[ thyroidal tuberculosis]

It is defined by the presence of bacilli Kock [BK] and/ or specific histologic lesions within the thyroid parenchyma. The diagnosis should be discussed before excision of a thyroid, because medical treatment may be sufficient in these cases. This location is still rare even in endemic countries and its clinical diagnosis is rarely made. Its frequency varies between 0.1 and 0.4% [1]. A new case of acute thyroiditis of tuberculous origin associated with nodular goiter is reported by the authors. Surgical treatment was necessary because of the importance of local and general inflammatory signs provocated by this association. Though this case report with literature review we will try to discuss the new diagnostic and therapeutic strategies. Thyroidal tuberculosis is a rare condition whose diagnosis is difficult. Only the bacteriological examination and/ or histology confirm bacillary nature of the thyroid. The medical treatment and possibly surgery depend on the anatomical shape. We must emphasize the prevention of tuberculosis through widespread vaccination, the only guarantee of the eradication of this scourge in our country[2]

lesions osseuses de la sarcoidose

Sarcoidosis is a chronic granulomatous disease of undeterminable aetiology affecting multiple organs. Bony affection is rare, and often difficult to be diagnosed. Through observation of two cases we tried to characterize clinically the osseous lesions and their effect on prognosis by clarifing the interest of osseous scintiscanning in the early detection of these lesions. Observation 1: A female patient aged 44 years, treated from pulmonary sarcoidosis since 6 years. Diagnosis of bony sarcoidosis of the right radius has been suspected depending on the clinical picture, radiological and isotopic scanning features. Bone scanning also spotted other lesions in the controlateral left wrist. Observationn 2: A female patient aged 56 years, in whom a neurological sarcoidosis with a cranial bone affection has been diagnosed by a direct osseous scintigraphic bone biopsy. Discussion: Osseous sarcoidosis affection predominates at the hands and feet bones. Often starting, with phalengeal pain tumification. In our observation, bony scintigraphy has been individualised by accurate precession of different diseased sites if compared with standard x. ray images and also by discovering asymptomatic lesions. This exploration also contributes in evaluation of the disease similar to the biological assessment, ensuring early mangement of infammatory attacks

Apport de la scintigraphie dans l'etude de la perfusion pulmonaire

109 patients with different lungs or extra lungs diseases were investigated by perfusion scintigraphy. The r‚sults showed a good sensitivity of this exploration in the diagnosis of pulmonary perfusion and study lung perfusion in different diseases, which constitute advantages to draw up the balance sheet for lesions, their forward and the pulmonary after- effects valuation

Mise au point: protocole de surveillance isotopique des cancers differencies du corps thyroide au service des isotopes au CHUIbn Sina

Each patient presenting a differenciaded Carcinoma must have an iodine 131 test for reference 25 day after the surgical operation. Patients having high risk of local-re ional recurrence and/or metastasis require special attention subjects whose cancer has been discorvered after the age of 45 independently of its histological form. subjects presenting follicular cancere especially a moderatly-differentiated form, at any age For these patients, a semi-annual isotopic check-up must be imposed for minimum 5 years, but only 2 years, for patients presenting pure of mixed papillary cancers discovered before 45 years. The check-up includes a delicat clinic contrrol radiologic examination [and control of the TSH] Which is accompaned with a total scaning, 2 or 3 days after an oral drink of 2 or 3 mCi [74-101 MBq] of iodine 131. The patient must have stopped therapy 30 days before the isotopic check-up. I If this general check-up shows any active metastasis, a therapeutic decision is taken and consists of a new carcionologic dose of iodine 131 This treatment is always followed by a post therapeutic scanning 5 days later and then another new general check-up 3 or 5 months later in order to assess the efficiency of the treatment. The clinical and radiologic check-up must be semi-annual during all the life of the patient, in case of any doubt, the balance sheet must be stopped and the patient who accused an iodine desaturation is submitted for a total scanning