.2 yrs. Evolution time after initial diagnosis vary from one month to 15 yrs (median time: 14 months). Lesions were classified as 8 leiomyosarcomas and 2 carcinosarcomas. FIGO staging were establish resulting 5 patients stage I, 1 patient stage III, and 4 patients stage IV. Results. 4 of 7 patients under suspicion of recurrence showed discrepancies between positron emission tomography (PET) and conventional imaging techniques (CIT) information. FDG-PET was negative in three cases of non-conclusive CT. PET was negative in one case with pulmonary metastases. The 3 staging studies were concordant both FDG-PET and CIT images. Pathological information was obtained in 5 cases, and a mean time of 14 months of clinical follow up was made. Conclusions. FDG-PET can be useful in the follow up of uterine sarcoma patients, and also when it is an incidental finding in other causes hysterectomy

Osteosarcoma extraóseo / Extraosseous osteosarcoma

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