scholarly journals A Patient with Limbic Encephalitis, Ear Perichondritis, and Episcleritis – An Unusual Presentation of Relapsing Polychondritis

2020 ◽  
Vol 12 (3) ◽  
pp. 378-386
Author(s):  
Stanley Angkodjojo ◽  
Crystal Jing Jing Yeo
Keyword(s):  
Limbic Encephalitis ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Relapsing Polychondritis ◽  
Response To Treatment ◽  
Diagnostic Challenge ◽  
Positron Emission ◽  
Pet Ct ◽  
System Manifestation ◽  
Recurrent Inflammation

Relapsing polychondritis (RPC) is a rare autoimmune disease that is characterized by recurrent inflammation and destruction of cartilaginous tissues. Limbic encephalitis is a rare central nervous system manifestation of RPC that has been mentioned in case reports. Recognition of this association, and reliable methods of diagnosis, including the utility of neuroimaging modalities such as positron emission tomography/computed tomography (PET/CT) can be useful in the evaluation of this diagnostic challenge. We report a patient with limbic encephalitis associated with RPC, where PET/CT was effectively used in the diagnosis, and monitoring of response to treatment. We also demonstrate that it can be a useful modality in certain situations when brain magnetic resonance imaging cannot be done.

scholarly journals Limbic encephalitis with relapsing polychondritis: persistent white matter lesions and brain atrophy

2018 ◽  
Vol 46 (12) ◽  
pp. 5297-5302 ◽  
Author(s):  
Zilong Zhu ◽  
Decai Tian ◽  
Ning Ren ◽  
Zhihong Zhao ◽  
Xin Wang ◽  
...  
Keyword(s):  
White Matter ◽  
Limbic Encephalitis ◽  
Relapsing Polychondritis ◽  
White Matter Lesions ◽  
Autoimmune Disorder ◽  
Current Case ◽  
System Manifestation ◽  
Temporal Lobe Lesions ◽  
Chinese Male

Relapsing polychondritis (RP) is a rare autoimmune disorder affecting cartilage. Limbic encephalitis is a rare central nervous system manifestation of RP. This current case report describes a 66-year-old Chinese male patient who complained of developing myoclonus in the left leg, ataxia and speech difficulties 3 weeks prior to hospital admission. The patient presented with cognitive impairment, sleep disorder and extrapyramidal symptoms. The patient was diagnosed with RP that affected auricular cartilage, which also manifested as limbic encephalitis. Magnetic resonance imaging showed bilateral temporal lobe lesions involving the hippocampi and basal ganglia. Signal abnormalities in the white matter persisted during the 15-month follow-up period after treatment with corticosteroids and intravenous immunoglobulin. Over the same period, the bilateral hippocampi showed significant atrophy.

scholarly journals The Role of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography in Evaluating the Response to Treatment in Patients with Multiple Myeloma

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Carmelo Caldarella ◽  
Giorgio Treglia ◽  
Maria Antonietta Isgrò ◽  
Ivan Treglia ◽  
Alessandro Giordano
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Response To Treatment ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Fluorine 18 Fluorodeoxyglucose ◽  
Fluorodeoxyglucose Positron Emission

Background and Aim. Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) is well recognized as a powerful diagnostic tool in the initial staging of patients with multiple myeloma (MM). The aim of this paper is to perform a systematic review about the usefulness of FDG-PET or PET/CT in evaluating the response to treatment in patients with MM. Methods. The scientific literature about the role of FDG-PET or PET/CT in evaluating the response to treatment in patients affected by MM was systematically reviewed. Results. Ten studies about the role of FDG-PET or PET/CT in evaluating treatment response in MM were retrieved and discussed. Conclusions. FDG-PET or PET/CT seems to be helpful in assessing the response to treatment in patients with MM and in the evaluation of possible sites of recurrent or progressive disease.

scholarly journals FDOPA-(18F): a PET radiopharmaceutical recently registered for diagnostic use in countries of the European Union

2007 ◽  
Vol 50 (spe) ◽  
pp. 77-90 ◽  
Author(s):  
Yanna-Marina Chevalme ◽  
Françoise Montravers ◽  
Jean-Philippe Vuillez ◽  
Michel Zanca ◽  
Charles Fallais ◽  
...  
Keyword(s):  
Case Reports ◽  
The Body ◽  
Clinical Usefulness ◽  
Diagnostic Tools ◽  
The European Union ◽  
Commercial Preparation ◽  
Non Invasive ◽  
Positron Emission ◽  
Pet Ct ◽  
Pet Radiopharmaceutical

Positron emission tomography (PET) and its recent update PET/CT are very effective diagnostic tools for non-invasive imaging of metabolic or functional disorders in target tissues. The clinical usefulness of fluorodeoxyglucose-(18F) (FDG) has been now widely accepted. Recently, the clinical usefulness of fluoroDOPA-(18F) or FDOPA, an aminoacid labelled with the same positron emitter fluorine-18, has been evaluated and recognised in France and subsequently in several EU countries. FDOPA is diagnostic PET agent, which has been used for decades in imaging the loss of dopaminergic neurons in Parkinson's disease, and more recently to detect, stage and restage neuroendocrine tumours and to search for recurrence of viable glioma tissue. The present article summarises the body of evidence that led the French Medicines Agency (AFSSAPS) to grant a marketing authorisation to IASOdopa, a commercial preparation of FDOPA. Brief case reports and figures illustrate the diagnostic performance of FDOPA PET or PET/CT in the different settings that are currently approved in oncology.

scholarly journals Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunxiang Zeng ◽  
Minfang Li ◽  
Sheng Chen ◽  
Lin Lin ◽  
Shiyue Li ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Therapeutic Response ◽  
Relapsing Polychondritis ◽  
Ct Guided ◽  
Promising Tool ◽  
Positron Emission ◽  
Pet Ct ◽  
Ct Guided Biopsy ◽  
Fdg Pet Ct ◽  
Monitoring Response

Abstract Background 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a promising tool for diagnosing relapsing polychondritis (RP). However, its usefulness in assessing RP with airway involvement is unknown. Objective This study aimed to further evaluate and confirm the potency of 18F-FDG PET/CT in diagnosing RP with airway involvement and monitoring response to steroid-based therapy. Methods A total of 30 patients from a dedicated respiratory centre, diagnosed with RP in accordance with McAdam, Damiani or Levine criteria, were included in this study. All patients underwent baseline 18F-FDG PET/CT, and 10 patients underwent second scans after 2.5–15 months of steroid-based therapy. Visual scores (VS) and maximal standard uptake values (SUVmax) were analysed. Results In the initial scan, 83.3% (25/30) of patients were found to have FDG uptake in more than one cartilage. The median VS and SUVmax in the cartilages were 3 (range, 1–3) and 3.8 (range, 1.9–17.9), respectively. Positive rates for PET/CT-guided biopsy in nasal, auricular, and tracheal/bronchial cartilages were 100% (5/5), 88.9% (8/9), and 10.5% (2/19), respectively, but the positive biopsy rate in the auricular cartilage was 92.3% (12/13) even without PET/CT assessment. Based on biopsy-proven sites, the sensitivity of PET/CT was 55.6%, and the specificity was 5.3%. Compared with the baseline scan, the second scan showed much lower median VS (2 vs 3, respectively; p < 0.0001) and SUVmax (2.9 vs 3.8, respectively; p < 0.001). Of 10 patients who underwent second PET/CT, 8 had complete therapeutic response, while 2 had partial response. Conclusion 18F-FDG PET/CT assists in identifying multiple cartilage involvement in RP, but it seems neither a sensitive nor specific modality in diagnosing RP with airway involvement. Moreover, PET/CT has limited utility in locating biopsy sites and monitoring therapeutic response to corticosteroids.

scholarly journals Pigmented villous nodular synovitis mimicking metastases on 18F-FDG PET/CT in a patient with rectal mucosal melanoma: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu-An Yen ◽  
Li-Chun Wu ◽  
Na-Mi Lu ◽  
Chiang Hsuan Lee
Keyword(s):  
Fdg Pet ◽  
Case Reports ◽  
Distant Metastases ◽  
Final Diagnosis ◽  
Mucosal Melanoma ◽  
Extensive Literature ◽  
Extensive Resection ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background Mucosal melanomas are rare and have a high potential for metastasizing. Surgical resection is the treatment of choice for single distant metastases. Malignant melanoma usually shows the highest uptake of fluorine-18 fluorodeoxyglucose (18F-FDG). 18F- FDG positron emission tomography /computed tomography (PET/CT) is usually used for melanoma staging. An extensive literature review revealed only 4 published case reports and an original paper involving 8 cases (12 cases in total) of patients with skin melanomas in whom pigmented villous nodular synovitis (PVNS) mimicked metastatic melanoma, however, none of the melanomas reported were of rectal mucosal origin. Case presentation A 60-year-old woman presented with recent diagnosis of rectal mucosal melanoma, two additional 18F-FDG-avid lesions in the left ankle and left foot were detected on 18F-FDG PET/CT. Metastases were initially suspected; however, the final diagnosis was PVNS. Conclusions This is the first report of PVNS mimicking metastases on 18F-FDG PET/CT in a patient with rectal mucosal melanoma. Although high 18F-FDG-avid lesions in patients with rectal mucosal melanoma are highly suspected to be metastasis and warrant an meticulous examination, the present case is a reminder that in such patients, not all lesions with high 18F-FDG uptake, especially those near a joint, are metastases and that more extensive resection is unnecessary.

scholarly journals Benign Histiocyte-Rich Pseudotumor Developing Postchemotherapy and Mimicking Residual Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Amrit P. Singh ◽  
Glenn P. Murray ◽  
Soumya Pandey
Keyword(s):  
Residual Disease ◽  
B Cell Lymphoma ◽  
Excisional Biopsy ◽  
Ct Imaging ◽  
Response To Treatment ◽  
Large B Cell Lymphoma ◽  
Positron Emission ◽  
Pet Ct ◽  
History Of ◽  
Relapsed Disease

Histiocyte-rich pseudotumors (HRPT) developing postchemoradiation therapy are a florid response to treatment and reparative change. Although these are benign processes, clinically and radiologically, these may mimic recurrent/relapsed disease. We describe a case of an adult male with history of diffuse large B-cell lymphoma (DLBCL), status postchemoradiation therapy, who developed HRPT at the site of original involvement, mimicking relapse of disease on positron emission tomography/computed tomography (PET/CT) imaging. This is one of the few reported cases of posttreatment HRPT. This entity is important to point out the limitations of PET/CT imaging in patients with lymphomas and metastatic disease and stresses the importance of an excisional biopsy for determining relapse and the need for further treatment.

scholarly journals 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Management of Aggressive Non-Hodgkin's B-Cell Lymphoma

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
M. J. Shelly ◽  
S. McDermott ◽  
O. J. O'Connor ◽  
M. A. Blake
Keyword(s):  
B Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Imaging Modality ◽  
B Cell Lymphoma ◽  
Cost Effective ◽  
Response To Treatment ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

18-Fluorodeoxyglucose (FDG-PET/CT) is an established imaging modality that has been proven to be of benefit in the management of aggressive B-cell non-Hodgkin's lymphoma, such as diffuse large B-cell lymphoma and advanced stage follicular lymphoma. The combination of anatomic and functional imaging afforded by FDG-PET/CT has led to superior sensitivity and specificity in the primary staging, restaging, and assessment of response to treatment of hematological malignancies when compared to FDG-PET and CT alone. The use of FDG-PET/CT for posttreatment surveillance imaging remains controversial, and further study is needed to ascertain whether this modality is cost effective and appropriate for use in this setting.

scholarly journals WITHDRAWN: A re-evaluation of 18F-FDG PET/CT for diagnosing relapsing polychondritis and monitoring the therapeutic response to treatment

Oncotarget ◽  
2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Jinlin Wang ◽  
Minfang Li ◽  
Sheng Chen ◽  
Shiyue Li ◽  
Jianxing He ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Therapeutic Response ◽  
Relapsing Polychondritis ◽  
Response To Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Diogenes syndrome in dementia: a case report

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Luca Sacchi ◽  
Emanuela Rotondo ◽  
Sara Pozzoli ◽  
Alessio Fiorentini ◽  
Giuseppina Schinco ◽  
...  
Keyword(s):  
Verbal Fluency ◽  
Brain Magnetic Resonance Imaging ◽  
Superior Temporal Gyrus ◽  
Amyloid Pet ◽  
Resonance Imaging ◽  
Mental Functioning ◽  
Diagnostic Challenge ◽  
Positron Emission ◽  
Diogenes Syndrome ◽  
State Examination

Background Diogenes syndrome is a neurobehavioural syndrome characterised by domestic squalor, hoarding and lack of insight. It is an uncommon but high-mortality condition, often associated with dementia. Aims To describe the clinical features and treatment of Diogenes syndrome secondary to behavioural variant frontotemporal dementia (bvFTD). Method We describe a case of bvFTD in a 77-year-old man presenting with Diogenes syndrome. Results The patient's medical and psychiatric histories were unremarkable, but in recent years he had begun packing his flat with ‘art pieces’. Mental state examination revealed confabulation and more structured delusions. Neuropsychological evaluation outlined an impairment in selective attention and letter verbal fluency, but no semantic impairment, in the context of an overall preserved mental functioning. Brain magnetic resonance imaging and positron emission tomography (PET) with fluorodeoxyglucose showed mild bilateral temporo-insular atrophy and hypometabolism in the left-superior temporal gyrus respectively. An amyloid PET scan and genetic analysis covering the dementia spectrum were normal. A diagnosis of bvFTD was made. Conclusions The clinical framing of behavioural symptoms of dementia such as hoarding poses a diagnostic challenge. This case illustrates the importance of a deeper understanding of Diogenes syndrome, leading to timelier diagnosis and effective therapeutic strategies.

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