A case of myeloid sarcoma of the mandibular gingiva as extramedullary relapse of acute myeloid leukemia.

PURPOSE: Myeloid sarcoma (MS) is defined as a tumorous mass of myeloblasts or immature myeloid cells involving an extramedullary anatomic site. MS occurs in 3 to 8% of patients with acute myeloid leukemia. The overwhelming majority of MS occurs in the skin, bones, and gastrointestinal tract; intraoral MS (IMS) is extremely rare. METHODS: We describe a case of MS of the mandibular gingiva in a patient with acute myeloid leukemia that was in remission. We also present a review of the English and Japanese literature with a special focus on the management and prognosis of intraoral MS. RESULTS: The patient was discharged while in remission 8 months after the initial examination. CONCLUSION: The prognosis of IMS is extremely poor in general, and a diagnostic delay can prevent adequate therapy by hematologists and oncologists. All dental clinicians must keep the possibility of IMS in mind and carefully examine all patients with AML.

[Examination of R-L shunt ratio mensuration using dynamic images in lung perfusion scintigraphy].

OBJECTIVE: We examined a method of quantitative analysis that used dynamic and static images to measure the Right-left (R-L) shunt ratio in lung perfusion scintigraphy. METHODS: A total of 18 patients suspected of having R-L shunt brought on by congenital heart disease were referred for lung perfusion scintigraphy from November 2005 to February 2007 at our hospital. We acquired anterior dynamic images, set ROIs in all fields of view, and measured the highest count. We acquired anterior and posterior static images of the chest and measured lung counts. We considered the highest count on dynamic images to be the total injection dose per one second, normalized the acquisition time of static images, and calculated the R-L shunt ratio. We weighed the measurement results of the R-L shunt ratio obtained by the dynamic method against that of the whole-body method by t-test and the least-squares method. RESULTS: When we used a posterior static image in the dynamic method, we found that the coefficient of correlation (r) was 0.9831. The result of the t-test was that there was no significant difference at a level of significance of 1%. DISCUSSION: We think the use of the dynamic method is possible in R-L shunt ratio measurement and can shorten the examination time.