Evaluation of rare choroid plexus metastasis from papillary thyroid carcinoma with multimodality imaging.

Papillary thyroid carcinoma (PTC) is the most common malignancy of thyroid gland. Though it metastasizes primarily through lymphatics, hematogenous spread is not infrequent. We report the case of a 62-year-old male patient with intraventricular choroid plexus metastasis from PTC, incidentally detected on post-high-dose radioiodine therapy whole-body I scan, which is an extremely rare presentation. Only 3 cases of choroid plexus metastasis from thyroid carcinoma have been reported. Further multimodality radiological investigations confirmed diagnosis and helped in assessing treatment response. The patient received gamma-knife stereotactic radiosurgery, and follow-up radiological imaging suggested improvement of intracranial metastasis.

Myocardial perfusion imaging after transient balloon occlusion during percutaneous coronary interventions.

BACKGROUND: Myocardial perfusion imaging (MPI) is highly sensitive in detecting rest ischemia when the radiotracer is injected during the episode of ischemia. The frequency of abnormal MPI results after resolution of ischemia is not well defined. The aim of this study was to determine how long MPI results remain abnormal after transient coronary artery occlusion. METHODS AND RESULTS: Patients undergoing single-vessel percutaneous coronary intervention were injected with technetium 99m sestamibi at 30 to 60 minutes (group 1) (n = 20) or 90 to 120 minutes (group 2) (n = 10) after the last balloon inflation and 24 hours later. There were 30 men aged 59 +/- 8 years. The culprit vessel was the left anterior descending artery in 14 patients and the right coronary artery in 13. The diameter stenosis was reduced from 76.1% +/- 8.7% to 3.0% +/- 6.4% (P < .001). The duration of balloon inflation was 40.3 +/- 12.5 seconds. Chest pain or ST shifts occurred in 66% of patients. A perfusion defect in the territory of the culprit artery was detected in 3 of 20 patients (15%) in group 1 and in 0 of 10 patients (0%) in group 2 (P = .3). One of those three patients had a perfusion defect on MPI done 24 hours later, along with a regional wall motion abnormality on the 2 sets of images. CONCLUSIONS: Abnormal perfusion is seen in a small percentage of patients at 30 to 60 minutes and in none at 90 to 120 minutes after a brief transient balloon occlusion. These results might have important implications in patient care.

Recurrent lymphoma detected on F-18 FDG coincidence imaging with negative findings on Ga-67 citrate scintigraphy.

Ga-67 citrate scintigraphy and computer tomography have been used in tumor staging, to determine disease extent, and for the pre- and post-therapeutic management of Hodgkin's and non-Hodgkin's lymphoma. Today, localization of hypermetabolic tissue using F-18 FDG is beginning to play a role in the staging and restaging of lymphoma. The authors report a case of recurrent Hodgkin's lymphoma in a 31-year-old man detected by F-18 FDG. Findings of the Ga-67 citrate scintigram were negative. Palpable right axillary adenopathy was found on routine physical examination follow-up. Comparison with previous negative findings obtained with Ga-67 citrate was unchanged. However, computed tomography revealed new right axilla lymphadenopathy, prompting further investigation with F-18 FDG SPECT, which showed hypermetabolic activity corresponding to the region of the right axilla involvement. Pathologic examination showed changes indicative of interfollicular recurrence of Hodgkin's lymphoma.