Human Immunodeficiency Virus
John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie in Basic Sciences Endocrine Surgery Rhinology, 2018
Facial nerve dysfunction should lead the physician to suspect a malignant neoplasm. Fine-needle aspiration reveals fluid with lymphocytes and squamous epithelial cells. Computed tomography or ultrasound imaging will show multiple thin walled cysts in the parotid gland. With fine-needle aspiration biopsy (FNAB) and imaging, open biopsies or surgical excision for diagnosis is rarely indicated. The cysts usually resolve with HAART and surgery is only necessary for enlarged lesions that are a cosmetic challenge or where the diagnosis is equivocal. Needle aspiration of cyst contents is ineffective for long-term cure as recurrence almost always happens.31 In patients not receiving HAART, slerotherapy with alcohol or sodium morrhuate can be effective.32, 33
Multifocal Branch Duct Intraductal Papillary Mucinous Neoplasm with 3 cm Lesion in Head of Pancreas
Savio George Barreto, Shailesh V. Shrikhande in Dilemmas in Abdominal Surgery, 2020
A 55-year-old woman presented to a local hospital with abdominal pain. An abdominal ultrasound was advised that revealed a 3 cm cystic mass in the head of pancreas. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scans were performed which showed three cystic lesions in the pancreatic head (34 mm), body (5 mm), and tail (8 mm) with a maximal main pancreatic duct diameter of 2.4 mm (Figure 39.1). The serum carbohydrate antigen (CA) 19-9 level was 15.4 U/mL and carcinoembryonic antigen was 2.2 mg/dL. The patient had no significant personal or family history neither for pancreatic, nor other malignancies. Her abdominal pain was treated with simple analgesia. An endoscopic ultrasound was performed which confirmed the findings noted on cross-sectional imaging. No solid components were identified in the cyst. A fine-needle aspiration was performed. Cystic fluid carcinoembryonic antigen was 400 ng/mL. Based on all the investiagtions, the patient was diagnosed as a case of multifocal branch duct type intraductal papillary mucinous neoplasm for which a total pancreatectomy was recommended. She was referred to our hospital for a second opinion regarding the management of her lesions.
FDG PET/CT Imaging: Clinical Uses and Opportunities
Martin G. Pomper, Juri G. Gelovani, Benjamin Tsui, Kathleen Gabrielson, Richard Wahl, S. Sam Gambhir, Jeff Bulte, Raymond Gibson, William C. Eckelman in Molecular Imaging in Oncology, 2008
Evaluation of solitary pulmonary nodules is a very common clinical problem. The differential diagnosis of a pulmonary nodule is quite extensive with significant overlap in imaging appearance between benign and malignant lesions. Lung biopsies are technically difficult and are associated with significant morbidity due to a risk of pneumothorax and bleeding. While fine needle aspiration biopsy can be relatively safe, it can suffer in diagnostic accuracy due to sampling error issues. In a study by Yi et al., FDG PET/CT was significantly more accurate (93% vs. 85%; p = 0.011) than CT alone for evaluation of solitary pulmonary nodules (8). The authors concluded from their findings that PET/CT should be the test of choice for characterizing lung nodules. Potential pitfalls include increased FDG uptake on PET can be seen with both tumor and inflammation. False-negative PET can be seen on non-FDG avid, or only modestly FDG avid, tumors like BAC and carcinoid tumors. Another source of false-negative exams is small size of the nodule (8 mm is the typical clinical resolution of PET) and respiratory motion. However, recent developments of respiratory gating techniques and faster 3D acquisitions have improved evaluation of smaller lesions. Certainly, PET should be considered in the work up of pulmonary nodules 8 mm and larger in size and may be useful, if positive, in smaller lesions.
Radiotherapy for Orbital Pseudotumor: The University of Florida Experience
Published in Cancer Investigation, 2018
Meriem Mokhtech, Sommer Nurkic, Christopher G. Morris, Nancy P. Mendenhall, William M. Mendenhall
Definitive diagnosis of OP is based typically on clinical presentation, symptom duration, imaging, and pathology. Radiographically, OP appears nonspecific as a focal or diffuse process involving enlarged extraocular muscles, optic nerve thickening, and enhancement with iodinated contrast or gadolinium (6). Biopsy is indicated in patients with persistent or recurrent disease. Fine-needle aspiration can be used for accessible lesions to make a tissue diagnosis and assess response to treatment (7). On histology, OP is seen as an inflammatory process with infiltration of immature lymphoid cells as well as granulomatous and sclerosing changes (8). Lymphoid follicles, small mature lymphocytes, plasma cells, neutrophils, eosinophils, and macrophages may be present (9). The differential diagnosis can include infection, sarcoidosis, granulomatosis with polyangiitis (previously Wegner’s granulomatosis), Sjogren’s disease, connective tissue disease, or malignancy (4).
Substantial intrinsic variability in chemoradiosensitivity of newly established anaplastic thyroid cancer cell-lines
Published in Acta Oto-Laryngologica, 2020
Sigurdur Gretarsson, Alexander Nygren, Ann H. Rosendahl, Nektaria Mylona, Elisabeth Kjellén, Yuesheng Jin, Kajsa Paulsson, Åke Borg, Eva Brun, Jan Tennvall, Anders Bergenfelz, Lennart Greiff, Johan Wennerberg, Lars Ekblad
Tissue sampling was performed with conventional fine-needle aspiration technique using a 0.6–0.7 mm needle. The aspirates were directly transferred to R10 medium, i.e. RPMI 1640 with stable glutamine supplemented with 1.0 mmol/L sodium pyruvate, minimum essential medium (MEM) non-essential amino acids, 20 µg/mL gentamicin, and 10% foetal bovine serum all from GE Healthcare (Piscataway, NJ). The suspensions were immediately transferred into cell culture flasks and left to attach and grow at 37 °C under a humidified atmosphere with 5% CO2. The ATC cells grew faster than the fibroblasts and detached from the surface. Therefore, the cancer cells could be sequentially transferred into new flasks without trypsin treatment until visibly free from fibroblasts. The average time from initial seeding to established cell line was 4–5 months (Table 1). In the subsequent experiments, the cell lines were always analysed at passage numbers below 20. Mycoplasma tests were negative for all cell lines.
Thyrotoxicosis secondary to thyroiditis following SARS-CoV-2 infection
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2021
Ankia Coetzee, Raisa Bhikoo, Bianca Berndorfler, Wilhelmina Conradie, Jantjie J Taljaard, Marli Conradie-Smit
Thyroid scintigraphy is an important imaging modality in the evaluation of thyrotoxic patients and allows for the differentiation of hyperthyroidism from other causes of thyrotoxicosis. In cases of Graves’ disease, or nodular thyroid disease with autonomous function, various patterns of increased uptake are seen. In the early thyrotoxic phase of subacute thyroiditis, decreased or absent uptake is observed.8 It can be confirmed semi-quantitatively by calculating the percentage of thyroid uptake. Differential diagnoses to consider with decreased or absent thyroid uptake in the context of thyrotoxicosis include other types of thyroiditis (subacute thyroiditis, amiodarone-induced thyroiditis, acute thyroiditis), iatrogenic or factitious thyrotoxicosis (due to exogenous thyroxine) and ectopic hyperfunctioning thyroid tissue.9. The role of thyroid ultrasound in diffusely enlarged thyroid glands is to exclude pathology undetectable on clinical examination and, in the case of a painful gland, the exclusion of suppurative thyroiditis. It also enables fine-needle aspiration if malignancy is suspected. The characteristics in subacute thyroiditis include patchy poorly circumscribed hypoechoic areas with decreased vascularity on doppler.10 Lee categorises these changes into nodular, non-nodular and mixed subtypes that can be focal or multifocal, unilateral or bilateral.11 These findings can overlap with malignancy and other forms of thyroiditis, therefore clinical correlation is of utmost importance. Most changes normalise after one year, but nodular change might persist.10
Related Knowledge Centers
- Biopsy
- Cytopathology
- Histopathology
- Hypodermic Needle
- Microscope
- Surgery
- Sampling
- Staining
- Surgeon
- Radiology