Introduction. Thyroid hemiagenesis (TH) is a congenital developmental disorder. Most cases are euthyroid although hyperthyroidism, hypothyroidism, and malignancy may develop. We present a case of hemiagenesis with Graves' disease (GD) and review the literature about the association. Case report. A 45-year-old female patient was admitted to the endocrinology department due to nausea and diarrhea. Her past medical history revealed hyperthyroidism diagnosed a year ago. On thyroid examination, right thyroid lobe was palpable, but left lobe and isthmus were not. Physical examination involving other organ systems was unremarkable except for fine tremor of the hands. Thyroid function tests revealed a high level of free T4 and T3 with a low serum TSH. Thyroid antibodies were all positive. Left lobe and isthmus were invisible on thyroid ultrasonography (US) and the right thyroid lobe measuring 44x18x12 mm was diffusely heterogeneous in echo texture. Thyroid scan using Technetium-99m showed increased homogeneous tracer uptake in the right lobe. The patient was diagnosed with TH and GD. Discussion. In case of unilateral increased uptake on scintiscan, GD with hemiagenesis must be kept in mind in the differential diagnosis of autonomous solitary adenoma, postinflammatory atrophy of thyroid in Hashimoto's disease, focal or unilateral subacute thyroiditis, and primary or metastatic carcinoma. It is prudent to do thyroid ultrasound along with scintigram. US is a valuable tool for the quick diagnosis of TH and differential diagnosis from other causes.
Objective: End-stage chronic liver disease (CLD) adversely affects the function of multiple organ systems including the skeletal system. The aim of this study was to assess osseous and nonosseous bone scintigraphy (BS) findings in liver transplant (LT) candidates with end-stage CLD.Methods: We retrospectively evaluated BS findings in 50 consecutive patients with end-stage CLD who were undergoing preoperative assessment for LT from January 2006 to December 2011. All the patients were analyzed with respect to clinical and laboratory parameters, and BS findings. Scintigrams were visually assessed for the presence of osseous and nonosseous abnormalities. Osseous abnormalities were classified as those indicating bone metabolism changes or metastatic bone disease. Typical scintigraphic findings denoting to changes in bone metabolism were the presence of decreased osseous uptake, increased periarticular uptake, asymmetrical or unusual uptake patterns. Nonosseous findings were classified according to the degree of soft-tissue uptake as mild and severe.Results: The group consisted of 46 adult and 4 adolescent patients. All adolescent patients had normal skeletal accumulation with growth plate uptake and one had mildly increased renal cortical activity. A total of 46 adult patients had one or more of the following osseous findings: generalized decrease in osseous uptake (n=4, 8.7%); bilateral decrease in lower extremity uptake (n=26, 56.5%); symmetrically increased periarticular uptake (n=26, 56.5%); bilateral cortical/periosteal increased uptake in the lower extremity indicating hepatic hypertrophic osteoarthropathy (HOA) (n=8, 17.4%); bilateral increased sacroiliac activity (n=16, 34.8%); sacral activity (n=10, 21.7%), coccygeal activity (n=2, 4.3%), focally increased uptake suggestive of metastases (n=5, 10.9%). Three rib metastases appeared to be linear. Nonosseous findings observed in adult patients were mild diffuse liver uptake (n=4, 8.7%) and bilateral diffuse mild or severe degree of renal cortical uptake (n=20, 43.5%). There was a statistically significant difference in serum creatinine values between mild and severe renal uptake groups (p<0.05). There was also statistically significant difference in serum BUN and creatinine values between patients with severe degree of renal uptake and without renal uptake (p<0.05).Conclusion: The results of the current study has shown that adolescent LT candidates with end-stage CLD had no osseous abnormality on BS. However, all of adult patients exhibited one or one more osseous abnormalities. Typical scintigraphic findings denoting to abnormalities in bone metabolism were generalized decreased osseous uptake, decreased lower extremity osseous uptake, increased periarticular uptake, increased cortical/periosteal uptake indicating hepatic HOA, and other unusual uptake patterns. Hepatocellular carcinoma metastases may present itself as rib metastases linear in pattern. Soft-tissue uptake in the form of diffuse bilateral mild or severe degree of renal uptake and less commonly mil...
We present the case of a 40-year-old man who underwent a FDG PET/CT study for restaging of renal cell carcinoma treated with left nephrectomy, for suspected metastasis in lung and retroperitoneal lymph nodes. The patient had a history of left inguinal hernia repair with implantation of mesh prosthesis 5 years ago. PET/CT image revealed linear intense FDG uptake in left inguinal region most likely corresponding to a persistent foreign body reaction. In this article, a case with an intense FDG uptake around mesh prosthesis after many years was reported, and a summary of the literature about surgical mesh and foreign body reaction causing FDG uptake was reviewed.Conflict of interest:None declared.
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