RESUMO
This study correlates the findings of bone marrow biopsy with those of bone scan in patients with common cancers and highlights the comparable sensitivities of the two methods at the authors' institution. The results show that bone scintigraphy may be slightly more sensitive than bone marrow examination for the detection of carcinomatous metastases. This experience suggests that institutions should devise clinical pathways based on their testing sensitivities and patient characteristics. These considerations will ultimately result in better and more cost-effective treatment of these patients.
Assuntos
Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/secundário , Medronato de Tecnécio Tc 99m , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia/métodos , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
A 59-year-old man showed asynchronous development of noninfectious granulomatous aortitis with aneurysm, followed 9 months later by pulmonary capillaritis and glomerulonephritis in association with elevated serum antineutrophil cytoplasmic antibody levels. To our knowledge, the combination of large artery vasculitis and small vessel systemic vasculitis (capillaritis) has not been previously reported. This case may represent a hybrid type of systemic vasculitis combining features of giant cell arteritis and Wegener's granulomatosis.
Assuntos
Capilares/patologia , Arterite de Células Gigantes/patologia , Glomerulonefrite/patologia , Granulomatose com Poliangiite/patologia , Pulmão/irrigação sanguínea , Vasculite/patologia , Anticorpos/imunologia , Citoplasma/imunologia , Arterite de Células Gigantes/complicações , Glomerulonefrite/etiologia , Granulomatose com Poliangiite/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Vasculite/etiologiaRESUMO
A patient with Cushing's syndrome is described who had a metastatic medullary carcinoma of the thyroid which contained corticotropin-releasing factor. ACTH was found by an immunohistochemical method in the patient's pituitary, but not in the thyroid tumor. This is the second report demonstrating corticotropin-releasing factor in tumor tissue in this syndrome. Wider use of immunohistological methods can help distinguish this variety from other tumors associated with the ectopic ACTH syndrome when bioassays are not available.
