Captación atípica de la vesícula biliar como causa de falso positivo en rastreo postablación de restos tiroideos con 131I / Atypical uptake of gallbladder as cause of False-positive iodine-131 in post-surgical removalscanning of thyroid remains

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Hallazgo con PET-FDG de cáncer de amígdala en varón con tumor de origen desconocido / PET finding of primary tonsilar cancer in a man with unknown tumor

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Control evolutivo con PET-FDG cerebral de pinealoblastoma metastásico / Brain PET-FDG evolutive control of a metastatic pinealoblastoma

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[Early detection with FDG-PET of colonic tumors in patients with another known tumor]. / Detección temprana con PET-FDG de tumores inesperados de colon en pacientes con otra patología tumoral conocida.

Patients with known tumors can have other tumors in unexpected places, the so-called synchronic or second primary cancers. In these patients, whole-body fluorodeoxyglucose positron emission tomography (FDG-PET) to study known tumors can identify other tumors that would escape notice if only the sites of known tumors were investigated. We present 3 patients in whom whole-body FDG-PET was requested to study known tumors: 2 lung cancers and one melanoma. FDG-PET localized the known lesions and revealed hypermetabolic uptake in the abdomen in all 3 patients. Endoscopic polypectomy and pathologic analysis were performed, revealing 2 colon cancers and a tubular adenoma with a high degree of focal atypia. Whole body FDG-PET is a highly useful technique in the early diagnosis of colorectal cancer, which in turn allows complete cure of patients with this disease.

Detección temprana con PET-FDG de tumores inesperados de colon en pacientes con otra patología tumoral conocida / Early detection with FDG-PET of colonic tumors in patients with another known tumor

Los pacientes con tumoraciones conocidas pueden presentar otras tumoraciones en localizaciones no esperadas, los llamados cánceres sincrónicos o segundos primarios. En tales pacientes la realización de una tomografía por emisión de positrones con fluorodesoxiglucosa (PET-FDG) de cuerpo completo para el estudio de tumoraciones conocidas nos permitirá la localización de otras tumoraciones que pasarían inadvertidas si únicamente se empleasen procedimientos diagnósticos enfocados a la zona de estudio de la enfermedad conocida. Exponemos 3 casos en los que se solicitó una PET-FDG de cuerpo completo para el estudio de tumores conocidos, 2 cánceres de pulmón y un melanoma. Estas lesiones fueron verificadas a la vez que se localizaron sendos focos de hipermetabolismo anómalo de la FDG en abdomen. Tras una posterior polipectomía por endoscopia y un estudio anatomopatológico, se concluyó que correspondían a 2 cánceres de colon y uno a adenoma tubular con atipia focal de alto grado. La PET-FDG de cuerpo completo se muestra como una técnica de imagen de gran importancia en el diagnóstico temprano del cáncer colorrectal. Al ser detectada la enfermedad en un estadio temprano, permitirá un tratamiento rápido y efectivo que logrará curaciones completas de estas patologías

Patients with known tumors can have other tumors in unexpected places, the so-called synchronic or second primary cancers. In these patients, whole-body fluorodeoxyglucose positron emission tomography (FDG-PET) to study known tumors can identify other tumors that would escape notice if only the sites of known tumors were investigated. We present 3 patients in whom whole-body FDG-PET was requested to study known tumors: 2 lung cancers and one melanoma. FDG-PET localized the known lesions and revealed hypermetabolic uptake in the abdomen in all 3 patients. Endoscopic polypectomy and pathologic analysis were performed, revealing 2 colon cancers and a tubular adenoma with a high degree of focal atypia. Whole body FDG-PET is a highly useful technique in the early diagnosis of colorectal cancer, which in turn allows complete cure of patients with this disease

[FDG-PET in hepatocellular carcinoma. Based on one case]. / PET-FDG en el hepatocarcinoma. A propósito de un caso.

We present a case of a 73 year old man, who lost 12 kg of weight in one month, had abdominal pain and progressive hepatic failure. A MRI and liver ultrasound were performed and, with the patient's symptoms, hepatocellular carcinoma Vs metastatic liver was suspected. A PET-FDG was performed and the images showed hepatomegaly and splenomegaly, without other findings of interest. FDG distribution in the liver was homogeneous. The patient was diagnosed of hepatocellular carcinoma after liver biopsy. FDG-PET detects only 50 % to 70 % of hepatocellular carcinomas due to varying degrees of activity of the enzyme glucose-6-phosphatase in these tumors. This paper reviews the literature on this type of situations.

[Utility of esophageal scintigraphy in congenital "H" type tracheoesofagea fistula]. / Utilidad de la gammagrafía esofágica en la fístula traqueoesofágica congénita tipo "H".

We present the case of 15 day old female baby, with respiratory insufficiency, asphyxia and cyanosis when fed. She was diagnosed by ultrasound of intraauricular communication ostium secundum type. Passage of the contrast to the right respiratory tract but without localization of the fistula was observed in the esophagogastric contrast study. We performed esophageal scintigraphy that showed the passage of the isotope to both lungs, showing "H" type tracheoesophageal fistula. We review the bibliography on this special kind of disease.

PET-FDG en cáncer de mama / FDG-PET in breast cancer

El cáncer de mama es la neoplasia más frecuente del sexo femenino. La PET-FDG se muestra como una técnica diagnóstica de imagen avanzada en el cáncer de mama, tanto en el diagnóstico precoz en determinadas situaciones, estudio de extensión y estadificación previo a la terapia, valoración precoz de la eficacia de la quimioterapia, detección del tumor residual tras la terapia y detección de recurrencias con posterior re-evaluación de la extensión. La PET-FDG está basada en la identificación del aumento de actividad glicolítica en las células malignas. En este trabajo hacemos una revisión de los artículos publicados en la bibliografía sobre las indicaciones de la PET-FDG en el cáncer de mama (AU)

Osteoma osteoide diagnosticado por gammagrafía ósea en tres fases y SPECT en joven con lumbalgia / Osteoid osteoma diagnosed by three phase bone scintigraphy in a young woman with back pain

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Captación pulmonar de 99mTc-pertecnetato al realizar gammagrafía tiroidea / Lung accumulation of 99mTc-pertechnetate in thyroid scintigraphy

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Serum concentrations of carotenoids and vitamins A, E, and C in control subjects from five European countries.

High intakes of fruits and vegetables, or high circulating levels of their biomarkers (carotenoids, vitamins C and E), have been associated with a relatively low incidence of cardiovascular disease, cataract and cancer. Exposure to a high fruit and vegetable diet increases antioxidant concentrations in blood and body tissues, and potentially protects against oxidative damage to cells and tissues. This paper describes blood concentrations of carotenoids, tocopherols, ascorbic acid and retinol in well-defined groups of healthy, non-smokers, aged 25-45 years, 175 men and 174 women from five European countries (France, UK (Northern Ireland), Republic of Ireland, The Netherlands and Spain). Analysis was centralised and performed within 18 months. Within-gender, vitamin C showed no significant differences between centres. Females in France, Republic of Ireland and Spain had significantly higher plasma vitamin C concentrations than their male counterparts. Serum retinol and alpha-tocopherol levels were similar between centres, but gamma-tocopherol showed a great variability being the lowest in Spain and France, and the highest in The Netherlands. The provitamin A: non-provitamin A carotenoid ratio was similar among countries, whereas the xanthophylls (lutein, zeaxanthin, beta-cryptoxanthin) to carotenes (alpha-carotene, beta-carotene, lycopene) ratio was double in southern (Spain) compared to the northern areas (Northern Ireland and Republic of Ireland). Serum concentrations of lutein and zeaxanthin were highest in France and Spain; beta-cryptoxanthin was highest in Spain and The Netherlands; trans-lycopene tended to be highest in Irish males and lowest in Spanish males; alpha-carotene and beta-carotene were higher in the French volunteers. Due to the study design, the concentrations of carotenoids and vitamins A, C and E represent physiological ranges achievable by dietary means and may be considered as 'reference values' in serum of healthy, non-smoking middle-aged subjects from five European countries. The results suggest that lutein (and zeaxanthin), beta-cryptoxanthin, total xanthophylls and gamma-tocopherol (and alpha- : gamma-tocopherol) may be important markers related to the healthy or protective effects of the Mediterranean-like diet.

Carotenoids, retinol and tocopherols in patients with insulin-dependent diabetes mellitus and their immediate relatives.

1. Patients with insulin-dependent diabetes mellitus are classified among the groups at risk for low vitamin status, and recent studies suggest that some degree of supplementation with antioxidants may be beneficial in helping to prevent certain long-term complications of diabetes mellitus. Our objective was to compare the status of the fat-soluble vitamins and antioxidant-related compounds in patients with well-defined insulin-dependent diabetes mellitus with that of their first-degree relatives, controlling seasonal and analytical variability as factors influencing the interpretation of the data. 2. Fifty-four patients with insulin-dependent diabetes mellitus, 214 non-diabetic, first-degree relatives (controls) and 236 unrelated controls were analysed for retinol, tocopherols (alpha and gamma) and main carotenoids in serum (beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein, zeaxanthin and lycopene) by means of a validated HPLC method. 3. Insulin-dependent diabetes mellitus was associated with lower retinol levels and higher levels of beta-carotene, alpha-carotene and beta-cryptoxanthin than sex-matched, first-degree relatives. alpha-Tocopherol, the alpha-tocopherol/cholesterol ratio, gamma-tocopherol, lutein, zeaxanthin and lycopene showed no differences. Retinol and beta-carotene were the variables most closely associated with diabetes. 4. Patients with insulin-dependent diabetes mellitus showed lower serum retinol status together with higher concentrations of provitamin-A carotenoids. Serum fat-soluble antioxidant levels were greater than or equal to those in controls. According to the serum status observed, individuals with diabetes do not require supplementation with alpha-tocopherol or carotenoids, although the need for retinol supplementation in patients with marginal serum levels should be evaluated.

Lutein ester in serum after lutein supplementation in human subjects.

Lutein, one of the major carotenoids present in serum, is also widely consumed by most populations. For the purpose of testing the potential health benefits of several carotenoids, lutein was supplied as part of an intervention trial to test whether the consumption of these food constituents reduces oxidative damage to human tissue components. Lutein from a natural source (15 mg/d as mixed ester forms) was supplied for 4 months to eighteen non-smoking, apparently healthy volunteers (nine men, nine women) aged 25-45 years. The serum carotenoid profile was analysed at baseline and monthly thereafter. On average, lutein concentrations increased 5-fold after the first month of supplementation (mean 1.34 (range 0.6-3.34) mumol/l). On reviewing the results, in those volunteers whose lutein levels surpassed 1.05 mumol/l (fourteen of seventeen), we tentatively identified lutein monopalmitate along with another unidentified ester (possibly from a monoketocarotenoid) in serum. Lutein levels returned to baseline values and ester forms were not present 3 months after supplementation was discontinued. Their concentrations did not correlate with, and represented less than 3% of, lutein levels achieved in serum. They were observed before development of, and despite the presence of, carotenodermia. To our knowledge, this is the first time xanthophyll esters have been described in human serum. In view of the fact that xanthophyll esters have not been previously reported in serum and chylomicrons, it seems unlikely that these ester forms would be a reflection of the contents of the capsule. They may indicate a 'ceiling effect' on or saturation of the transport capacity for xanthophylls, and may have been re-esterified in vivo because of the unusual dietary conditions. The determination of the physiological importance of this finding will require further investigation, although neither haematological nor biochemical changes were detected.

[Serum status of carotenoids in control subjects and its relation to the diet]. / Status sérico de carotenoides en sujetos control y su relación con la dieta.

Carotenoids are a group of fat soluble pigments which are present in the human being, both in blood, as in tissues, and which are obtained through the diet, mainly from fruits and vegetables. The interest of these compounds is due not only to the provitamin A activity of some of them, but also due to a whole series of biological activities such as: antioxidant or prooxidant, photo-protective, modulator of the immune response, anti-carcinogen, etc. The best analytical method available for the analysis of carotenoids is high performance liquid chromatography (HPLC), which is used in our study both for serum as for foods, and it is controlled throughout periodic quality controls. In this article we present the preliminary results of the levels of the major serum carotenoids (b-carotene, a-carotene, b-cryptoxanthin, lutein, zeaxanthin, and lycopene) in control subjects from five European countries, as well as indicating the major dietary contributors to the carotenoids intake in the Spanish population. The percentage of each carotenoid to the total of the carotenoids analyzed, varies according to the origin of the studied population. Ireland and the UK show a very similar carotenoids profile. France presents the highest levels of lutein and b-carotene, which are present simultaneously in green vegetables. Spain shows the lowest levels of b-carotene, along with the highest levels of b-cryptoxanthin, which in our country is supplied mainly by oranges and tangerines. The most abundant carotenoid in all countries was lycopene. The average daily intake of these carotenoids (from fresh fruits and vegetables) in our population, is 3.5 mg/day. Through the relationships between the dietary carotenoid contents and serum the identification of "biomarkers" have been proposed, which might be correlated with several pathological situations, and thus contribute to the prevention of certain diseases.