RESUMO
Scrotal scintigraphy has become a relatively uncommon examination in many nuclear medicine departments. However, scrotal perfusion is visualized during three-phase bone imaging of the pelvis and hips. The authors present a compilation of three cases of hip pain secondary to unsuspected scrotal pathology documented on routine three-phase bone scintigraphy, discussing this topic for the first time in the literature. A short review of the pathophysiology of referred hip pain, differential diagnosis, and imaging alternatives emphasize the unique contribution of nuclear imaging.
Assuntos
Articulação do Quadril/diagnóstico por imagem , Dor/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Escroto/diagnóstico por imagem , Adolescente , Idoso , Criança , Diagnóstico Diferencial , Epididimite/complicações , Epididimite/diagnóstico por imagem , Doenças dos Genitais Masculinos/diagnóstico por imagem , Humanos , Masculino , Orquite/complicações , Orquite/diagnóstico por imagem , Dor/etiologia , Dor/fisiopatologia , Prostatite/complicações , Prostatite/diagnóstico por imagem , Cintilografia , Doenças Testiculares/complicações , Doenças Testiculares/diagnóstico por imagem , Anormalidade Torcional/complicações , Anormalidade Torcional/diagnóstico por imagemRESUMO
In this case, a distinctive amyloid tumor of the breast clinically simulated carcinoma, although the patient related onset to trauma. Hepatosplenomegaly, elevated globulins, and anemia led to identification of large amounts of monoclonal IgG-kappa production. The patient died of renal failure within several months despite chemotherapy. The matrix of the breast tumor was tinctorially characteristic of amyloid light chain (AL) protein. The mass contained islands of plasma cells that morphologically suggested local production of amyloid matrix. Moreover, plasma cell and matrix immunohistochemically displayed reactivity of IgG-kappa protein, indicating a clonal plasma cell infiltrate. Pseudo-acinar arrangement of plasma cells may be misinterpreted as epithelial cells in needle biopsy specimens. The notion that some amyloidomas may represent in situ production of protein by clonal immunocytes ("secretory immunocytomas") should be further studied.
Assuntos
Amiloidose/patologia , Doenças Mamárias/patologia , Calcinose/patologia , Idoso , Carcinoma/diagnóstico , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Imunoglobulina G/análise , Cadeias Leves de Imunoglobulina/análise , Cadeias kappa de Imunoglobulina/análise , Plasmócitos/patologia , Insuficiência Renal/patologiaRESUMO
Insertion of a permanent dual chamber pacemaker by the Seldinger technique usually requires two needle punctures of the vein or the use of a large introducer, thus increasing the risks associated with this procedure. We describe a modified technique using a relatively small introducer and a single subclavian vein puncture that we have found to be safe and simple to perform.
