Gallbladder Metastasis From Renal Cell Carcinoma Revealed With 18 F-FDG PET/CT.

ABSTRACT: Gallbladder metastasis from renal cell carcinoma is a rare condition. To our knowledge, only 1 case has been reported with 18 F-FDG PET/CT findings. Herein, we report the case of a 53-year-old man with renal cell carcinoma, having gallbladder metastasis revealed with restaging 18 F-FDG PET/CT.

Evaluation of cervical screening results in a population at normal risk.

OBJECTIVE: To evaluate the frequency of dysplasia and other cervical conditions in a population at normal risk, and compare demographic characteristics of the women with normal and abnormal results. METHODS: Characteristics such as gravidity, parity, age at marriage, and smoking status were obtained from a questionnaire completed from January 2004 through July 2005 at Denizli State Hospital, Denizli, Turkey, by the 19639 participants before they were screened. The results were analyzed. RESULTS: The dysplasias detected in 107 smears (0.54%) included ASCUS (0.31%), LSIL (0.15%), and HSIL (0.07%); there were also 1 case of AGUS and 1 of squamous cell carcinoma. Age, age at marriage, number of pregnancies, number of deliveries, and smoking habit were similar for participants with and without dysplasia (P>0.05). Bacterial vaginosis was seen in 1633 smears (8.3%), candidiasis in 1346 (6.9%), Actinomyces sp. in 648 (3.3%), and Trichomonas vaginalis in 143 (0.7%). CONCLUSION: Cytologic abnormalities in a cervical smear can point to precancerous or cancerous processes or to other conditions. The prevalence of dysplasia was lower for our participants than in Western populations, which could be explained by a conservative lifestyle and a lower prevalence of HPV in Turkey.

Relationship between serum cytokine levels and histopathological changes of liver in patients with hepatitis B.

AIM: To investigate whether there was a relationship between the liver functions and fibrosis scores of hepatitis B patients and their TNF-alpha, IFN-gamma, IL-4, and TGF-beta(1) serum levels based on the studies of liver biopsies. METHODS: Thirty patients with chronic hepatitis B (CHB) receiving no treatment and 30 healthy individuals with negative hepatitis serology and normal values of liver biochemistry were studied. After serum samples of the patients were collected, liver needle biopsy was performed on each patient. Cytokine levels were studied by ELISA. The biopsy materials were scored based on Knodell's histological activity index. RESULTS: In comparison of cytokine levels between CHB patients and control group, TNF-alpha, IL-4, and TGF-beta(1) levels of the patients were higher in CHB patients than in the controls, while IFN-gamma level was lower in the patients than in the controls. There were significant differences between the groups in TNF-alpha, IL-4, TGF-beta(1), and IFN-gamma (P<0.005, 0.03, 0.002, 0.0001, respectively). There was a negative correlation between TGF-beta(1) and IL-4 and IFN-gamma (P<0.05), TNF-alpha and the other cytokines and IFN-gamma and IL-4 were not correlated (P>0.05). TGF-beta(1) was correlated with fibrosis (P<0.05). Liver necroinflammatory activity and fibrosis and TNF-alpha, IL-4, and IFN-gamma were not correlated (P>0.05). CONCLUSION: In the course of HBV infection and its chronic progress, cytokines play an important role. IL-4 and IFN-gamma are effective in the chronic progression, while TGF-beta(1) is effective in the development of fibrosis. Serum cytokine levels may be effective tools in the estimation of chronic progression and fibrosis development.

Skull metastasis from thyroid follicular carcinoma with difficult diagnosis of the primary lesion.

A 57-year-old male patient presented with an immobile ellipsoid mass of 6-cm diameter in the right occipitoparietal region. Cranial computed tomography showed the mass with dense contrast enhancement causing bone destruction. After embolization of the mass, total resection was performed. Histological examination showed the mass had a capsule, with no invasion of the dura mater or dermis, and the follicles of various sizes covered with mono-lined thyrocytes were full of colloid. Immunohistochemical examination showed positive staining for thyroglobulin. Postoperatively, levels of thyroid hormones were normal, and thyroid ultrasonography and technetium-99m scintigraphy showed no abnormalities. Fine needle aspiration biopsy performed at various locations of the thyroid gland revealed no atypical thyroid cells. Whole body technetium-99m scintigraphy found no abnormal bone involvement. The histological evidence was suggestive of follicular carcinoma metastasis. Surgical treatment was planned for the thyroid gland, but the patient did not consent. Two years later, the patient presented with the pain and sensitivity in the sacrum, the right iliac wing, and the right caput femoris. Computed tomography revealed lytic lesions in these areas. Bone metastases were identified. Whole body scintigraphy showed increased activity in these regions, but the cranium and all other tissues were normal. The patient underwent total thyroidectomy under a diagnosis of follicular carcinoma. The present case of a lytic skull lesion associated with normal thyroid tissue on admission but finally treated as follicular thyroid cancer emphasizes the difficulty in histological discrimination of follicular carcinoma from normal thyroid tissue.

[Malignant jugular paraganglioma: a case report]. / Malign juguler paraganglioma: Olgu sunumu.

Paragangliomas are usually benign tumors. Overall, less than 10% of all paragangliomas become malignant. Although the indicator of malignancy is regarded as detection of histopathological findings of tumor by some authors, most authors accept extension to regional lymph nodes or distant metastasis as the only reliable indicators of malignancy. A 66-year old woman was admitted to our hospital with hearing loss, vertigo, and hoarseness. CT examination revealed a mass in the left jugular foramen. The tumor was confirmed as malignant paraganglioma. Indicators of malignant paragangliomas are discussed in this article.