ABSTRACT
A 64-year-old woman was biochemically diagnosed with hyperparathyroidism. Technetium-99m sestamibi parathyroid scan demonstrated persistent uptake in the left lower pole of the thyroid. She underwent F-18 FDG PET due to unrelated causes. Incidentally, we found focal FDG accumulation in the lower portion of left thyroid lobe. An ultrasound showed a 2.2-cm nodule containing cystic component in the left lower pole of the thyroid. The intact PTH level in the cystic fluid was much higher than the serum intact PTH level, suggesting an intrathyroidal parathyroid adenoma. Left lobectomy revealed an intrathyroidal parathyroid adenoma in the left thyroid lobe.
Subject(s)
Adenoma/diagnostic imaging , Fluorodeoxyglucose F18 , Thyroid Neoplasms/diagnostic imaging , Adenoma/metabolism , Adenoma/pathology , Diagnosis, Differential , Female , Fluorodeoxyglucose F18/metabolism , Humans , Hyperparathyroidism/diagnostic imaging , Hyperparathyroidism/metabolism , Hyperparathyroidism/pathology , Middle Aged , Positron-Emission Tomography , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/pathologyABSTRACT
The potential hepatotoxicity of herbal remedies and/or health foods is usually ignored in daily life. There have been cases showing the toxic hepatitis and renal failure associated with the ingestion of raw carp bile. We experienced a case of toxic hepatitis without any evidence of renal failure that was associated with carp juice ingestion. The clinical manifestations were characterized by nausea and vomiting after the ingestion of carp juice for 3 months. The diagnosis of toxic hepatitis was made on the basis of the patient's history, laboratory data, RUCAM (Russel Uclaf Causality Assessment) and the results of ultrasonography guided liver biopsy. The patient showed rapid improvement after instituting supportive therapy.
