RESUMO
ABSTRACT: A 69-year-old man presented with recurring drops in hemoglobin levels and suspected gastrointestinal bleeding. Endoscopy did not show a site of bleeding so further examinations became necessary. Scintigraphy and SPECT/CT with 99m TcO 4- -labeled red blood cells were performed without evidence of a hemorrhage. Based on an established protocol for splenic PET/CT, autologous erythrocytes can be labeled with 68 Ga-oxine and used as a tracer for the localization of active bleeding sites. In the patient, PET/CT with 68 Ga-oxine-labeled undamaged erythrocytes was performed successfully and revealed a hemorrhage of the gastric corpus that was confirmed and treated by endoscopy.
Assuntos
Hemorragia Gastrointestinal , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Masculino , Humanos , Idoso , Hemorragia Gastrointestinal/diagnóstico por imagem , Cintilografia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Eritrócitos , TecnécioRESUMO
ABSTRACT: An 83-year-old woman presented with new-onset hyperthyroidism and suspicious thyroid nodules on ultrasound (US). Conventional 99m TcO 4 thyroid scintigraphy showed hyperfunctioning areas that could not be clearly assigned to the US findings. With the aid of 123 I-SPECT/US fusion imaging, suspicious nodules were unambiguously identified as autonomously hyperfunctioning lesions. Additional 123 I whole-body scan revealed iodine-avid lymphonodular and pulmonal metastases. Clinical diagnosis of hormone-active thyroid carcinoma was made and histologically confirmed. Because of significant hyperthyroidism as well as multiple partially iodine-negative metastases, a multimodal treatment regime consisting of 131 I radioiodine therapy, surgery, and radiation therapy was conducted, leading to almost complete remission.
Assuntos
Adenocarcinoma Folicular , Hipertireoidismo , Neoplasias da Glândula Tireoide , Feminino , Humanos , Idoso de 80 Anos ou mais , Radioisótopos do Iodo/uso terapêutico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/terapia , Neoplasias da Glândula Tireoide/patologia , Tomografia Computadorizada de Emissão de Fóton Único , Terapia CombinadaRESUMO
ABSTRACT: A 64-year-old man with metastatic castration-resistant prostate cancer presented for prostate-specific membrane antigen (PSMA) PET/CT in preparation for 177 Lu-PSMA radioligand therapy. For precedent BRCA mutation assessment, fine-needle aspiration cytology of 2 PSMA-positive lymph node metastases was conducted. The acquired material was suitable for next-generation sequencing-based gene panel diagnostics and did not show a BRCA1 / 2 mutation, thus PSMA radioligand therapy was initiated. Fine-needle aspiration cytology of lymph node metastases may be a viable option in evaluating further therapeutic alternatives.
Assuntos
Neoplasias de Próstata Resistentes à Castração , Masculino , Humanos , Pessoa de Meia-Idade , Metástase Linfática , Neoplasias de Próstata Resistentes à Castração/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Biópsia por Agulha Fina , Compostos Radiofarmacêuticos/uso terapêutico , Lutécio/uso terapêutico , Mutação , Antígeno Prostático Específico , Compostos Heterocíclicos com 1 Anel/uso terapêutico , Dipeptídeos/uso terapêuticoRESUMO
ABSTRACT: PSMA-targeted PET/CT can be used for diagnosis and staging of clear cell renal cell carcinoma. A 68-year-old woman with suspected hepatic metastases from clear cell renal cell carcinoma underwent PET/CT with 68Ga-PSMA, which showed a focus of moderately increased tracer uptake in the right thyroid lobe. Sonography displayed a correlating hypoechogenic, ill-defined node (TIRADS 5). Right hemithyroidectomy was performed in the assumption of a solitary metastasis of renal cell carcinoma. Histologic examination revealed subacute granulomatous thyroiditis (De Quervain thyroiditis) without evidence of malignancy.