ABSTRACT
Malignant peripheral nerve sheath tumours (MPNST) are exceedingly rare in an intracranial location. In this report clinical and pathological evidence for the diagnosis of a MPNST arising from of the oclumotor nerve is presented. To our knowledge this is the first such case reported in the medical literature.
Subject(s)
Cranial Nerve Neoplasms/surgery , Nerve Sheath Neoplasms/surgery , Oculomotor Nerve Diseases/surgery , Adult , Biomarkers, Tumor/analysis , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/pathology , Decompression, Surgical , Diagnosis, Differential , Diplopia/etiology , Female , Headache/etiology , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Microsurgery , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm, Residual/diagnosis , Neoplasm, Residual/surgery , Nerve Sheath Neoplasms/diagnosis , Nerve Sheath Neoplasms/pathology , Oculomotor Nerve Diseases/diagnosis , Oculomotor Nerve Diseases/pathology , Ophthalmoplegia/etiology , Postoperative Complications/diagnosis , Postoperative Complications/surgery , Radiosurgery , ReoperationABSTRACT
Lymphatic drainage from the peritoneal cavity to mediastinal lymph nodes has been reported, indicating that abdominal fluid is not immobile. We studied this movement in rats receiving Tc-99m albumin nanocolloid which has smaller particle sizes than does Tc-99m microaggregated albumin colloid used for liver/spleen imaging. The Tc-99m albumin nanocolloid had a radiochemical purity of 99.33%-99.77% with free pertechnetate of 0.23%-0.67%. During pentobarbital anesthesia, thoracoabdominal images were obtained 4-6 hr after intraperitoneal injection of 350 mCi Tc-99m albumin nanocolloid with 5 ml of normal saline. The images showed symmetrical radiotracer localization in the mediastinal lymph nodes. Scintigraphic demonstration of drainage to the mediastinal region from the peritoneal cavity may be explained by flow directly into mediastinum through the lymphatic system, indicating lymphatic patency between the peritoneal cavity and mediastinum. Absence of visualization may indicate lymphatic block. This type of information concerning lymphatic drainage may have clinical impact for a patient with malignant or intractable ascites. The radionuclide technique is easily performed for this assessment.
Subject(s)
Lymph Nodes/physiology , Lymphatic System/physiology , Mediastinum , Peritoneal Cavity/physiology , Technetium Tc 99m Aggregated Albumin , Animals , Ascitic Fluid , RatsABSTRACT
At irregular intervals, a 99mTc-labelled microcolloid for liver and spleen scintigraphy was reported to accumulate in the lungs, in the absence of any pathophysiological condition usually associated with this phenomenon. These findings were in direct contrast to the results obtained during quality control assays performed on the production batches of the kit. The authors tested the hypothesis that the presence of Al3+ ions in the generators eluate used to label the kit caused the formation of larger size aggregates. The experimental results suggest that the 99mTc-pertechnetate solution used for labelling contained far more than 40 micrograms Al3+ per ml, hence a many-fold increase of the maximum level tolerated by the pharmacopoeia. The authors advise caution when interpreting findings of pulmonary activity in the absence of clear evidence of pathological conditions that are sometimes associated with this biodistribution pattern.
