• Title/Summary/Keyword: Tomography, emission computed

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Primary Pulmonary Amyloidosis with Mediastinal Lymphadenopathy

  • Kim, Dohun;Lee, Yong-Moon;Kim, Si-Wook;Kim, Jong-Won;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.218-220
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    • 2016
  • We report a case of inadvertent hoarseness after surgery for primary pulmonary amyloidosis. A 55-year-old male was transferred to our facility due to a lung mass. Chest computed tomography revealed a solitary pulmonary nodule. Positron emission tomography-computed tomography showed fluorodeoxyglucose uptake in the main mass and in the mediastinal lymph nodes. To confirm the pathology of the mass, wedge resection and thorough lymph node dissection were performed via video-assisted thoracic surgery (VATS). No complications except for hoarseness were observed; hoarseness developed soon after surgery and lasted for 3 months. The main mass was diagnosed as amyloidosis, but this was not found in the lymph nodes. In conclusion, VATS wedge resection for peripheral amyloidosis is a feasible and safe procedure. However, mediastinal lymph node dissection is not recommended unless there is evidence of a clear benefit.

Moderate hypofractionated image-guided thoracic radiotherapy for locally advanced node-positive non-small cell lung cancer patients with very limited lung function: a case report

  • Manapov, Farkhad;Roengvoraphoj, Olarn;Li, Minglun;Eze, Chukwuka
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.180-184
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    • 2017
  • Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function ($FEV1{\leq}1L$).

An Insufficient Preoperative Diagnosis of Borrmann Type 4 Gastric Cancer in Spite of EMR

  • Ahn, Jae-Bong;Ha, Tae-Kyung;Lee, Hang-Rak;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.11 no.1
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    • pp.59-63
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    • 2011
  • Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findings (such as an upper gastrointestinal series, abdominal computed tomography and positron emission tomography/computed tomography) or the macroscopic findings of a gastrofiberscopy examination imply a high suspicion of cancer, there can be difficulty in getting the definite pathologic results despite multiple biopsies. In these cases, we have performed endoscopic mucosal resection under gastrofiberscopy as an alternative to simple biopsies. Here we report on a case in which no cancer cells were found even in the endoscopic mucosal resection specimen, but the radiologic evidence and clinical findings were highly suspicious for gastric cancer. The patient finally underwent total gastrectomy with lymph node resection, and she was pathologically diagnosed as having stage IV gastric cancer postoperatively.

Detection of Superior Vena Cava Tumor Thrombus by F-18 FDG PET/CT in Recurrent Hepatocellular Carcinoma (상행대정맥 종양혈전을 동반한 재발성 간세포암 환자의 F-18 FDG PET/CT소견)

  • Choi, Seung-Jin;Kim, Chul-Soo;Byun, Sung-Su;Lee, Kyung-Hee;Hyun, In-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.271-274
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    • 2006
  • We report the case of a 64-year-old man with superior vena cava (SVC) syndrome due to tumor thrombus from recurrent hepatocellular carcinoma (HCC). He presented with new onset of facial swelling for 10 days. HCC was detected ten years ago. He has undergone repeated transcatheter arterial embolization (TAE) and chemotherapy. Chest computed tomography (CT) demonstrated tumor thrombus in the SVC extending to right atrium. He underwent whole body F-18 fluorodeoxyglucose(FDG) positron emission tomography/computed tomography (PET/CT) scanning for assessing the effect of TAE in HCC. F-18 FDG PET/CT showed increased uptake in the residual liver mass indicating viable tumor. There was another intense F-18 FDG accumulation in SUV extending to right atrium to suggest tumor thrombus. This case illustrates that F-18 FDG PET/CT is useful to identification of distant metastases as well as assessment of response to therapy in long-term survival HCC patients.

A Case Report on Extranodal Marginal Zone B Cell of Mucosa-associated Lymphoid Tissue (MALT) Type Lymphoma Treated with Hangam-dan (항암단을 투여 받은 림프절 외 변연부 B세포 림프종 환자에 대한 증례보고)

  • Han, Sung-Soo;Cho, Chong-Kwan;Lee, Yeon-Weol;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.810-818
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    • 2008
  • Objective : The aim of this case report is to drive further studies evaluating the effectiveness of Korean oriental medicine on extranodal marginal zone B cells of MALT (mucosa-associated lymphoid tissue) type lymphoma. Methods : This case report is about a patient who was diagnosed with extranodal marginal zone B cell of MALT type lymphoma, who refused chemotherapy and preferred to be treated with Korean oriental medicine. Neck, chest abdomen & pelvis with enhanced computed tomography (CT) and positron emission tomography computed tomography (PET-CT) were performed to evaluate the anticancer effect of Hangam-dan (HAD). Results : The patient diagnosed with MALT showed partial response after receiving 17 months of Korean oriental medical treatment. Neck, chest, abdomen & pelvic CT and PET-CT show decrease in size. Conclusion : This case report shows a possibility that Korean oriental treatment could offer potential benefits for patients with extranodal marginal zone B cell of MALT type lymphoma.

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Case of Remission of Progressive Breast Cancer Treated by Capecitabine with Integrative Medicine Therapy (카페시타빈과 통합의학 프로그램 치료 병용을 통해 호전된 진행성 유방암 1례)

  • Jin, Yong Jae;Shin, Kwang Soon;Ha, Jee Yong
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.43-51
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    • 2014
  • This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating breast cancer metastasized to several portion. A 55-year-old woman who was diagnosed breast cancer and treated by breast conservation surgery (BCS) IN 2002. (pT2M0N0), adjuvant chemotherapy and radiotherapy till Jan. in 2013. But cancer had metastasized to sacrum (2009), liver (2012) and ribs (2013). Finally cause of several side effects of Xeloda(neuralgia and vommiting), she gave up to be treated by Xeloda and started to receive IMT including Abnoba Viscum, Vitamin C therapy Xeloda again, Korean herbal medicine and pharmacopuncture from Jul. in 2013. The effect was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and cancers to ribs, their size decreased after 12 months and pain of sacrum maintained VAS 2 continually. These results suggest that IMT is a therapeutic method to treat metastatic tumor originated from breast cancer.

A Case of Improvement of Metastatic Ovarian and Endometrial Cancer Treated by Integrative Medicine Therapy Combined with Chemotherapy (항암치료와 통합암치료 병용으로 호전된 전이성 난소 및 자궁내막암 환자 1례)

  • Jin, Yong Jae;Shin, Kwang Soon;Ha, Jee Yong
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.33-41
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    • 2014
  • This report is aimed to investigate the effect of Integrative Medicine Therapy (IMT) in treating metastasized ovary and endometrial cancer. A 51-year-old woman who was diagnosed double primary ovarian and endometrial cancer in 2009. The patient was treated with Laparoscopic Assisted Vaginal Hysterectomy (LAVH), Bilateral Salpingo Oophorectomy (BSO) Pelvic Lymph Node Dissection (PLND), adjuvant chemotherapy till Sep. in 2013. But metastases to Rt. External Iliac artery, Aortocaval area Lymph Nodes, Liver(caudate lobe), Rt. Buttock subcutaneous area, Lt. Gastric Area Lymph Nodes were found. Finally, the patient decided to be treated by IMT including Abnoba Viscum, Vitamin C, herbal medication and pharmacopuncture combined with chemotherapy. The efficacy was evaluated with Positron Emission Tomography and Computed Tomography (PET-CT) and Abdomen Computed Tomography (CT). The metastatic tumor in liver was disappeared and Rt. external iliac artery, aortocaval area Lymph Nodes, Rt. buttock subcutaneous area were also decreased after 6 months treatment. These results suggest that IMT may have a potential role for metastatic cancer.

PET/CT Manifestation of the Meniscus Sign of Ulcerating Gastric Carcinoma (궤양성 위 암종에 나타난 초승달 징후의 펫/시티 소견)

  • Bahk, Yong-Whee
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.335-336
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    • 2007
  • Meniscus-like presentation of ulcerating gastric carcinoma on upper gastrointestinal series radiograph was first described in 1921 by Carman and has since been known as a useful differential diagnostic sign in radiology. In 1982 using then newly introduced computed tomography (CT) Widder and Mueller revisited the meniscus sign. Their study was primarily focused on a dynamic assessment of the demonstrability of the meniscus sign that largely depends on the judgment and technical skill of examiner, especially graded compression and patient positioning. One year earlier Balfe et al. assessed the diagnostic reliability of gastric wall thickening as observed on CT scan in adenocarcinoma, lymphoma and leiomyosarcoma and concluded that it is not a reliable finding. In contrast, however, Lee et al. recently emphasized that the wall thickness measurement on CT of exophytic carcinoma, myoma and ulcers was a useful diagnostic means. Thus, it appears that gastric wall thickening or mucosal heave-up is by itself not as reliable as the meniscus sign. The electronic search of world literature failed to disclose earlier report of this sign demonstrated by $^{18}F-FDG$ positron emission tomography and computed tomography (PET/CT). The present communication documents $^{18}F-FDG$ PET/CT finding of the meniscus sign as encountered in a case of ulcerating gastric carcinoma, the histological diagnosis of which was moderately differentiated tubular adenocarcinoma. Unlike most gastric tumors without ulceration that tend to unimpressively accumulate $^{18}F-FDG$ the present case of Borrmann type III gastric carcinoma demonstrated markedly increased $^{18}F-FDG$ uptake.

Neuroendocrine Tumor of Unknown Primary Accompanied with Stomach Adenocarcinoma

  • Kim, Ho-Yeun;Choi, Sung-Il;Kim, Young-Ho
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.234-238
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    • 2011
  • A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close followup. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

  • Kim, Myojeong;Lee, Eun Ji;Hwang, Jiyoung;Hong, Seong Sook;Chang, Yun-Woo;Oh, Eunsun;Nam, Bo Da;Choi, Inho;Kim, Jeong Sig
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.4
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    • pp.367-373
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    • 2019
  • Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.