RESUMO
Objective Technetium-99m labeled prostate-specific membrane antigen (PSMA) single-photon emission computed tomography/computed tomography (SPECT/CT) is a suitable alternative to prostate-specific membrane antigen-positron emission tomography (PSMA-PET) imaging. However, the availability of SPECT/CT in many developing countries is limited. Materials and Methods To evaluate the utility of planar 99m Tc-PSMA in the absence of SPECT/CT, we compared planar 99m Tc-PSMA and routine bone scan imaging in low-, intermediate-, and high-risk prostate cancer in five patients with histologically confirmed prostate cancer who had both scans within a period of less than 4 days. The mean age of patients was 66.8 ± 5.24, and the median prostate-specific antigen level was 175 ng/mL (range: 0-778 ng/mL). Results Planar 99m Tc-PSMA scan provided no additional benefit over bone scans in the low-risk prostate cancer cases. In the cases with intermediate-risk prostate cancers, planar 99m Tc-PSMA indicated complete and partial response to treatment in oligometastatic and widespread metastatic disease, respectively. In one patient with high-risk prostate cancer, planar 99m Tc-PSMA detected additional skeletal lesions that were not seen on bone scan. Conclusion In the absence of SPECT/CT, planar 99m Tc-PSMA was useful for confirming extent of disease in treated intermediate- and high-risk prostate cancer. It showed little value in low-risk prostate cancer, especially when bone scan is normal. It was particularly useful for treatment response assessment in oligometastatic disease, and its utility should be further explored.
RESUMO
We report a case of Rosai-Dorfman disease in a 28-year-old Nigerian woman with a 7-year history of painless prominent bilateral neck swelling which waxed and waned over the years. She had two misdiagnosis hence appropriate therapy was not initiated over the years. She was eventually referred for independent opinion and was diagnosed correctly with review of the histology sections and with the use of CD45, S100, CD 68, CD 15, CD 20, synaptophysin and AE1/AE3 immunohistochemistry markers. Classic features on Haematoxylin and eosin stained sections and positivity of the lesional cells for S100 and CD68 were diagnostic of Rosai-Dorfman disease. She was subsequently placed on oral steroids with minimal objective reduction in the neck circumference from 57 to 46 cm. After two months, she was managed with three courses of chemotherapy (cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone) which resulted to a significant sustained reduction in her neck circumference to 36 cm. She has been on follow up for about a year without a recurrence.
Nous rapportons un cas de maladie de Rosai-Dorfman chez une femme nigériane de 28 ans avec des antécédents de 7 ans de gonflement bilatéral indolore du cou qui a augmenté et diminué au fil des ans. Elle a eu deux erreurs de diagnostic et une thérapie appropriée n'a donc pas été initiée au fil des ans. Elle a finalement été référée pour opinion indépendante et a été diagnostiquée correctement avec la revue des coupes histologiques et avec l'utilisation des marqueurs immunohistochimiques CD45, S100, CD 68, CD 15, CD 20, synaptophysine et AE1 / AE3. Les caractéristiques classiques des coupes colorées à l'hématoxyline et à l'éosine et la positivité des cellules lésionnelles pour S100 et CD68 étaient diagnostic de la maladie de Rosai-Dorfman. Elle a ensuite été placée sous stéroïdes oraux avec une réduction objective minimale de la tour de cou de 57 à 46 cm. Après deux mois, elle a été prise en charge par trois cours de chimiothérapie (cyclophosphamide, chlorhydrate de doxorubicine, vincristine et prednisolone) qui ont entraîné une réduction significative et soutenue de la circonférence de son cou à 36 cm. Elle fait un suivi depuis environ un an sans récidive. Mots clés: maladie de Rosai-Dorfman, immunohistochimie, ganglions lymphatiques cervicaux, chimiothérapie, diagnostic erroné.
Assuntos
Histiocitose Sinusal , Adulto , Feminino , Histiocitose Sinusal/diagnóstico , Histiocitose Sinusal/tratamento farmacológico , Humanos , Imuno-Histoquímica , LinfonodosRESUMO
Hyperimmunoglobulin E syndrome is a Primary Immuno-deficiency Syndrome (PIDS) characterized by high serum immunoglobulin E, eczema rash and recurrent sinopulmonary and skin infections. In this report, we present a case of squamous cell carcinoma of the lower lip in a young patient with Hyper IgE syndrome. The patient had initially developed a chronic non-healing ulcer and a biopsy done revealed a squamous cell carcinoma. Immunodeficiency has been recognized as an essential risk factor for cancer through immune dysregulation and defective immunosurveillance.