ABSTRACT
OBJECTIVE: To study the usefulness of 18F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma. MATERIAL AND METHODS: A retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial 18F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up. RESULTS: Initial 18F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P<.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by 18F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P=.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma. CONCLUSIONS: MRI appears to be the method of choice for detecting brain disease in patients with primary brain lymphoma, whereas 18F-FDG PET/CT seems to play a relevant role in the assessment of extra-cerebral disease.
Subject(s)
Brain Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Neuroimaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Aged , Brain Neoplasms/therapy , Female , Humans , Lymphoma, Large B-Cell, Diffuse/therapy , Male , Middle Aged , Retrospective StudiesABSTRACT
OBJECTIVE: The aim of this work was to review the incidence of monoclonal gammopathy of undetermined significance (MGUS) and complications in kidney transplant (KT) patients at the Puerta del Mar Hospital in Cádiz, Spain. This diagnosis was not considered to be a contraindication for transplantation. METHODS: To estimate the incidence of MGUS in KT patients we used the database of our hospital, which included 1,016 patients who received a KT from 1992 to 2012 with a median follow-up of 30 months. The incidence of MGUS in non-transplant patients was estimated from the literature. RESULTS: Out of 1,016 KT patients, 16 developed MGUS; 10 (72.5%) were >50 years old. Two patients developed post-transplantation lymphoproliferative disorders. No cases of progression to multiple myeloma or amyloidosis were seen during immune suppression therapy or after. CONCLUSIONS: MGUS was >100 times more frequent in KT recipients than in the general population (P < .05). But in contrast to MGUS in general population, progression to plasma cell dyscrasia in these patients was absent and its incidence is unknown in KT patients.
Subject(s)
Kidney Transplantation , Monoclonal Gammopathy of Undetermined Significance/etiology , Postoperative Complications , Adult , Aged , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Monoclonal Gammopathy of Undetermined Significance/epidemiology , Outcome Assessment, Health Care , Postoperative Complications/epidemiology , Retrospective Studies , SpainABSTRACT
We have performed 18 plasmapheresis [correction of plasma exchange] sessions in a group of 5 patients diagnosed as having Guillain-Barré Syndrome. These patients were diagnosed according to clinical, analytical and electromyographic criteria. In three patients we observed an obvious clinical improvement during the treatment. In one of the patients there was no appreciable evolution. This patient suffered from acute lymphocytic leukemia. We were unable to evaluate the remaining patient since this child underwent posthypoxic encephalopathy secondary to cardiac arrest. On the basis of the results obtained, we advocate the treatment of this polyneuropathy by plasmapheresis [correction of plasma exchange].
