TC-99m-labeled red blood cell scintigraphy in the investigation of patients with hepatic cavernous hemangioma.

OBJECTIVE: To evaluate the diagnostic accuracy of 99mTc-red blood cell scintigraphy in the diagnosis of hepatic cavernous hemangiomas. PATIENTS AND METHODS: Sixty three patients, 56 females (89%) and 7 males (1 I%), with ages between 22 and 54 years (median 33 years) were investigated for liver masses found on ultrasonography of the abdomen. All the patients had undergone 99mTc-liver-spleen scan followed by 99mTc-red blood cells scintigraphy. The size of the lesions ranged between 3 and 9 cm. The final diagnosis was reached through cytology, and/or histopathology or follow up for more than 3 years. RESULTS: A total of 70 lesions were found as a single lesion in 60 patients and multiple (i.e. total of 10 lesions) in the other 3 patients. The results of 99mTc-red blood cells scintigraphy, compared to the results of the final diagnosis, showed sensitivity and specificity rates of 100% and 89% respectively, positive and negative predictive values of 98% and 100% respectively, and accuracy rate of 98.6%. A single false positive case was a hepatocellular carcinoma. CONCLUSION: 99mTc- red blood cell scintigraphy is highly accurate in the diagnosis of liver cavernous hemangioma and should characterize liver mass found on ultrasonography and suspected for hemangioma.

Bilateral femoral nerve compression by iliacus hematomas complicating anticoagulant therapy.

An unusual case of bilateral femoral nerve compression caused by iliacus hematomas in a patient on anticoagulant therapy is herein reported with special reference to the comparative diagnostic value of ultrasonography, computerized tomorgraphy, and magnetic resonance imaging. The importance of early surgical decompression is also emphasized.

Cerebello-pontine angle paraganglioma simulating an acoustic neurinoma.

An unusual case of paraganglioma arising from the internal auditory meatus and growing into the cerebello-pontine angle is reported. Clinical features, pre-operative radiological appearances and intra-operative findings were indistinguishable from those of an acoustic neurinoma. However, the paraganglionic nature of the tumour was confirmed by the electron microscopic evidence of neurosecretory features.