Adult embryonal rhabdomyosarcoma in axilla.

A case of embryonal rhabdomyosarcoma (RMS) arising from an axillary space is described. RMS is one of the most common soft-tissue neoplasms in children, but adult embryonal RMS is rare. The patient was a 55-year-old man with a tumor of the left axillary area. RMS arising from an axillary area is also uncommon. The histological diagnosis was embryonal RMS. He received irradiation combined with chemotherapy (VAC: VCR, act-D, CPA) for the primary and metastatic lesions, obtained complete remission, and has remained disease-free for over four years as of this report.

Gallium-67 demonstration of extensive soft-tissue involvement of multiple myeloma.

A 46-year-old woman with multiple myeloma presented with neurological symptoms in the right upper extremity. After MR imaging of the cervical spine failed to show the cause of her symptoms, Ga-67 scintigraphy demonstrated increased uptake in multiple areas including the right supraclavicular region and bilateral lower extremities. Histology of the specimen obtained from the left thigh proved soft-tissue involvement of myeloma, and extensive extramedullary involvement was diagnosed. Radiotherapy to the right supraclavicular mass relieved her symptoms. Although Ga-67 scintigraphy is generally considered of limited value in multiple myeloma, this modality contributed to the development of an appropriate strategy in this patient with extensive extramedullary involvement.

Intense Ga-67 accumulation in pure primary mediastinal seminomas.

The authors examined three patients with pure primary mediastinal seminomas, all of whom had marked Ga-67 uptake on scintigraphy. The unusual presentation of sclerotic bone metastases with remarkable extraosseous soft tissue involvement was observed in one patient. Another had a seminoma associated with a multiloculated thymic cyst, which is a rare lesion.

[Audit of the safety of hepatic arterial infusion of degradable starch microspheres (DSM). Adriamycin (ADM).mitomycin C (MMC) on aged patients with liver metastases of colorectal cancer].

The purpose of this study was to clarify the safety of hepatic arterial infusion of degradable starch microspheres (DSM).adriamycin (ADM).mitomycin C (MMC) on aged patients with liver metastases of colorectal cancer. A total of 19 patients who received this therapy (DSM: 600 mg or less, ADM: 30 mg, and MMC: 10 mg) three times or more every three weeks were included. Changes in laboratory data and frequency of the occurrence of the adverse effects were compared between patients aged 75 (n = 5) or more and those aged 74 or less (n = 14). There were no significant differences in changes in the leukocyte counts, AST, ALT, and c-reactive protein levels between the groups. The frequency of adverse effects also was not different between the groups. These results suggests that this therapy is feasible with acceptable safety even in patients aged 75 years or more.

Scintigraphic findings of MALT lymphoma of the thyroid.

Mucosa-associated lymphoid tissue (MALT) lymphoma has been established as a distinct entity among non-Hodgkin's lymphomas, and the most common primary site is the stomach. We describe scintigraphic findings in a patient with MALT lymphoma of the thyroid. A 71-year-old woman with Hashimoto's thyroiditis suffered from rapid cervical swelling, and ultrasonography and CT revealed a thyroid nodule. The nodule showed accumulation of 99mTc pertechnetate comparable to the surrounding thyroid tissue, mimicking a benign nodule. Both 67Ga and 201Tl imaging visualized the lesion as an increased uptake area. After radiotherapy, abnormally increased uptake disappeared on 67Ga images, which predicted a favorable outcome. MALT lymphoma of the thyroid may be visualized as a warm nodule on 99mTc pertechnetate scintigraphy.

Quantitative lung perfusion scintigraphy and detection of intrapulmonary shunt in liver cirrhosis.

OBJECTIVE: Frequent association between liver cirrhosis and hypoxemia has been well documented. It is mostly attributable to intrapulmonary shunt due to dilation of pulmonary vasculature. We performed quantitative lung perfusion scintigraphy to detect an intrapulmonary shunt in cirrhosis patients. METHODS: Prior to injection, Tc-99m MAA was applied to thin layer chromatography for quality control. Three cirrhosis patients who had hypoxemia were examined as well as 11 control subjects. After i.v. injection of Tc-99m MAA, whole body anterior and posterior images were taken at 5 min in patients with cirrhosis and at 8 time points up to 60 min in control subjects. Regions of interest were placed at the bilateral lungs and the whole body, and pulmonary accumulation was calculated. RESULTS: All the control subjects demonstrated more than 90% of radioactivity in the lungs until 20 min. In contrast, all the patients showed values less than 80% at 5 min. In the cirrhosis patients with hypoxemia, the presence of intrapulmonary shunt was confirmed on quantitative lung perfusion scan. In control subjects, pulmonary accumulation of Tc-99m MAA dropped as a function of time and became less than 90% after 30 min. CONCLUSION: The timing of measurements is essential in evaluating intrapulmonary shunt.