scholarly journals Pancreatic Cancer Masked by Acute Pancreatitis as well as an Unusual Iatrogenic Complication

2018 ◽  
Vol 09 (02) ◽  
pp. 088-091 ◽  
Author(s):  
Surinder Singh Rana ◽  
Ujjwal Gorsi ◽  
Pankaj Gupta ◽  
Ravi Sharma ◽  
Rajender Basher ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Inflammatory Cells ◽  
Liver Lesion ◽  
Needle Aspiration ◽  
Positron Emission ◽  
Pet Ct ◽  
Right Lobe ◽  
The Right

ABSTRACT A 62‑year‑old female presented with abdominal pain and was diagnosed as acute on chronic pancreatitis based on elevated serum amylase and imaging findings. The pancreatic duct was dilated with abrupt cutoff at neck of pancreas, but no mass was visualized. Positron emission tomography‑computed tomography (PET‑CT) revealed a fluorodeoxyglucose (FDG) avid lesion in the neck of the pancreas but ultrasound (USG)‑guided fine‑needle aspiration (FNA) from the lesion revealed only inflammatory cells. Endoscopic ultrasound, done 2 days after USG‑guided FNA, revealed pseudoaneurysm (PA) in the neck of pancreas that was confirmed on CT angiography. The PA was occluded by USG‑guided percutaneous cyanoacrylate injection. As pain persisted, repeat PET CT was done which revealed FDG avidity around the cyanoacrylate cast as well in multiple small hypodense lesions in the right lobe of the liver. USG‑guided FNA from both the liver lesion as well as the periphery of the glue cast revealed features of adenocarcinoma. We herein report a case of pancreatic adenocarcinoma that presented as acute pancreatitis and got masked because of formation of PA consequent to USG‑guided FNA.

Liver rheumatoid nodules imitating liver malignancy: a rare occurrence

2020 ◽  
Vol 13 (12) ◽  
pp. e234366
Author(s):  
Jason Wee ◽  
Salar Sobhi ◽  
Bastiaan De Boer ◽  
Dan Xu
Keyword(s):  
Histological Analysis ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Upper Respiratory Tract ◽  
Positron Emission Tomography Scan ◽  
Liver Malignancy ◽  
Positron Emission ◽  
Right Lobe ◽  
Upper Respiratory ◽  
Tomography Scan

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.

scholarly journals Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroki Sato ◽  
Kiyoaki Tsukahara ◽  
Ray Motohashi ◽  
Midori Wakiya ◽  
Hiromi Serizawa ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Thyroid Hemiagenesis ◽  
Poorly Differentiated ◽  
Node Metastases ◽  
Right Lobe ◽  
The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

Abstract 35: DVT Inflammation Assessed by 18F-FDG-PET/CT Predicts Subsequent Vein Wall Scarring

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Chase W Kessinger ◽  
Ahmed Tawakol ◽  
Gregory R Wojtkiewicz ◽  
Peter K Henke ◽  
Ralph Weissleder ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Vena Cava ◽  
Standard Uptake Value ◽  
Vein Wall ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

Objective: While venous thrombosis (VT)-induced inflammation facilitates thrombus resolution, inflammation causes vein wall scarring (VWS). Recently, statins have shown to improve VT resolution and reduce VT inflammatory components. In this study, we hypothesized that early VT inflammation detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) could predict subsequent late stage VWS, and would be attenuated by statin therapy. Methods: Stasis VT was induced in 8-12 week old male C57BL/6 mice (n=31) in either the right jugular vein (n=13) or inferior vena cava (IVC,n=18). Animals in the IVC VT cohort were randomized to statin (n=8) or control (n=10) treatment. Statin, rosuvastatin (5mg/kg), was administered by oral gavage, daily starting 24 hours prior to VT induction; control mice received saline. All mice underwent survival FDG-PET/CT venography imaging on day 2. FDG inflammation signals (standard uptake value=SUV) were measured in the thrombosed vein and compared to the sham-operated venous segments or treatment control. On day 14, mice were sacrificed and VT tissue was resected. Picrosirius red staining allowed measurement of collagen and vein wall thickness in VT sections. Results: FDG-PET/CT at day 2 revealed increased inflammation signal activity in jugular VT (SUV 1.43 ± 0.3 VT vs. 0.81 ± 0.3 contralateral vein, p<0.0001). Statin-treated mice showed a trend of decreased inflammation signal at day 2 in the IVC VT models (SUV 1.02 ± 0.1 statin VT vs. 1.42 ± 0.2 control VT, p=0.07). Day 14 histological analysis revealed significantly reduced vein wall injury in statin-treated animals (thickness, 32±9.4 μm statin; vs. 56.2±14.7 μm control, p=0.02). Day 2 FDG-PET inflammation in VT correlated positively with the magnitude of day 14 VWS (jugular VT, Spearman r=0.62, p=0.02; IVC VT r=0.74, p<0.001, respectively). Conclusions: Quantitative FDG-PET/CT imaging demonstrates that early in vivo VT inflammation predicts subsequent VWS, a driver of post-thrombotic syndrome (PTS). The overall findings strengthen: (i) the link between inflammation and PTS; (ii) the translational potential of FDG-PET inflammation to predict VWS and PTS; and (iii) the concept that statins and other anti-inflammatory therapies could reduce VWS and PTS.

From palliative to curative intent: PET/CT findings in the light of breast cancer intrinsic subgroup

2019 ◽  
Vol 105 (6) ◽  
pp. NP79-NP82
Author(s):  
Maxime Brunet ◽  
Anne-Laure Cazeau ◽  
Houda Ben Rejeb ◽  
Vittorio Catena ◽  
Thomas Grellety
Keyword(s):  
Breast Cancer ◽  
Liver Lesion ◽  
Luminal A ◽  
Curative Intent ◽  
Palliative Intent ◽  
Ct Findings ◽  
Positron Emission ◽  
Pet Ct ◽  
Cancer Subtype ◽  
Contrast Ultrasound

Purpose: Among breast cancer subgroups, Luminal A is the subgroup with the best prognosis. We report the case of a young woman presenting with a localized luminal A breast cancer with a suspicious liver lesion on initial positron emission tomography (PET)/computed tomography (CT) scan staging. Case description: A 31-year-old woman presented with localized breast cancer accessible to curative treatment. However, PET/CT staging revealed an increase of focal activity in the liver, suspicious of a secondary malignant localization, changing the care towards palliative intent. Discrepancy between breast cancer luminal A subtype and the liver lesion led to further investigations (contrast ultrasound, magnetic resonance imaging, and biopsy), excluding a malignant process, and were in favor of toxic hepatitis, probably secondary to herbal tea consumption. Conclusions: Questioning PET/CT findings in light of the cancer subtype enabled us to rectify the diagnosis and allow this patient to be treated with curative intent.

scholarly journals Acute Pancreatitis with Rapid Clinical Improvement in a Child with Isovaleric Acidemia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Elpis Mantadakis ◽  
Ioannis Chrysafis ◽  
Emmanouela Tsouvala ◽  
Athanassios Evangeliou ◽  
Athanassios Chatzimichael
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
Elevated Serum ◽  
Unknown Origin ◽  
Organic Acidemia ◽  
Abdominal Ultrasonography ◽  
Isovaleric Acidemia ◽  
Intravenous Hydration ◽  
Branched Chain

Isovaleric acidemia is a rare branched-chain organic acidemia. The authors describe a 3.5-year-old girl with isovaleric acidemia and acute abdominal pain associated with bilious emesis. Elevated serum amylase and abdominal ultrasonography demonstrating an enlarged and edematous pancreas, along with the presence of peripancreatic exudates, confirmed the presence of acute pancreatitis. The patient recovered quickly with intravenous hydration, pancreatic rest, and administration of intravenous L-carnitine. Pancreatitis should be ruled out in the context of vomiting in any patient with isovaleric acidemia. Conversely, branched-chain organic acidemias should be included in the differential diagnosis of any child with pancreatitis of unknown origin.

scholarly journals Hepatic Adenoma - A Case Report

2016 ◽  
pp. 59-62
Author(s):  
Tareq M Bhuiyan ◽  
Indrajit Kumar Datta ◽  
Md Mohsin Kabir ◽  
Md Nazmul Haque ◽  
Md Golam Azam ◽  
...  
Keyword(s):  
Oral Contraceptive Pill ◽  
Abdominal Ultrasound ◽  
Malignant Cell ◽  
Needle Aspiration ◽  
Posterior Aspect ◽  
Ct Guided ◽  
Right Lobe ◽  
Alpha Feto Protein ◽  
Needle Aspiration Cytology ◽  
The Right

We report the case of a 32-year-old female who presented to us with incidental findings of a space occupying lesion (SOL) in liver on abdominal ultrasound (USG). She was taking oral contraceptive pill for last 9 years. Clinical examination was unremarkable and liver investigation revealed mildly raised Serum alanine aminotrasferase (ALT). Dyslipidemia was also present. Computed tomography (CT) identified a 2.5 cm lesion in the right lobe of liver at posterior aspect which was isodense. Alpha-feto protein was normal. CT guided Fine Needle Aspiration Cytology (FNAC) showed adequate cellular material containing organized reactive hepatocytes in the background of blood. No granuloma or malignant cell was seen. Findings were suggestive of hepatic adenoma.Birdem Med J 2015; 5(1) Supplement: 59-62

scholarly journals FDG PET-CT in rheumatological diseases

Rheumatology ◽  
2021 ◽  
Author(s):  
Manil Subesinghe ◽  
Shaheel Bhuva ◽  
Nikita Arumalla ◽  
Andrew Cope ◽  
David D’Cruz ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Inflammatory Diseases ◽  
Inflammatory Cells ◽  
Cellular Processes ◽  
Positron Emission ◽  
Pet Ct ◽  
Wide Range ◽  
Oncological Imaging ◽  
Fdg Pet Ct ◽  
Rheumatological Diseases

Abstract 2-deoxy-2[18F]fluoro-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) has revolutionised oncological imaging. The cellular processes that make cancer cells visible on FDG PET-CT, also occur in a wide range of inflammatory cells; exploiting this phenomenon has led to a growth of evidence supporting the use of FDG PET-CT in a wide range of infective and inflammatory diseases. Rheumatological diseases can affect multiple sites within the musculoskeletal system alongside multi-organ extra-articular disease manifestations. Inflammation is central to these diseases, making FDG PET-CT a logical choice. In this review article, we will describe the various applications of FDG PET-CT in rheumatological diseases using illustrative examples to highlight the beneficial role of FDG PET-CT in each case.

scholarly journals Abdominal pain and a raised amylase? It’s not always pancreatitis…

2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
High Serum ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.

scholarly journals Primary Hepatic Choriocarcinoma in a Male Patient: A Case Report and Literature Review

2021 ◽  
Author(s):  
Ke Zhao ◽  
Ke Rao ◽  
Xin Chen ◽  
Si Chen ◽  
Haifeng Xu
Keyword(s):  
Male Patient ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Clinical Manifestations ◽  
Deep Understanding ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Fdg Pet Ct

Abstract BackgroundChoriocarcinoma is a rare malignant tumor and rarely occurs outside the gonads. Primary hepatic choriocarcinoma is more infrequent, with hidden clinical manifestations, rapid progress, and extremely poor prognosis. Only more than 10 cases were publicly reported in the world. Therefore, there is still a lack of deep understanding of the diagnosis and treatment of the disease.Case presentationWe report a case of primary hepatic choriocarcinoma in a man diagnosed by pathology. A 65-year-old male patient presented with fever and anorexia, nothing but mild jaundice of the skin and sclera was found on physical examination. Abdominal enhanced magnetic resonance imaging (MRI) showed a huge mass in the right hepatic lobe. Fludeoxyglucose-positron emission tomography-computed tomography (FDG-PET/CT) scan showed increased uptake in the liver and sigmoid colon and no uptake in the testes. The patient underwent the right hepatectomy, and postoperative pathology showed that the tumor was primary hepatic choriocarcinoma. Then he received one course of adjuvant chemotherapy. Then he developed severe myelosuppression and was transferred to the intensive care unit for further treatment. He eventually died of severe liver failure about 100 days after surgery. Primary hepatic choriocarcinoma is extremely rare, and its diagnosis is challenging.ConclusionsPrimary hepatic choriocarcinoma is a rare and highly malignant tumor with a poor prognosis. We believe that this differential diagnosis should be considered in liver tumor patients. The effective treatment for this disease is still to be explored.

scholarly journals Right thyroid lobed cyst in a middle-aged woman: A case report

2020 ◽  
Vol 7 (1) ◽  
pp. 4-10
Author(s):  
Adam Moyosore Afodun ◽  
Khadijah Kofoworola Quadri ◽  
Akeem Ayodeji Okesina ◽  
Abdulfatai Olakunle Ojewale ◽  
Airat Adeola Bakare ◽  
...  
Keyword(s):  
Cervical Lymphadenopathy ◽  
The United States ◽  
Needle Aspiration ◽  
Cystic Mass ◽  
Aged Woman ◽  
Thyroid Cyst ◽  
Middle Aged Woman ◽  
Right Lobe ◽  
The Right

Background: Thyroidal ultrasound has been used to detect neck lesions and nodules for decades. However, cystic thyroid disease is rare with few reported series. Different consensus exists concerning availability of medical treatment and the limited role of surgical management. Case presentation: We present a 31-year-old female with obvious neck swelling and dysphagia. Ultrasound diagnosed a suspected colloidal thyroid cyst in the right lobe. The hypoechoic cystic mass measures 3.2 cm x 3.6 cm on frozen sonogram, with evidence of bilateral (cervical) lymphadenopathy. Thyroid cystic nodule viewed via sonar corresponds to detected mass finding on observation and palpitation. Researchers have recently standardized Thyroid-Imaging- Reporting and Data System (TIRADS), mostly in the United States. Conclusion: If Fine Needle Aspiration (FNA) and hormone therapy fail, cysts larger than >2.8cm may require surgical intervention, especially when there is a danger of great-vessel compression.

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