Search

Situs inversus is a rare condition in which transposition of the viscera occurs in the thorax and abdomen. While this condition may be associated with mild to severe multi-organ anomalies, patients may occasionally be completely asymptomatic. We present a case where this condition was incidentally detected during scintigraphic assessment of gastric emptying.

A 35-year-old Asian male presented with complaints offever, right-sided pleuritic chest pain and shortness ofbreath of 7 days’ duration, 1 month after a rightpercutaneous nephrolithotomy (PCNL) by supracostalpuncture. On examination, the patient was pale andtachypnaeic with pulse 120/min and blood pressure150/100mm Hg. He had stony dullness with decreasedbreath sounds in the right mammary, axillary andinterscapular areas.A chest radiograph demonstrated massive right-sided pleural effusion. Thoracocentesis of the rightside of the chest yielded about 900ml of pleuralfluid, analysis of which revealed a pleural fluid:serum creatinine ratio of 58 (normal

Purpose Sonographically guided percutaneous ethanol injection has been used for treating benign thyroid nodules. The side effects include mild local pain in all patients and transient vocal cord palsy and venous thrombosis in sporadic cases.Sodium tetradecyl sulfate (STS) is an alternate sclerosant but has not been used for treating thyroid nodules. The purpose of this study was to compare the efficacy of percutaneous STS with ethanol injection in benign thyroid nodules in patients with colloid goiter. Materials and Methods After obtaining institutional review board approval, 50 euthyroid patients with cytologically proven benign thyroid nodules were prospectively randomized into two groups; 20 in the ethanol arm and 30 in the STS arm. The patients were matched with respect to age, gender and nodule consistency (solid, cystic and mixed solid cystic). The mean volume of the nodule was 25.58cc (range 4-122.10 cc) in the ethanol arm and 25.39cc (range 0.72-129 cc) in the STS arm. Percutaneous instillation of sclerosant was done once in 20 patients while multiple injections were given in 30 patients. The mean volume of ethanol and STS instilled per sitting was 5.33cc and 7.85cc respectively. Follow-up sonography of the thyroid gland was done at 1,3,6 and 12 months after the last instillation and the volume of the nodules was recorded. Results The final mean volume of the nodules at 12 months was 4.07cc (range 0.34-15.18cc) and 4.36cc (range 0.01-29.57cc) in the ethanol group and the STS group respectively (p=0.846). The mean volume reduction was 84% and 82.86% in the two groups. Greater than 50% volume reduction was seen in 80% and 76.7% patients in the ethanol group and the STS group respectively (p=0.33). Mild overlying tissue necrosis occurred in one patient in the STS group. However, the degree of local pain experienced was less in all the patients in this group. No other significant adverse effects were seen in either of the two groups. Conclusion Sonographically guided percutaneous STS and ethanol instillations are not significantly different from each other in terms of the volume reduction of the benign thyroid nodules. STS may be used as an alternate sclerosing agent in such nodules.

Background: Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. Materials and Methods: We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. Results: All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Conclusion: Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa.

Purpose of the Study: To study quality control parameters of routinely prepared positron emission tomography (PET) radiopharmaceuticals. Materials and Methods: Three PET radiopharmaceuticals fluorine-18 fluorodeoxyglucose (F-18 FDG), N-13 ammonia (N-13 NH 3 ), and Ga-68 DOTATATE ( n = 25 each), prepared by standardized protocols were used. The radionuclide purity, radiochemical purity, residual solvents, pH, endotoxins, and sterility of these radiopharmaceuticals were determined. Results: The physical half-life of radionuclide in radiopharmaceuticals, determined by both graphical and formula method, demonstrated purity of radionuclides used. pH of all PET radiopharmaceuticals used was in the range of 5-6.5. No microbial growth was observed in radiopharmaceutical preparations. The residual solvents, chemical impurity, and pyrogens were within the permissible limits. Conclusions: All three PET radiopharmaceuticals were safe for intravenous administration.

Introduction: Treatment of cervical cancer is usually surgery in the early stages and radiotherapy or chemoradiotherapy in more advanced stages of the disease. Recurrence may occur in multiple sites following primary treatment. Although recurrent metastatic disease is not curable, surgical treatment may be of great help if locoregional recurrence is detected early. Fluorine-18 Fluorodeoxyglucose positron emission tomography - computed tomography (F-18 FDG PET/CT) forms an important part of investigations in the diagnosis of clinically suspicious recurrent cervical cancer. Objective: To assess the role of F-18 FDG PET/CT in diagnosing recurrence in patients with clinical suspicion of recurrent cervical cancer. Materials and Methods: We retrospectively evaluated 53 histopathologically proved patients of cervical cancer. All the patients had been treated with either surgery/radiation therapy with or without chemotherapy. The standard PET/CT acquisition protocol, with delayed post void static pelvic images, wherever required, was followed in all patients. Significant uptake of FDG in the lymph nodes was considered to be a recurrence suggestive of metastasis. Para-aortic lymph nodal involvement was considered to be distant metastasis. Any significant uptake in the lung nodule on FDG PET was evaluated either by histological confirmation, by taking fine needle aspiration cytology (FNAC), or by a follow-up chest CT done after three months. Results: Of the 53 patients with clinically equivocal recurrence, FDG PET/CT suggested recurrence in 41 patients (local recurrence in 14 patients and distant recurrence/metastasis with or without local recurrence in 27 patients). It had a sensitivity of 97.5%, a specificity of 63.6%, positive predictive value of 90.9%, and negative predictive value of 87.5%. Conclusion: PET/CT appears to have an important role in detecting recurrence following primary treatment of cervical cancer. The high positive and negative predictive values of PET/CT may be helpful in planning management of recurrent cervical cancer.

The authors describe a 50 days old pre-term infant with persistent hyperinsulinemic hypoglycemia of infancy in whom Ga-68 DOTATATE positron emission tomography/computerized tomography scan showed diffusely increased tracer uptake in the entire pancreas with no abnormal tracer uptake anywhere else in the body, suggestive of a diffuse variant of nesidioblastosis.

A primitive neuroectodermal tumor (PNET) of the thoraco-abdominal region is one of a group of small round cell tumors usually found in children and young adults, originally described by Askin et al. Most cases arise in the soft-tissues of the thorax, but may rarely occur within the lung with the symptoms of chest wall pain, pleural effusion and dyspnea. The authors present two cases demonstrating the utility of F18 fluorodeoxyglucose positron-emission tomography/computed tomography in the staging and prognosis of PNET of the chest wall.

Skeletal muscle metastasis as the initial presentation of the unknown primary lung cancer is unusual. A 65-year-old male patient presented with pain and swelling of the right forearm. Fine needle aspiration of the swelling revealed metastatic squamous cell carcinoma. The patient underwent whole body F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to identify the site of the primary malignancy. The authors present PET/ CT images showing FDG-avid metastases to the skeletal muscles along with a previously unknown primary tumor in the right lung, in a patient presenting with initial muscular symptoms without any pulmonary manifestations.

Introduction: Complex regional pain syndrome (CRPS) is primarily a clinical diagnosis. Diagnostic imaging in CRPS can be used, especially to exclude other disorders. The sensitivity and specificity of three phase bone scintigraphy (TPBS) for the diagnosis of CRPS is variable throughout the literature. Aim: To establish a simple and effective quantitative approach to help in the diagnosis of CRPS by TPBS. Materials and Methods: TPBS done in patients (n = 68) with suspected CRPS was analyzed retrospectively. They were classified into bone scan positive group (BSP), bone scan negative group (BSN) and non-CRPS group based on diffusely increased periarticular uptake, symmetrical uptake, and focal uptake respectively. Asymmetry score (AS) was also measured between the affected and unaffected side. Results: 16 patients showed focal uptake, 37 were in BSP group with mean AS score of 1.57 ± 0.5 and 15 were in BSN group with mean AS score of 1.01 ± 0.05. The mean AS was significantly different (P < 0.0001). AS of 1.06 had sensitivity and specificity of 96.43% and 100% respectively (P = 0.0001). There was a trend of negative correlation between the AS and the duration, r = −0.21; however, it was not statistically significant (P = 0.28). Conclusion: TPBS should be considered in the evaluation of CRPS to rule out patients who have focal involvement, not diagnostic of CRPS (~24% in this study). Quantitative AS of 1.06 can be included to support visual interpretation in the delayed phase.

Eighty-six hypertensive patients with clinical suspicion of renovascular hypertension (RVH) were evaluated by captopril renal scintigraphy (CRS) and intra-arterial digital subtraction angiography (IADSA) to determine the usefulness of CRS in the diagnosis of RVH and to predict the outcome of revascularization procedures. Technetium 99m-diethlenetriaminepentaacetic acid (DTPA) renal scintigraphy was performed on 2 consecutive days before and after captopril administration. Captopril renal scintigraphy was considered positive if there were changes in the time activity curve according to the criteria specified by the American Society of Hypertension working group. Captopril renal scintigraphy data were compared with presence or absence of anatomic renal artery stenosis (RAS). Of 86 hypertensive patients investigated, 45 had RAS. Aortoarteritis was the cause of RAS in 40 (89%) patients. Revascularization was done in 25 patients, and response to revascularization was compared with that of captopril renography. Compared with IADSA, CRS showed a sensitivity of 82.8% and a specificity of 98.2%. Fourteen patients had bilateral RAS on IADSA. In these patients, CRS was suggestive of bilateral disease in seven patients, unilateral in four, and negative in three. Comparison of CRS with the results of revascularization showed a sensitivity and specificity in detecting curable RAS (RVH) of 95% and 100%, respectively (positive predictive value, 100%; negative predictive value, 85%). In conclusion, we found CRS to be useful in the diagnosis of RVH due to aortoarteritis.

Demonstration of peritoneopleural communication in patients with cirrhotic ascites has an important impact on treatment planning. We studied 12 such patients and found presence of peritoneopleural communication in five. Two had bilateral, one right-side and two left-side, pleural effusion. Pleural fluid protein content was less than 2 g/dL in all patients.

A case of left-sided diaphragmatic hernia associated with congenital aplasia/agenesis of the left lobe (left lateral segment) of the liver is reported. This association of defects, to the best of the authors' knowledge, has not been reported previously.

100%, 93.3%. The sensitivity of Level 1 and Level 2 ductal finding was 93.5%, 95%. The accuracy, sensitivity, and specificity of Level 1 serology were 70.4%, 63%, and 94.1%, respectively. The accuracy, sensitivity, and specificity of Level 2 serology were 22.5%, 27.8%, and 5.9%, respectively. Level 1 other organ involvement (OOI) for Type 1 AIP were 12 patients (21.4%), Level 2 OOI for Type 1 AIP were 13 patients (23.2%), and Level 2 OOI for Type 2 AIP was 1 patient (50%). Level 1 histology for Type 1 AIP was 11 patients, and Level 1 histology for Type 2 AIP was 1 patient. All of patients received steroid therapy (100%) showed resolution or improvement of the pancreatic lesion or OOI clinically and morphologically. Conclusions ICDC is the most sensitive in 5 major criteria, and useful to diagnose and classify AIP with Type 1 and Type 2. However, further studies are necessary to investigate whether it is ideal or not with validation the Level 1 and Level 2.

The cyclotron is the most widely used particle accelerator for producing medically important radio nuclides. Many medical centers in India have installed compact medical cyclotrons for on-site production of short-lived positron-emitting radio nuclides such as 18 F, 13 N, and 11 C. A mandatory requirement for cyclotron installation is radiation control permit from Atomic Energy Regulatory Board. Cyclotron radiation survey is an integral part of the overall radiation safety in the cyclotron facility. Radiation surveillance in and around a newly installed cyclotron was performed using ionization chamber counter and Geiger Muller counter before, during and after operating the cyclotron. The readings were recorded at various locations where a high radiation field was expected. The results were recorded, tabulated and analyzed. The highest exposure level (0.93 μ Sv) was found at the back wall of the radiochemistry lab facing the cyclotron vault. Reason for the high exposure of 0.93 μ Sv/h: Synthesis of 18 F-Fluoro-Deoxy-Glucose ( 18 F-FDG) was going in the synthesis module and activity ( 18 F) was present in the synthesis module when reading was taken. All other values were found to be below the recommended levels of exposure.

A 42-year-old female patient with a past history of right breast cancer and recent onset swelling of the right forearm underwent routine whole-body bone scintigraphy with Tc-99m methylene diphosphonate, 2 years after a modified radical mastectomy. Diffuse soft tissue tracer concentration was seen in the right forearm. Subsequent lymphoscintigraphy using Tc-99m sulphur colloid revealed obstructed lymphatic drainage in the right upper limb.

We present the challenges in performing the stress test and acquisition of images in myocardial scintigraphy in a 54-year-old female patient with dextrocardia. Dextrocardia and situs inversus were documented on prior investigations including a chest roentgenogram and sonography.

Detection of recurrence of tumors with conventional imaging like computed tomography (CT) and magnetic resonance imaging (MRI) can be difficult because of distorted anatomy and implants in situ. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT has been shown to be very useful in detection of recurrent tumors with higher accuracy than conventional imaging method. Giant cell tumors of foot though rare have high recurrence potential after initial curative treatment. However, currently there is no literature addressing the role of F-18 FDG PET/CT in evaluation of these tumors. We report a case of post excisional recurrent giant cell tumor of foot diagnosed on F-18 FDG PET/CT. In addition, to detection of recurrence F-18 FDG PET/CT also aided in accurate management of the patient.

Dyspepsia is a common complaint in patients presenting with gallstone disease. Since the stomach appears to be its site of origin, the present study was undertaken to assess gastric emptying in patients with gallstone disease and to find out its correlation with dyspeptic symptoms before and after cholecystectomy. Gastric emptying (t1/2) was prospectively assessed in 43 patients with symptomatic gallstones (29 with and 14 without dyspepsia). These data were compared with that of 20 healthy volunteers (control group). Delayed gastric emptying (> 112 min: mean + 2 s.d. of the control group) was observed in 18 patients (42%; P < 0.002), 10 of whom presented with dyspepsia and eight without (NS). Re-evaluation in 18 of the 29 patients with dyspepsia, 3 months after cholecystectomy, revealed complete disappearance of symptoms in three, improvement in 11 and no change in four patients. After 6 months, two patients had reverted back to their pre-operative dyspeptic status; resulting in three patients completely cured, nine partially cured and six without any change in their dyspeptic status at this time. Gastric emptying was delayed in nine of the 18 patients before cholecystectomy. After cholecystectomy, normal emptying was observed in all but one patient (P < 0.005). Dyspeptic symptoms, however, completely disappeared in one patient, improved in five and remained unchanged in three. In the remaining nine patients, gastric emptying was normal both before and after cholecystectomy. Gallstone disease is associated with delayed gastric emptying but this delay was not the cause of dyspepsia in these patients. Cholecystectomy normalizes gastric emptying, a finding that has not been reported previously.(ABSTRACT TRUNCATED AT 250 WORDS)

Department of Pediatric Surgery, Post Graduate Medical Institute (PGIMER), Chandigarh 160012, India b Experimental Medicine and Molecular Biology, Post Graduate Medical Institute (PGIMER), Chandigarh 160012, India Department of Nuclear Medicine, Post Graduate Medical Institute (PGIMER), Chandigarh 160012, India Department of Pharmacology, Post Graduate Medical Institute (PGIMER), Chandigarh 160012, India

A 20-year-old woman presented with gradually increasing swelling of the left forearm for 3 years with accompanying pain for 2 months. There was no history of trauma to the forearm. Radiographs of the left forearm showed areas of extraosseous calcifications. Magnetic resonance imaging showed multiple nodular lesions with calcification within the muscles of the extensor compartment, suggestive of myositis ossificans (MO). The patient underwent PET/CT scans using [ 18 F]fluoride (a–c) and [ 18 F]fluorodeoxyglucose (FDG) (d–f) on 2 different days. Multiple areas of dense calcification were seen in the extensor muscles of the left forearm with intense [ 18 F]fluoride uptake in the adjacent soft tissues, indicating ongoing osteoblastic activity. FDG uptake was detected in a few of these regions, suggestive of active inflammation (myositis). Biopsy from this region confirmed the presence of extra-osseous bony fragments.

Diaschisis is the inhibition of function produced by focal disturbances in a portion of the brain at a distance from original site of injury. Many studies using brain SPECT (single-photon emission computed tomography) have demonstrated crossed cerebellar diaschisis (CCD) in patients with cerebral cortical infarct. We report a case of cerebrovascular accident involving the left middle cerebral artery territory. PET/CT performed one month after stroke showed hypometabolism in the left cerebral hemisphere with hypometabolism of the contralateral cerebellum. The finding of diminished glucose metabolism in the contralateral cerebellum represents CCD.

Osseous metastases from retinoblastoma, the most common ocular malignant neoplasm of childhood, are reported most commonly in the skull and long bones. However, metastases to forearm bones are very rare. Here we present a case of bilateral retinoblastoma with metastases to right forearm bones four years after the initial treatment.

Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.

F-18 fluoro-deoxyglucose (FDG) uptake in the thyroid and thymus is well reported in patients with Graves’ disease. Incidental skeletal muscle uptake has also been reported in other non-musculoskeletal (benign and malignant) pathologies. We report a patient of Graves’ disease showing symmetrical skeletal muscle uptake but no thyroidal or thymus uptake of FDG.

Aim: To determine whether F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) can be used to differentiate among common enhancing brain tumors such as gliomas, metastatic brain tumors, and lymphoma. Materials and Methods: We evaluated 20 patients with an enhancing brain tumor on magnetic resonance imaging (MRI). FDG PET scan was done in all patients pre operatively. For PET image analysis, regions of interest were placed over the tumor (T), contralateral cortex (C), and white matter (WM). Average and maximum pixel values were determined at each site. On the basis of these measurements, average and maximum standard uptake values (SUV avg and SUV max ) were calculated, and comparisons among lesions were then made. Results: SUVavg and SUVmax are significantly higher for central nervous system (CNS) lymphoma than for other tumors (P < 0.01). High-grade gliomas showed significantly higher SUVavg and SUVmax than the low grade gliomas (P < 0.05) and metastatic tumor showed higher SUVavg and SUVmax than all gliomas, both low and high grade (P < 0.05). When the lowest values of CNS lymphoma parameter were used as cutoff levels to distinguish CNS lymphomas from other tumors (i.e. 100% sensitivity), SUVmax was the most accurate parameter. Using a SUVmax of 15.0 as a cutoff for diagnosing CNS lymphoma, only one case of metastasis (SUV max , 16.3) was found to be false positive in this study. Conclusion: FDG PET appears to provide additional information for differentiating common enhancing malignant brain tumors, namely lymphoma versus high grade glioma and metastatic tumor, particularly when differential diagnoses are difficult to narrow using MRI alone.

A 60-year-old-woman presented with fever, mild jaundice, and an external biliary fistula following cholecystectomy. Her hospital course was complicated by worsening general condition, intractable diarrhea, and cessation of bile output from the fistula site. An ultrasonogram did not reveal any intra-abdominal collection. Hepatobiliary scintigraphy demonstrated a subhepatic bile leak communicating witin the hepatic flexure of the colon. On exploration, the hepatic flexure was adherent to the porta hepatis forming an inflammatory mass. Limited exploration with external drainage was performed. The patient succumbed to her illness on the 3rd postoperative day

A 22-year-old male patient suffered a grade IV liver injurywith haemoperitoneum in a roadside accident 2 monthsearlier, for which laparotomy and biliary stenting weredone. However, after a few days, the stent was passedduring defecation. A week later, the patient developedintractable cough with copious expectoration of greensputum. Chest X-ray showed right-sided pleural effusionwith consolidation in the right lower lobe. Sputumexamination confirmed the presence of bile, which raisedthe suspicion of a biliobronchial communication.[

The management protocol for differentiated thyroid cancer includes whole body iodine-131 imaging, to detect residual thyroid tissue and distant metastasis, after thyroidectomy. However, the diagnostic dose of radioiodine may fail to detect the non-functioning or poorly functioning metastasis. We present a case where hybrid single photon-emission computed tomographic and computed tomographic (SPECT-CT) fusion imaging, using a diagnostic dose of iodine-131, was able to detect both functioning as well as non-functioning pulmonary metastases, prior to high-dose radioiodine therapy.

Objective: To evaluate the role of computed tomographic (CT) pulmonary angiography (CT-PA) in detecting additional information that may help in making an alternative clinical diagnosis in patients referred to CT for a suspected acute pulmonary embolism (PE). Materials and Methods: 50 patients (34 males, 16 females) in the age group of 18-72 years (mean 42.3 years), having high clinical suspicion of PE, underwent CTPA over a 2 year period. Chest x-ray, arterial blood gas (ABG) analysis, echocardiography were done in all patients. All patients underwent at least one other imaging examination besides CTPA: ventilation perfusion scan, Doppler ultrasound or compression ultrasound (for DVT). All patients were followed for 3 months after completion of the diagnostic work up at baseline. The final diagnosis was achieved by a combination of clinical, imaging, and laboratory analysis, after adequate imaging, laboratory tests, and follow up. Result: CTPA helped correctly identify 29 of 30 patients with PE. In the remaining 20 patients (with no evidence of PE), CT-PA provided additional information (that suggested or confirmed alternate clinical diagnosis) in 15 patients (75%): pleural effusion (n=8), mediastinal or hilar lymphadenopathy (6), pneumonia/airspace consolidation (5), atelectasis/collapse (2), aspergilloma (1), malignancy (1), and others (2). Conclusion: CT-PA is highly specific and sensitive for diagnosis of PE. In addition, in a majority of patients who do not have PE, it also provides important ancillary additional information and helps in making an alternative clinical diagnosis.

A seven-year-old male child presented with swelling at the left temporal region. His skull X-ray was normal. A three-phase bone scan showed increased blood flow, soft tissue activity, and increased tracer concentration in the left temporal region. Single photon emission computed tomography (SPECT) imaging of the skull revealed full thickness involvement of the left temporal bone. Our case report shows that, in osteomyelitis of the skull, SPECT imaging provides significantly more information for identifying the extent and thickness of bone involvement.

Authors describe the incremental value of hybrid SPECT-CT in upstaging disease and changing the management strategy of a case of renal cell carcinoma

A 30-year-old woman was examined for a history of exertional breathlessness, swelling of her feet, and a mild dry cough of 4 to 5 months' duration. Her symptoms developed during the last month of her pregnancy, with gradually increasing dyspnea, swelling of the feet, and reduced urinary output. There was no history of expectoration, hemoptysis, chest pain, or tuberculosis. General physical examination showed no evidence of clubbing of the nails or lymphadenopathy. Chest auscultation revealed a few end-inspiratory crepitations at both lung bases. Bronchial alveolar lavage showed calcium particles, whereas results of the transbronchial lung biopsy were consistent with alveolar microlithiasis.

BackgroundClinical, biochemical, ultrasonographic, radionuclide and cytomorphological observations in Lymphocytic thyroiditis (LT), to define the cytological grading criteria on smears and correlation of grades with above parameters. MethodsThis prospective study was conducted on 76 patients attending the Fine needle aspiration cytology clinic of a tertiary care institute in North India. The various parameters like patients’ clinical presentation, thyroid antimicrosomal antibodies, hormonal profiles, radionuclide thyroid scan and thyroid ultrasound were studied. Fine needle aspiration of thyroid gland and grading of thyroiditis was done on smears. The grades were correlated with above parameters and the correlation indices were evaluated statistically. ResultsMost of the patients were females (70, 92.11%) who presented with a diffuse goiter (68, 89.47%). Hypothyroid features (56, 73.68%) and elevated TSH (75, 98.68%) were common, but radioiodide uptake was low or normal in majority of patients. Thyroid antimicrosomal antibody was elevated in 46/70 (65.71%) patients. Cytomorphology in fine needle aspirates was diagnostic of lymphocytic thyroiditis in 75 (98.68%) patients. Most of them had grade I/II disease by cytology. No correlation was observed between grades of cytomorphology and clinical, biochemical, ultrasonographic and radionuclide parameters. ConclusionDespite the availability of several tests for diagnosis of LT, FNAC remains the gold standard. The grades of thyroiditis at cytology however do not correlate with clinical, biochemical, radionuclide and ultrasonographic parameters.

1549 Background: Brain tumors are of diverse histological types, the most common being from glial tissue. The clinical management and prognosis of brain tumor patients is dependent on accurate neur...

The coexistence of a pituitary neoplasm and pheochromocytoma is a rare condition, which may be another undefined variant of Multiple endocrine neoplasia (MEN) syndrome. Moreover, the coexistence of pituitary macroadenoma and multiple paragangliomas is more uncommon and only few authors have reported these findings. We are reporting the use of Ga DOTATATE PET/CT in a rare case of coexisting pituitary macroadenoma and multiple paragangliomas.

We report a case of renal cell carcinoma detected to have isolated deltoid metastasis on 18F-FDG PET/CT 12 years after radical nephrectomy. Isolate muscle (deltoid) metastasis from renal cell carcinoma has not been reported in the literature.