Right ventricular metastatic choriocarcinoma obstructing inflow and outflow tract

We operated on a 34-year-old man with a metastatic tumor that extended from the tricuspid valve to the pulmonary valve and obstructed the right ventricle inflow and outflow tracts. The tumor was removed with preservation of the tricuspid valve. Additional chemotherapy was carried out according to the BEPO (etoposid, eisplatin, bleomycin, vincritin) scheme. Histology revealed metastasis of a choriocarcinoma originating from the right testis. Computed tomography performed after 6 months detected no metastases in the lungs. Magnetic resonance imaging showed a thickened right ventricle free wall and apex. The patient is doing well 18 months postoperatively.     

Laparoscopic scar: A mimicker of Sister Mary Joseph’s nodule on positron emission tomography/CT

Positron emission tomography/CT is an established imaging method in the diagnosis and staging of cancers. ¹⁸F‐fluoro‐2‐deoxy‐d ‐glucose (FDG) is the most commonly used radiotracer in positron emission tomography/CT. It is a tumour viability agent and usually its uptake within a lesion reflects the presence of a viable tumour tissue. However, false‐positive FDG uptake is known to occur in benign processes of either inflammatory or infectious aetiology. We describe FDG uptake at the site of laparoscopic scar that mimicked Sister Mary Joseph’s nodule in a patient with gastric adenocarcinoma. Here, the knowledge of the patient’s history and subtle imaging findings helped in accurate staging of the patient. In this case report, we emphasize the value of the knowledge of the patient history and awareness of different pitfalls of FDG to achieve a correct diagnosis on positron emission tomography/CT.     

Pneumocystis carinii pneumonia studied by gallium-67 scanning

The validity and reliability of gallium-67 (Ga-67) scanning for diagnosis and follow-up of Pneumocystis carinii pneumonia (PCP) were assessed in 34 patients thought to have pulmonary complications of acquired immunodeficiency syndrome (AIDS). Overall sensitivity was 94% and specificity 74%. Among patients with normal or equivocal chest radiographs at the time of admission, sensitivity was 86% and specificity 85%. The authors consider Ga-67 scanning a valid and reliable adjunct in the diagnosis of PCP in AIDS patients with respiratory symptoms when the chest radiograph is normal or equivocal.     

HYPERVENTILATION AND DIZZINESS: CASE REPORTS AND MANAGEMENT

SUMMARY Dizziness is a common symptom in patients presenting to an otorhinolaryngologist. Hyperventilation accounts for up to 5% of cases with dizziness and is a contributory factor in a further 20% of cases. Six cases of dizziness due to hyperventilation are presented to illustrate the authors' simple management policy. A high index of suspicion in the absence of an organic cause of dizziness and a simple provocation test will identify these cases. Management is aimed at demonstrating resting hypocapnia, investigations to exclude organic causes of hyperventilation and rehabilitation in collaboration with a clinical psychologist ensures the appropriate treatment for the dizziness and can avoid the development of chronic somatisation behaviours.     

异基因造血干细胞移植受者代谢综合征的发生情况

异基因造血干细胞移植（hematopoieticcelltransplantation,HCT）后代谢综合征的发生主要由预处理导致的神经激素系统紊乱、血管内皮损伤、移植物的免疫和炎症作用以及继发的移植物抗宿主病及其治疗等引起。对代谢综合征及其组分（糖尿病、高血压、血脂紊乱等）的筛查可以尽早地调整治疗策略,控制危险因素的发生,进而降低远期的心血管疾病的发生率和致死率。为此,美国的研究人员回顾性分析了86例异基因HCT受者代谢综合征的发生情况,并与代谢综合征在普通人群中的流行情况进行比较。