ABSTRACT
We describe two patients of the Department of Medicine at Sultan Qaboos University Hospital, Muscat, Oman, with Cushing's disease. Their magnetic resonance imaging scans of the pituitary were negative. One patient was treated by transsphenoidal surgery and the other by bilateral endoscopic adrenalectomy. Both procedures were successful and the patients cured. The advantages and disadvantages of these two approaches are discussed
Subject(s)
Humans , Male , Female , Pituitary ACTH Hypersecretion/surgery , Adrenalectomy/methods , Pituitary Gland/surgery , Magnetic Resonance Imaging , Adrenocorticotropic Hormone , Endoscopy/methods , ACTH-Secreting Pituitary Adenoma/surgeryABSTRACT
Nodular lymphocyte predominant Hodgkin's lymphoma [NLPHL] is a recently described type of Hodgkin's lymphoma [HL] and accounts for 5-6% of all the cases of HL. Here we report the case of an elderly man who presented to Sultan Qaboos University Hospital, Oman, with severe hypercalcemia, and was diagnosed to have stage IV NLPHL. Although the incidence of hypercalcemia is estimated to be between 1-5% in classical HL, to our knowledge this is the first report of NLPHL presenting with severe hypercalcemia. The patient responded to the anti-CD20 monoclonal antibody, Rituximab, and has been in clinical remission for more than 3 years
Subject(s)
Humans , Male , Hypercalcemia , Thrombocytopenia , Lymph Nodes/pathology , Lymphocytes , Antibodies, Monoclonal , Tomography, X-Ray Computed , AxillaSubject(s)
Humans , Male , Lymphatic Diseases , Lymph Nodes , Neck , Gallium Radioisotopes , Histiocytic Necrotizing Lymphadenitis/drug therapyABSTRACT
To evaluate the effi cacy of scintigraphy, ultrasound and fi ne-needle aspiration in thyroid nodules and to establish the best diagnostic pathway in detecting thyroid cancer. Two hundred and sixteen patients with thyroid nodules were examined using high-resolution ultrasonography, 99mTc thyroid scintigraphy and ultrasound-guided fi ne-needle aspiration. Of these, 113 patients subsequently underwent thyroidectomy. The remaining 103 were followed up for two years without any evidence of malignancy. Cytopathology classifi ed 71% of the aspirate as benign, 3% as positive for malignancy, 21% as suspected neoplasia and 5% as unsatisfactory. Fine- needle aspiration cytology had a sensitivity of 87.5% and specifi city of 80%. On ultrasound 33% of malignant nodules were hypo-echoic and on scintigraphy 16% of solitary cold nodules were malignant. Neither test could reliably diagnose thyroid cancer. Ultrasound-guided fi ne-needle aspiration cytology should be the fi rst test performed in euthyroid patients with a thyroid nodule. Scintigraphy and ultrasound imaging should be reserved for follow-up studies and patients who have suppressed levels of thyroid stimulating hormone
Subject(s)
Humans , Male , Female , Thyroid Nodule/diagnostic imaging , Thyroid Nodule/diagnostic imaging , Ultrasonography , Biopsy, Fine-Needle , Thyroidectomy , Thyroid Neoplasms , Sensitivity and SpecificityABSTRACT
A series of 137 aspiration biopsies of thyroid nodules were reviewed. In 110 biopsies adequate material was obtained and the diagnosis rendered included papillary carcinoma 31; follicular neoplasms 11; medullary carcinoma 2; anaplastic carcinoma 12; Hurthle cell tumor 1; undifferentiated carcinoma 1; malignant lymphoma 6; indeterminate 6, nodular goiter 30, thryoiditis 8, and tuberculosis 2. Histologic examination of excisional biopsies in 49 of these cases revealed a good correlation with cytologic diagnosis in cases of papillary carcinoma, anaplastic carcinoma, and nodular goiter. Only two of five medullary carcinoma were correctly diagnosed initially but all were confirmed by staining for calcitonin. In the indeterminate group, histologic examination in five cases revealed one papillary carcinoma, one medullary carcinoma, and three cases of nodular goiter. The morphologic spectrum of aspiration cytology in the various thyroid lesions is briefly described