Whole-body (18)F-FDG PET/CT in primary non-Hodgkin's lymphoma of the thyroid associated with Hashimoto's thyroiditis and bilateral kidney infiltration.

An 82-year-old female patient with hypothyroidism and Hashimoto's thyroiditis noted three years ago to have a small asymmetric goiter (left > right). Nevertheless, a rapid growth of the thyroid over 3-6 months caused dysphagia and shortness of breath. Ultrasound and a thyroid gammagram showed an image consistent with multinodular goiter with a hyperfunctioning nodule in the right lobe. Due to the history of Hashimoto's thyroiditis and a rapid increase in size of the thyroid gland, diagnoses of thyroid lymphoma and anaplastic thyroid cancer were considered. Thyroidectomy was attempted at an outside facility to relieve compressive symptoms. Fine needle aspiration was insufficient for diagnosis, and the product of thyroidectomy confirmed the diagnosis of diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan was performed in our institution for staging, revealing nodal and extranodal metastasis. Chemotherapy using cyclophosphamide, vincristine and dexamethasone (COP modified) led to a dramatic response of the tumor and a complete resolution of compressive symptoms.

(18)F-FDG PET/CT for discrimination between tumor extension and blood thrombus in pancreatic adenocarcinoma associated with portal vein thrombosis.

Pancreatic cancer is a malignancy with an extremely poor prognosis. Less than 3 % of patients are alive 5 years after diagnosis. Pancreatic neoplasms represent a possible but uncommon etiology of portal venous invasion. It is important to differentiate the nature of the thrombus, if it is a bland thrombus or is a direct tumor extension. Intense uptake of 18F-fluorodeoxyglucose ((18)F-FDG) has been reported in portal vein tumor thrombus. We present a case of pancreatic adenocarcinoma and clinical findings of portal hypertension due to portal vein thrombosis. (18)F-FDG positron emission tomography (PET)/computed tomography (CT) evaluation discarded a tumor thrombus; imaging findings of the pancreatic tumor and the bland thrombus are presented.

Whole-body 18F-FDG PET/CT in primary non-Hodgkin's lymphoma of the thyroid associated with Hashimoto's thyroiditis and bilateral kidney infiltration

Paciente mujer de 82 años con hipotiroidismo y tiroiditis de Hashimoto, observó desde hace tres años la presencia de un bocio asimétrico pequeño (izquierdo > derecho). Sin embargo, un crecimiento rápido de la glándula en un periodo de 3-6 meses causó disfagia y respiración corta. La ecografía y la gammagrafía tiroidea mostraron imágenes consistentes con bocio multinodular con un nódulo hiperfuncionante en el lóbulo derecho. Por la historia previa de tiroiditis de Hashimoto y el aumento rápido en el tamaño de la glándula tiroides, se consideró un diagnóstico de linfoma tiroideo y cáncer tiroideo anaplásico. Se realizó tiroidectomía en un hospital externo para aliviar los síntomas compresivos. La aspiración con aguja fina fue insuficiente para el diagnóstico, y en la pieza de la tiroidectomía se confirmó el diagnóstico de un linfoma difuso de células grandes tipo B. En nuestro centro se realiza un rastreo con FDG-PET/CT para estadificación, mostrando metástasis intra y extraganglionares. La quimioterapia con ciclofosfamida, vincristina y dexametasona (COP modificado), produjo una respuesta dramática del tumor y una resolución completa de los síntomas compresivos

An 82-year-old female patient with hypothyroidism and Hashimoto's thyroiditis noted three years ago to have a small asymmetric goiter (left > right). Nevertheless, a rapid growth of the thyroid over 3-6 months caused dysphagia and shortness of breath. Ultrasound and a thyroid gammagram showed an image consistent with multinodular goiter with a hyperfunctioning nodule in the right lobe. Due to the history of Hashimoto's thyroiditis and a rapid increase in size of the thyroid gland, diagnoses of thyroid lymphoma and anaplastic thyroid cancer were considered. Thyroidectomy was attempted at an outside facility to relieve compressive symptoms. Fine needle aspiration was insufficient for diagnosis, and the product of thyroidectomy confirmed the diagnosis of diffuse large B-cell lymphoma. A positron emission tomography/computed tomography scan was performed in our institution for staging, revealing nodal and extranodal metastasis. Chemotherapy using cyclophosphamide, vincristine and dexamethasone (COP modified) led to a dramatic response of the tumor and a complete resolution of compressive symptoms

18F-FDG PET/CT for discrimination between tumor extension and blood thrombus in pancreatic adenocarcinoma associated with portal vein thrombosis

El cáncer pancreático es una neoplasia con un pronóstico extremadamente pobre. Menos del 3 % de los pacientes están vivos cinco años después del diagnóstico. Las neoplasias del páncreas representan una etiología posible pero rara en la invasión de la vena porta. Es importante diferenciar la naturaleza del trombo, si este es un trombo blando o si es una extensión tumoral directa. La captación intensa de fluordesoxiglucosa f18 (18F-FDG) ya ha sido reportada en los casos de trombosis tumoral de la vena porta. Presentamos un caso de adenocarcinoma pancreático con síntomas clínicos de hipertensión portal debido a trombosis de la vena porta. La evaluación con 18F-FDG PET/TC descartó la trombosis tumoral; presentamos los hallazgos por imagen del tumor pancreático y el tumor blando en la vena porta

Pancreatic cancer is a malignancy with an extremely poor prognosis. Less than 3 % of patients are alive 5 years after diagnosis. Pancreatic neoplasms represent a possible but uncommon etiology of portal venous invasion. It is important to differentiate the nature of the thrombus, if it is a bland thrombus or is a direct tumor extension. Intense uptake of 18F-fluorodeoxyglucose (18F-FDG) has been reported in portal vein tumor thrombus. We present a case of pancreatic adenocarcinoma and clinical findings of portal hypertension due to portal vein thrombosis. 18F-FDG positron emission tomography (PET)/computed tomography (CT) evaluation discarded a tumor thrombus; imaging findings of the pancreatic tumor and the bland thrombus are presented

Tomographic findings in traumatic globe evulsion caused by blunt head trauma.

Evulsion of the globe as a result of trauma is a rarity; to the best of our knowledge, only four "evulsions of the globe" have been described. We present the case of a 35-year-old Hispanic woman with traumatic evulsion of the right eye and subarachnoid haemorrhage. The management of brain injury was the priority over preservation of globe structures. We briefly describe the tomographic features of this uncommon situation and the proposed "evulsion" mechanism.

Panaortitis diagnosed by 18F-FDG PET/CT scan in a patient with diffuse large B-cell lymphoma

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Non-resected solid papillary epithelial tumor of the pancreas: 18F-FDG PET/CT evaluation at 5 years after diagnosis

El tumor sólido papilar del páncreas (TSPP) es una masa abdominal encapsulada de lento crecimiento que nodemuestra evidencia de invasión capsular, afectación linfática regional o metástasis distal. Presentamos el caso de un hombre hispánico de 68 años diagnosticado de TSPP 5 años antes del rechazo de escisión quirúrgica. Ahora, se le ha realizado una 18 F-FDG PET/TC (tomografía por emisión de positrones/ tomografía computarizada) de rastreo completo. Aunque el tamaño del tumor, locación y rasgos en la TC no parece mostrar cambios significativos, la FDG-PET fue útil para enseñar persistente actividad tumoral. Se presenta unarevisión corta del diagnótico diferencial y de la utilidad de la FDG-PET en el TSPP (neoplasia pancreática de lento crecimiento)

Solid and papillary epithelial neoplasm of the pancreas (SPEN) is an encapsulated, slowly enlarging abdominal mass that generally shows no evidence of capsular invasion, regional lymph node involvement, or distal metastases. We present a 68 years old Hispanic male diagnosed with SPEN 5 years earlier that refused surgical excision. Presently he underwent a whole-body 18 F-FDG PET/CT. Although tumor size, location and CT features did not seem to depict significant changes, FDG-PET was useful showing persistent tumoral activity. A brief review of the differential diagnosis as well as the usefulness of FDG-PET in SPEN (a slow growing pancreatic neoplasm) is presented (AU)

Non-resected solid papillary epithelial tumor of the pancreas: 18F-FDG PET/CT evaluation at 5 years after diagnosis.

Solid and papillary epithelial neoplasm of the pancreas (SPEN) is an encapsulated, slowly enlarging abdominal mass that generally shows no evidence of capsular invasion, regional lymph node involvement, or distal metastases. We present a 68 years old Hispanic male diagnosed with SPEN 5 years earlier that refused surgical excision. Presently he underwent a whole-body 18F-FDG PET/CT. Although tumor size, location and CT features did not seem to depict significant changes, FDG-PET was useful showing persistent tumoral activity. A brief review of the differential diagnosis as well as the usefulness of FDG-PET in SPEN (a slow growing pancreatic neoplasm) is presented.

Incidental finding of horseshoe kidneys in whole-body 18F-FDG PET/CT evaluation

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[Monitoring dermatomal somatosensory evoked potentials at the ERB point, the cervical spinal cord and the cerebral cortex in the diagnosis of cervical radiculopathy]. / Registro de potenciales evocados somatosensoriales dermatómicos en punto de Erb, médula cervical y corteza cerebral en el diagnóstico de la radiculopatía cervical.

INTRODUCTION: Recording at various levels of the somatosensory pathway is often used in somatosensory evoked potentials to mixed nerve stimulation (SEP), but not in dermatomal somatosensory evoked potentials (DSEP) in which only the cortical potential is usually recorded. The aim of our study was to compare the recordings of upper limb DSEP at Erb point, cervical cord, and subcortical and cortical levels with SEP recordings in healthy subjects and patients with cervical radiculopathy. PATIENTS AND METHODS: 17 patients with clinical history, MRI and electromyography consistent with cervical radiculopathy and 17 healthy subjects were included. Median and ulnar nerves were stimulated at the wrist; and C6, C7 and C8 dermatomes at the 1st, 3rd and 5th fingers respectively. All the potentials obtained with SEP and DSEP were compared between controls and patients by t test for independent samples. We also used Pearson s correlation for height/latencies, weight/amplitude and age/peripheral nerve conduction velocity (PNCV). RESULTS: DSEP potentials were of similar morphology of those observed in SEP but had longer latencies and smaller amplitudes. We found a positive correlation between height and latencies, and a negative association of weight with amplitude of peripheral potential, and age/PNCV. No difference between controls and the neurological intact segments of patients was found. 13 patient had DSEP altered while only 5 of them had altered SEP recorded. The most common finding was prolongation of the conduction time of the segment N9 N13 on DSEP recordings. CONCLUSION: We found that it is possible to record and to identify all the potentials in DSEP as observed in the SEP. On cervical radiculopathy, DSEP with the present technique increase the sensitivity and give some additional and useful information regarding the extension and localization of the pathology. Besides, DSEP recording is a non invasive technique, non traumatic and well tolerated for our patients.