Visualización de ganglio centinela axilar contralateral por linfogammagrafía en cáncer de mama: implicaciones pronósticas / Detection of contralateral axillary sentinel lymph node by lymphoscintigraphy in breast cancer: prognostic implications

La medicina nuclear, aplicada a la detección de ganglios centinela en los tumores primarios mamarios, es de gran utilidad para conocer el drenaje linfático regional de la mama afecta, principalmente su variabilidad individual anatómica y/o tumoral, para determinar el estadio tumoral inicial.Presentamos el caso de un carcinoma ductal infiltrante mamario (T2), en la unión de cuadrantes internos de mama derecha estudiado por linfogammagrafía y sonda gammadetectora. Se reconocieron 3 ganglios centinelas, 2 axilares homolaterales, y uno axilar contralateral, no metastásicos.El hallazgo linfogammagráfico del ganglio centinela axilar, contralateral a la mama afecta, demuestra la variabilidad anatómica individual en el drenaje mamario, remarca la importancia de la medicina nuclear en su detección, generando nuevos planteamientos pronósticos con repercusión en las medidas terapéuticas y en el seguimiento de los pacientes(AU)

The role of nuclear medicine in the detection of sentinel lymph nodes (SLNs) in primary breast cancer is very useful to determine regional lymphatic drainage from the affected breast, mainly its anatomical and/or tumoral individual variability and to determine the initial tumor stage.We present the case of an infiltrating ductal carcinoma of the breast (T2) in the junction of the inner quadrants of the right breast studied by lymphoscintigraphy and gamma probe detection. Three non-metastatic sentinel lymph nodes were found with the selective lymphadenectomy: two in the ipsilateral axilla and one in the contralateral axilla.The lymphoscintigraphic finding of the axillary sentinel lymph node contralateral to the affected breast demonstrates the individual anatomical variability in mammary drainage. It emphasizes the importance of nuclear medicine imaging techniques in its detection and generates new prognostic approaches with impact on therapeutic measuresand patient follow-up(AU)

[Detection of contralateral axillary sentinel lymph node by lymphoscintigraphy in breast cancer: prognostic implications]. / Visualización de ganglio centinela axilar contralateral por linfogammagrafía en cáncer de mama: implicaciones pronósticas.

The role of nuclear medicine in the detection of sentinel lymph nodes (SLNs) in primary breast cancer is very useful to determine regional lymphatic drainage from the affected breast, mainly its anatomical and/or tumoral individual variability and to determine the initial tumor stage. We present the case of an infiltrating ductal carcinoma of the breast (T2) in the junction of the inner quadrants of the right breast studied by lymphoscintigraphy and gamma probe detection. Three non-metastatic sentinel lymph nodes were found with the selective lymphadenectomy: two in the ipsilateral axilla and one in the contralateral axilla. The lymphoscintigraphic finding of the axillary sentinel lymph node contralateral to the affected breast demonstrates the individual anatomical variability in mammary drainage. It emphasizes the importance of nuclear medicine imaging techniques in its detection and generates new prognostic approaches with impact on therapeutic measures and patient follow-up.

Effect of malabsorption on nutritional status and resting energy expenditure in HIV-infected patients.

OBJECTIVE: To assess the influence of malabsorption on nutritional status and energy expenditure in patients at different stages of HIV infection. DESIGN AND METHODS: Fifty HIV patients were classified into three groups: Group 1, HIV asymptomatic patients (n=17); Group 2, AIDS without opportunistic infection (n=16); Group 3, AIDS patients with active infection (n=17). Clinically-healthy subjects (n=19) were used as controls. Parameters measured were: anthropometry, body composition by tetrapolar bioelectrical impedance; resting energy expenditure (REE) by open-circuit indirect calorimetry; malabsoption by D-xylose absorption and triolein breath tests. RESULTS: Malabsorption (defined as abnormality of xylose and/or fat absorption test) was found in 34 (68%) of patients: 9 (53%) Group 1; 11 (69%) Group 2; 14 (82%) Group 3. Twenty-seven (54%) had sugar malabsorption and 21 (42%) fat malabsorption. A significant relationship was observed between malabsorption and weight loss. REE measured was significantly lower in malabsorptive patients than in non-malabsorptive patients and controls (6006.3+/-846.5 versus 6443.4 + 985.5 versus 6802.1+/-862.7 kJ/day, respectively; P < 0.05). The REE adjusted for fat-free mass was lower in malabsorptive than in non-malabsorptive patients and slightly higher than in controls, although the differences were not statistically significant. CONCLUSIONS: The results suggest that malabsorption is a frequent feature in HIV infection and is related to the HIV-related weight loss. Hypermetabolism is not a constant phenomenon in HIV infection since, in the presence of malabsorption, our patients show an appropriate metabolic response with a compensatory decrease in REE.

Bone SPECT in cholesteatoma assessment.

Bone SPECT in cholesteatoma assessment. Single photon emission computed tomography (SPECT) is a procedure in nuclear medicine which enables bone lesions to be better assessed. Twenty patients with cholesteatoma were studied to assess the efficiency of SPECT in bone lesions produced by cholesteatoma. Every patient also had a middle ear computed tomography (CT) and underwent surgery and anatomopathologic examination. Results obtained by SPECT are compared to CT results. SPECT was positive in 15 cases of which 2 of them with a negative CT for bone erosion. Five cases were false negative, but 2 of them had contralateral ear pathology and in one case bone erosion was not found. We conclude that in some patients SPECT can be a complementary diagnostic procedure in cholesteatomatous bone lesions.