cancer patients

Purpose: The aim of this study was to investigate the effects of tangential radiotherapy (RT) on lung clearance in the patients with breast cancer by using Tc-99m-DTPA aerosol scintigraphy.Material and methods: Thirty-three female patients [non-smoker: 20, ex-smoker: 13] performed surgery and systemic chemotherapy for breast carcinoma [47 +/- 13 years] were included in the study. All patients underwent Tc-99m-DTPA aerosol scintigraphy prior to RT (preRT), midway through RT (midRT) and after RT (postRT). Total dose was 50 Gy in modified radical mastectomy and 60 Gy in lumpectonny (2 Gy/fraction). Posterior dynamic images of lungs were obtained immediately after the inhalation of 99mTc-DTPA aerosol.Results: Pulmonary function tests were normal in three measurements for all cases. In the ex-smokers, there was no significant difference among preRT, midRT and postRT clearance values in both lungs. PreRT lung clearance in non-smoker group did not differ from that in ex-smokers. However, the lung clearance for non-smoker group showed significantly increase following RT.Conclusion: in this study, we observed that tangential radiotherapy caused an increase in the lung clearance in the cases of non-smokers even in non-irradiated lung, and that the effect of RT on lung clearance was closely depended on smoking habit before RT. (c) 2005 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 77 (2005) 262-266.C1 Pamukkale Univ, Fac Med, Dept Nucl Med, TR-20100 Denizli, Turkey.Gulhane Mil Med Fac, Dept Radiat Oncol, Ankara, Turkey.Gulhane Mil Med Fac, Dept Nucl Med, Ankara, Turkey.Gazi Univ, Fac Med, Dept Radiat Oncol, Ankara, Turkey

The role of Tc-99m (V) DMSA scintigraphy in the evaluation of superscan on bone scintigraphy

Purpose: This study evaluated the biodistribution of Tc-99m (V) DMSA in patients with superscans on bone imaging and defined its role in differentiating the underlying cause. Methods: Nine patients (five with metastatic and four with metabolic bone disease) with classical superscans were entered into the study. All patients had the necessary radiologic and biochemical studies and a final diagnosis was reached accordingly. Tc-99m (V) DMSA scintigraphy was performed 1 week after Tc-99m MDP whole-body bone imaging. Results: In four of five patients with widespread skeletal metastases, Tc-99m (V) DMSA scan showed diffusely increased bone uptake. In the remaining patient, the Tc-99m (V) DMSA scan showed a normal distribution pattern. All patients with metabolic bone disease had increased bone uptake on Tc-99m (V) DMSA scans. Conclusion: Tc-99m (V) DMSA shows increased bone uptake in patients having a superscan appearance in metastatic or metabolic bone disease. Tc-99m (V) DMSA imaging may play a role in the evaluation of patients with equivocal bone scan findings for a superscan

A late presentation of isolated lymph node tuberculosis postintravesical BCG therapy for superficial bladder cancer: a novel case

Intravesical BCG immunotherapy is commonly used in the treatment of superficial bladder cancer. We recount the case of an 82-year-old British man who completed a course of BCG immunotherapy in 2011 for superficial bladder cancer, and presented in January 2013 with a loss of appetite, loss of weight and severe back pain. CT scanning, followed by MRI displayed a 5.7cm×5 cm conglomerated necrotic, haemorrhagic mass of lymph nodes in the para-aortic region. A CT-guided biopsy revealed granulomatous inflammation, focal fibrosis and acid-fast bacilli consistent with Mycobacterium tuberculosis (TB). The patient was treated with combination antituberculous medication, and is recovering. To our knowledge, this is the only reported case of lymph node TB secondary to intravesical BCG immunotherapy. We suggest that in patients treated with postintravesical BCG with enlarged lymph nodes, a diagnosis of secondary TB should be considered