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Lymphomatoid granulomatosis is a rare extranodal Epstein-Barr virus-driven B-cell lymphoproliferative disease, involving predominantly lung, less often skin, kidney, and central nervous system. Here, we present a pediatric case with primary immunodeficiency, diagnosed with pathologically proven pulmonary grade-III lymphomatoid granulomatosis.18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging demonstrated18F-FDG avid pulmonary masses with central air-bronchograms and cavitations. Although the definitive diagnosis depends on biopsy,18F-FDG PET/CT serves as a complementary imaging tool to evaluate the extent of the disease and response to treatment.

Langerhans cell histiocytosis (LCH) is a rare disease that occurs mainly in pediatric patients and most adult LCH is considered a part of multisystem or multifocal disease. Only 7.3% of cases present as unifocal bone lesion. Herein, we present a case of an isolated scapular lesion of LCH in a 48-year-old man Langerhans hücreli histiyositoz (LHH), çoğunlukla pediatrik hastalarda ortaya çıkar ve yetişkin LHH genelikle multisistem veya multifokal hastalığın bir parçası olarak görülen nadir bir hastalıktır. Olguların sadece %7,3’ü tek odaklı kemik lezyonu olarak karşımıza çıkmaktadır.

Nasolacrimal duct obstruction (NLDO) is a rare complication after radioiodine therapy and may cause false positive 131I uptake at the point of obstruction in 131I whole body scan. Here, we report a 59-year-old female patient with papillary thyroid cancer treated with total thyroidectomy followed by 131I therapy. 131I whole body scan revealed focal uptake in the head. Single photon emission computed tomography/computed tomography (CT) showed focal uptake at the right proximal nasolacrimal duct. The ophthalmologic examination and the diagnostic maxillofacial CT confirmed the diagnosis of NLDO. Nazolakrimal kanal tıkanıklığı (NLKT), radyoiyot tedavisi sonrası nadir görülen bir komplikasyondur ve 131I tüm vücut tarama sintigrafisinde tıkanma noktasında yanlış pozitif 131I tutulumuna neden olabilir. Burada, 59 yaşında papiller tiroid kanserli, total tiroidektomi ve ardından 131I tedavisi uygulanan bir kadın hasta sunuldu. 131I tüm vücut tarama sintigrafisinde kafada odaksal bir 131I tutulumu izlendi. Tek foton emisyon tomografisi/ bilgisayarlı tomografi (BT) sağ nazolakrimal kanal proksimal kesiminde fokal 131I tutulumu gösterdi. Oftalmolojik muayene ve tanısal maksillofasiyal BT, NLKT tanısını doğruladı.

OBJECTIVE We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib.METHODS Computed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed. Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of height, was used to define sarcopenia with < 52.4 cm2/m2 for males and < 38.5 cm2/m2 for females. Cox hazard models were conducted to determine predictors of survival.RESULTS The study included 30 patients, and 11 (36.7%) were sarcopenic. All-grade and Grade 3 toxicities were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%, p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3). Response rates were 63.6% in sarcopenic and 68.4% in non-sarcopenic patients (p=0.789). Median progression-free survival was 7.9 and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561). However, median overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8 vs. 30.2 months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis (Hazard ratio=2.63, p=0.029).CONCLUSION Early recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant NSCLC patients treated with first-line erlotinib.

Objectives: Somatostatin is an endocrine peptide hormone that regulates neurotransmission and cell proliferation by interacting with G protein-coupled somatostatin receptors (SSTRs). SSTRs are specific molecular targets of several radiotracers for neuroendocrine tumor (NET) imaging. Gallium-68 (68Ga)-DOTA-TATE is widely used for positron emission tomography/computed tomography (PET/CT) imaging of SSTRs and has shown a higher affinity for SSTR2, the most common SSTR subtype found in NETs. We aimed to analyze the distribution pattern of 68Ga-DOTA-TATE in normal subjects. Methods: A total of 617 consecutive 68Ga-DOTA-TATE PET/CT whole-body scans performed in our department from May 2015 through April 2020 with known or suspected neuroendocrine malignancies, mostly to evaluate adrenal adenomas, were retrospectively analyzed by 2 nuclear medicine physicians. One hundred eighteen subjects without a diagnosis of NET, with no tracer avid lesion of NET on 68Ga-DOTA-TATE PET/CT, and followed up for at least 6 months (average 2-3 years) without any biochemical, clinical, or imaging findings suggestive of NET were included in this study. Results: The highest uptake of 68Ga-DOTA-TATE was noted in the spleen followed by the kidneys, adrenal glands, liver, stomach, small intestine, prostate gland, pancreas head, pancreas body, thyroid gland, and uterus, in descending order. Minimal to mild uptake was detected in the submandibular glands, parotid glands, thymus, muscles, bones, breast, lungs, and mediastinum. Conclusion: Our study shows the biodistribution pattern of 68Ga-DOTA-TATE in normal subjects and the ranges of the maximum standard uptake value (SUVmax) and SUVmean values of 68Ga-DOTA-TATE obtained in several tissues for reliably identifying malignancy in 68Ga-DOTA-TATE PET/CT studies.

© 2022 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.Caudal regression syndrome (CRS) or sacral agenesis is a rarely seen malformation with a varying degree of structural abnormalities, including multiorgan system dysfunctions, reported with higher incidence among children of mothers with diabetes, as in this case. Spinal anomalies can range from coccyx hemiagenesis to the total absence of lower lumbar vertebrae and sacrum in most severe cases. Herein, we have presented a 9-year-old patient with CRS who had renal failure. Technetium-99m dimercaptosuccinic acid renal scintigraphy revealed bilaterally non-functioning kidneys with no renal cortical uptake. Renal anomalies in CRS with vertebral, anorectal, cardiac, trachea-esophageal, renal, and limb anomalies association include one-sided renal agenesis, multicystic dysplastic kidneys, and ureter duplications. Kaudal regresyon sendromu (KRS) veya sakral agenezi, çoklu organ sistemlerini etkileyen, yapısal anomaliler ile seyreden ve olgumuzda olduğu gibi diyabetik annelerin çocukları arasında daha yüksek sıklıkta görülen nadir bir malformasyondur. Vertebral anomaliler koksiksin kısmi agenezisinden ağır olgularda sakral ve/veya lomber vertebraların total agenezisine kadar değişebilmektedir. Burada, teknesyum-99m DMSA böbrek sintigrafisinde bilateral kortikal aktivite tutulumu izlenmeyen, non-fonksiyonel böbrekler saptanan KRS tanılı 9 yaşında bir pediatrik vaka sunulmaktadır. Tek taraflı renal agenezi, multisistik displastik böbrekler ve toplayıcı sistem duplikasyonları gibi renal anomaliler KRS ile vertebral, anorektal, kardiyak, trakeoözafagial, renal ve ekstremite anomalileri birlikteliğinde görülebilmektedir.

Objectives: Our aim is to investigate the prognostic value and effect on chemotherapy toxicity of pre-treatment sarcopenia determined with positron emission tomography/computerized tomography(PET/CT) in patients with ampullary carcinoma. Methods: Characteristics of patients retrieved retrospectively. Skeletal muscle area(SMA) measurement of the muscle at L3 vertebra level was evaluated for each patient from their PET/CT scan taken at the time of diagnosis. The sex-specific cut-off levels for determining sarcopenia were

Langerhans' cell histiocytosis (LCH) is a rare disease observed in childhood characterized by the proliferation of Langerhans' cells resulting in focal or systemic manifestations (including the bones). Here, we present a pediatric case with a localized biopsy-proven LCH, who underwent progression from solitary to multifocal form detected on bone scintigraphy and single photon emission computerized tomography/computed tomography (SPECT/CT) performed within four months. Emphasizing on localized bone pain (predictive of osseous LCH) and local tenderness and swelling usually guides the nuclear physician to perform additional SPECT/CT with presumably an improvement of the diagnostic accuracy as demonstrated in our case.

Pituitary carcinomas are extremely rare and aggressive tumors that comprise only 0.2% of all pituitary tumors. Because of its rarity, pituitary carcinomas are difficult to diagnose. Conventional imaging methods are inadequate to detect metastatic lesions. Pituitary carcinomas are neuroendocrine tumors and express somatostatin receptors; therefore, Ga-68-DOTATATE PET/CT may be used in the staging of these rare tumors. Herein, we present an exceptional case of pituitary carcinoma with sclerotic skeletal metastases showing Ga-68-DOTATATE uptake.

Objectives: Somatostatin is an endocrine peptide hormone that regulates neurotransmission and cell proliferation by interacting with G protein coupled somatostatin receptors (SSTRs). SSTRs are specific molecular targets of several radiotracers for neuroendocrine tumor (NET) imaging. Gallium-68 (Ga-68)-DOTA-TATE is widely used for positron emission tomography/computed tomography (PET/CT) imaging of SSTRs and has shown a higher affinity for SSTR2, the most common SSTR subtype found in NETs. We aimed to analyze the distribution pattern of Ga-68-DOTA-TATE in normal subjects. Methods: A total of 617 consecutive Ga-68-DOTA-TATE PET/CT whole-body scans performed in our department from May 2015 through April 2020 with known or suspected neuroendocrine malignancies, mostly to evaluate adrenal adenomas, were retrospectively analyzed by 2 nuclear medicine physicians. One hundred eighteen subjects without a diagnosis of NET, with no tracer avid lesion of NET on Ga-68-DOTA-TATE PET/CT, and followed up for at least 6 months (average 2-3 years) without any biochemical, clinical, or imaging findings suggestive of NET were included in this study. Results: The highest uptake of Ga-68-DOTA-TATE was noted in the spleen followed by the kidneys, adrenal glands, liver, stomach, small intestine, prostate gland, pancreas head, pancreas body, thyroid gland, and uterus, in descending order. Minimal to mild uptake was detected in the submandibular glands, parotid glands, thymus, muscles, bones, breast, lungs, and mediastinum. Conclusion: Our study shows the biodistribution pattern of Ga-68-DOTA-TATE in normal subjects and the ranges of the maximum standard uptake value (SUVmax) and SUVmean values of Ga-68-DOTA-TATE obtained in several tissues for reliably identifying malignancy in Ga-68-DOTA-TATE PET/CT studies.