67Ga uptake in secondary tumoral calcinosis

Secondary tumoral calcinosis is a rare disorder that is most prevalent in patients with chronic renal failure. It is characterized by lobular densely calcified masses confined to the soft tissue, generally at the extensor surface of a joint in the anatomic distribution of a bursa. We describe a case of a 38-y-old man undergoing dialysis who presented with pyrexia of unknown origin and raised inflammatory markers but was otherwise asymptomatic. A (67)Ga scan was performed, on which an incidental diagnosis of secondary tumoral calcinosis was made.     

Periarticular tumoral calcinosis and hypercalcemia in a hemodialysis patient without hyperparathyroidism: a case report

We present a case of a 58-yr-old male to illustrate the scintigraphic, roentgenographic, clinical, and pathologic features of periarticular tumoral calcinosis that occurred in a hemodialysis patient. Soft-tissue calcifications developed 3 yr after onset of hemodialysis, became progressively larger during the ensuing five years, and culminated in voluntary withdrawal from dialysis because of the extreme discomfort and lack of mobility that resulted from the calcinosis. Histologically, an aplastic disorder was present with very low bone formation. On bone scintigraphy, intense calcium uptake in soft tissues implied that it was metabolically active. We hypothesize that this high metabolic activity contributed to the persistent hypercalcemia observed during the patient's last year of life.     

Tumoral calcinosis causing bone erosion in a renal dialysis patient.

Tumoral calcinosis is a rare disorder manifest by large calcific periarticular masses. Associated bone destruction has been described previously only once. The radiographic and computed tomographic (CT) findings of bone erosion in a case of tumoral calcinosis in a renal dialysis patient are presented. Although the presence of bone destruction may suggest a neoplasm, it does not exclude the diagnosis of tumoral calcinosis.     

Peritoneal calcifications in a patient on continuous ambulatory peritoneal dialysis

Complications in a long-term ambulatory peritoneal dialysis patient are described.     

Radiography and scintigraphy in tumoral calcinosis.

A case of tumoral calcinosis with tumoral deposits about the knee is reported. Radiographs demonstrate juxta-articular calcific deposits about the right second and fifth distal interphalangeal joints and the left first distal tuft, both hips, both shoulders, first distal phalanx of the left foot and right knee. Radionuclide images clearly demonstrate all areas of tumoral calcinosis.     

Iodine-131 ablation therapy for a patient receiving peritoneal dialysis

The authors describe a patient with follicular thyroid carcinoma who was receiving continuous ambulatory peritoneal dialysis to manage end-stage renal disease. To deliver radioiodine therapy to ablate thyroid remnants safely and under optimal conditions, the behavior of 37 MBq (1 mCi) I-131 was followed daily for 3 days. Blood activity and total body count decreased with a half-life of 100 hours (4.17 days). The daily iodide removal rate, estimated as a percentage of the total administrated activity, was low: 5.3% to 8.6% in peritoneal dialysate and 1.3% to 2.2% in urine. The thyroid uptake, measured using a probe, was 2.4% to 2.1% from day 1 to day 3 and 1.9% later at day 8. The volume of thyroid remnants was determined by ultrasonography to be 0.6 g. The patient received a reduced ablative I-131 dose of 814 MBq (22 mCi). Radiation emitted from the patient after I-131 therapy, monitored using a radiation monitor probe located at a distance of 1 meter, decreased with an effective half-life of 70 hours (2.9 days). The integration of the curve from t = 0 showed a level always less than 25 microSv/hour as early as 24 hours after treatment. Because the iodine removal rate is continuous but low in a case of peritoneal dialysis, smaller therapeutic doses must be administered to deliver maximal radiation to residual thyroid tissue while minimizing excessive radiation exposure to patients, their families, and medical staff.     

Evaluation of scrotal edema in a patient on peritoneal dialysis. A case report

A 50-year-old man placed on peritoneal dialysis for end stage renal disease developed unilateral (left) scrotal edema following infusion of dialysis fluid into the peritoneum. The left side of the scrotum and left inguinal canal were surgically explored and a left hydrocele was removed. Following surgery, the patient again demonstrated left scrotal edema during peritoneal dialysis. Tc-99m MAA (5.0 mCi, 185 mBq) was injected into a 2-liter bag of dialysis fluid, which was subsequently infused into the peritoneum. The communication between the peritoneal cavity and the left inguinal canal was demonstrated.     

Pericatheter leak in a peritoneal dialysis patient: SPECT/CT diagnosis

A 62-year-old patient with end-stage renal disease who is managed with continuous ambulatory peritoneal dialysis developed anterior abdominal wall swelling and pain that extended from just above peritoneal catheter site caudally. CT of the abdomen suggested pericatheter abscess with panniculitis. Tc-99m sulfur colloid peritoneal distribution planar scintigraphy suggested the diagnoses of pericatheter leak. The addition of SPECT/CT confirmed the latter diagnosis and pinpointed the exact location of the peritoneal leakage that was around insertion site. SPECT/CT was useful in establishing unequivocal diagnosis of peritoneal leak.     

Peritoneal-scrotal dialysate leakage demonstrated on SPECT/CT imaging in a patient on peritoneal dialysis

A 62-year-old male with end-stage renal failure on peritoneal dialysis presented with sudden onset scrotal swelling following a violent coughing fit. He was referred for a peritoneal leak study to evaluate the scrotal swelling. This case illustrates the benefit of SPECT/CT imaging in the diagnosis and anatomic localization of peritoneal leakage as a complication of peritoneal dialysis.     

Effect of uremia and peritoneal dialysis on peritoneal mesothelial cells

The aim of the study was to investigate the morphology of mesothelial cells of the peritoneum of patients with terminal renal failure (TRF), taken by the biopsy immediately before the onset of peritonal dialysis (PD), and to compare it with the findings in patients with PD. The samples were prepared in the way standard for light microscopy and transmission electron microscopy. In patients with TRF intracytoplasmatic inclusions could be observed, unusual protrusions of mesothelial apical surfaces, deformation of mesothelial cells and their detachment from the basal membrane, as well as the dilatated cisternae of granulated endoplasmatic reticulum with filamentous structures in some of them. In patients on PD cytoplasmic protrusions of different shapes and contents were observed at the surface of mesothelial cells, multiplication of basal membrane, occurrence of young forms of mesothelial cells as well as the detachment of those cells from the basal lamina.     

肿瘤样钙质沉着症影像表现（附1例报告并文献复习）

目的：认识肿瘤样钙质沉着症X线及CT特征表现,提高影像诊断正确率。方法回顾分析1例双下肢肿瘤样钙质沉着症患者的X线、CT影像表现及临床资料,并复习相关文献。结果患者双髋关节、双膝关节周围及大腿肌群软组织内见“卵石样”、“桑葚状”大小不一分叶状、团块状钙化灶,病灶未累及相邻骨质及关节。结论肿瘤样钙质沉着症具有影像学特征表现,结合临床表现可对其作出准确的诊断。     

Mimic ascites in a patient undergoing peritoneal dialysis on raw-data image Tc-99m tetrofosmin gated cardiac SPECT

Journal of Nuclear Cardiology -     

Demonstration of inguinal hernia by means of peritoneal99mTc-MAA scintigraphy with a load produced by standing in a patient treated by continuous ambulatory peritoneal dialysis

A 45-year-old man receiving continuous ambulatory peritoneal dialysis developed scrotal swelling and edema which was aggravated in the standing position. Physical examination failed to find inguinal hernia and although ultrasonography revealed the patent had processus vaginalias, it failed to prove its continuity to the peritesticular space of the tunica vaginalis. Peritoneal scintigraphy with intraperitoneal instillation of 99mTc-Macroaggregated albumin followed by standing clearly demonstrated the connection. The use of the standing load makes possible faster visualization of a positive finding and more accurate diagnosis than examination in the supine position.     

Scintigraphic detection of abdominal wall and diaphragmatic peritoneal leaks in patients on continuous ambulatory peritoneal dialysis

Continuous ambulatory peritoneal dialysis (CAPD) is utilized with increasing frequency for patients with end stage renal disease (ESRD). Several complications have been observed including catheter malfunction due to pericatheter leaks, abdominal wall and inguinal hernias and diaphragmatic leaks. Occasionally special diagnostic procedures are necessary to determine the nature of the abnormality and guide the surgical approach to correction. The four cases herein illustrate the usefulness of radionuclide imaging in diagnosing leakage of dialysate fluid in patients on CAPD.