ABSTRACT
Three cases of imaging with 99mTc-pertechnetate (99mTcO4) and unusual positive lymph node uptake in the neck are reported hereby. Two cases were later diagnosed to be well-differentiated thyroid carcinoma, (DTC) with nodal metastasis. The third was a confirmed case of carcinoma thyroid that had presented with mass in the neck soon after surgery, being prepared for ablative dose of radioactive iodine (131I). All three were young females under 40 years of age. These 3 cases signify that extra thyroidal areas of uptake on a routine thyroid scan with 99mTcO4 can some time be due to thyroid carcinoma with regional metastases. Foci of metastasis in patients with DTC may be incidentlly detected with 99mTcO4 scan. Multinodular goiter with palpable lymph node should always be investigated for exclusion of malignancy. The patients underwent near total thyroidectomy and radical neck dissection; histopathology confirmed the scan findings.
Subject(s)
Radiopharmaceuticals , Sodium Pertechnetate Tc 99m , Thyroid Neoplasms/diagnostic imaging , Adult , Female , Humans , Immunohistochemistry , Lymphoma, Non-Hodgkin , Neoplasm Metastasis , Thyroid Function Tests , Thyroid Neoplasms/drug therapy , Thyroid Neoplasms/surgery , Thyroid Neoplasms/therapy , Thyroidectomy , Tomography, Emission-Computed , Treatment Outcome , UltrasonographyABSTRACT
OBJECTIVE: To find an easy tool to detect dyshormonogenesis. METHODS: In this study, the standard perchlorate discharge test was modified by using a gamma-camera instead of a gamma-probe to detect this rare abnormality. RESULTS: By using this technique two cases of dyshormonogenesis were identified. CONCLUSION: The gamma-camera-based perchlorate discharge test is an easy, reliable, convenient, and feasible procedure where thyroid uptake probe is not available.
Subject(s)
Gamma Cameras , Perchlorates/metabolism , Thyroid Diseases/diagnosis , Thyroid Diseases/metabolism , Child , Child, Preschool , Congenital Hypothyroidism/complications , Humans , Male , Radionuclide Imaging , Thyroid Diseases/complications , Thyroid Diseases/diagnostic imagingABSTRACT
AIM: The most frequent non-thyroidal complication of high-dose (131)I therapy for thyroid carcinoma is salivary gland dysfunction, which may be transient or permanent. In this study, we assessed radioiodine-induced permanent salivary gland dysfunction using quantitative salivary gland scintigraphy. METHODS: Salivary scintigraphy was performed with (99m)Tc-pertechnetate on 50 thyroid carcinoma patients who had been given radioiodine for thyroid ablation; 20 normal subjects were imaged as the control population. Dynamic scintigraphy was performed and time-activity curves for four major salivary glands were generated. The glandular functional parameters maximum secretion, time at maximum count and uptake ratio of the parotid and submandibular glands were calculated. Correlation of the administered dose and subjective symptoms with findings of salivary gland scintigraphy was evaluated. RESULTS: The maximum secretion and uptake ratio were decreased in 46% and 42% of patients who received radioiodine therapy, respectively. Salivary gland dysfunction correlated well with the administered dose. The parotid glands were more affected than the submandibular glands. Fifty-two per cent of patients were symptomatic, 69.23% of whom showed salivary gland dysfunction. CONCLUSION: Parenchymal damage to the salivary glands induced by radioactive iodine treatment can be evaluated by salivary gland scintigraphy. The impairment was worse in parotid glands and increased with the total dose. The maximum secretion and uptake ratio were found to be sufficiently sensitive to distinguish the severity of the damage.