UTERUSTA DIAGNOSTIK KÜRETAJA SEKONDER ARTMIŞ F-18 FDG TUTULUMU OLGUSU

Endometrial cancer is one of the most common malignant tumors of the women, and if it can be detected in the earlier stages, the curability and the prognosis of the endometrial cancers can be better. A 52 year-old female patient, as part of ongoing research project in our clinic on endometrial carcinoma, was referred to our clinic with a suspicion of endometrial carcinoma with increased serum CA-125 measurement. Increased F-18 FDG uptake in uterine cavity that was secondary to the diagnostic curettage was demonstrated on F 18 FDG PET images. This uptake might be secondary to benign inflammatory changes or hemorrhage arising from diagnostic curettage that patient underwent ten days ago. According to our knowledge, this is the first case demonstrating increased F-18 FDG uptake secondary to diagnostic curettage Endometrium kanseri kadınlarda en çok görülen malign tümörlerden birisidir. Erken teşhis edildiğinde tam tedavi şansı yüksektir ve prognozu çok iyi seyirlidir. Bölümümüzde endometrium kanseri ile ilgili olarak devam eden bir proje kapsamında, serum CA-125 yüksekliği ile endometrium kanseri şüphesi olan 53 yaşında kadın hasta bölümümüze refere edildi. PET görüntülerinde uterusda artmış F-18 FDG tutulumu izlenmiştir. Bu bulgunun hastanın öyküsünde 10 gün önce geçirilmiş diagnostik küretaja bağlı benign inflamatuar değişiklikler veya hemoraji ile ilgili olduğu düşünülmüştür. Bu olgu sunumunda diagnostik küretaja sekonder olduğu düşünülen F-18 FDG tutulumu muhtemelen literatürde ilk kez gösterilmektedi

Ga-67 Uptake in a Patient with Breast Cancer

Omurgasızlardan omurgalılara kadar evrimsel olarak oldukça korunan Wnt/β-katenin sinyal yolu hem erken embriyonik gelişimin düzenlenmesinde, hem de erişkin dokularda apoptozis, adipogenez, anjiogenez, sinaps oluşumu gibi olaylarda rol almaktadır. Bununla birlikte bu sinyal yolunda meydana gelen bozuklukların kanser başta olmak üzere birçok ciddi hastalığın etiyolojisinde rolü olduğunun düşünülmesi, son yıllarda bu sinyal yolu ile ilgili araştırmaları oldukça arttırmıştır. Wnt/β-katenin sinyal yolunun bu hastalıklardaki rolünü belirlemeye yönelik çalışmalarda çoğunlukla β-katenin, Axin, Adenomatöz polipozis koli (APC) gibi biyomoleküller araştırılmaktadır. Ayrıca, bu biyomoleküller sadece hastalıkların oluşum mekanizmalarının belirlenmesinde değil, bu hastalıkların tedavisinde hedef olarak da kullanılmaktadırlar. Dolayısıyla Wnt/β-katenin sinyal yolunun en önemli basamağı olan sitoplazmik reaksiyonların ve bu reaksiyonlarda görev alan biyomoleküllerin ortaya konulması sinyal yolunun bütünün tam olarak anlaşılması için oldukça önemlidir. Bu sebeple derlememizde hedef hücre sitoplazmasında görev yapan biyomoleküllerin tartışılması ve bu şekilde sinyal yolunun tam olarak aydınlatılması amaçlanmıştır. Wnt/β-catenin signaling pathway, which is highly evolutionarily conserved from invertebrates to vertebrates, regulates apoptosis, adipogenesis, angiogenesis, synapse formation in adult tissues, and controls embryonic development in the embryo. Researches related to the signal pathway because of its probable role in the etiology of serious diseases such as cancer are quite increased. In the studies, for determining the role of Wnt/β-catenin signaling pathway in these diseases, are mostly investigated biomolecules such as β-catenin, Axin, Adenomatous polyposis coli (APC). In addition, these biomolecules are not only used in determining the mechanisms of diseases, but also used as a target for treatment. Thus, determination of the cytoplasmic reactions, which are the most important step of the Wnt/beta-catenin signaling pathway, and biomolecules of these reactions are very important for understanding of fully signaling mechanism. Therefore, discussion of biomolecules in the cytoplasm of target cells and identification of the entire mechanism of the signaling pathway were aimed in our review

Current barriers and recommendations on the diagnosis of transthyretin amyloid cardiomyopathy: a Delphi study

ObjectivesThis study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases.MethodsThis study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the “agree/strongly agree” or “disagree/strongly disagree” option.ResultsThe panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM.ConclusionThe diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis