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    Contrast enhanced computed tomography and 18-fluorine-labelled 2-deoxy-2-fluoro-d-glucose positron emission tomography/computed tomography correlation in the management of a patient with primary mediastinal seminoma and candidate to liver transplant”, Gazzetta Medica Italiana Archivio per le Scienze Mediche

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    We report a case of a 34 years old man with primary mediastinal seminoma, discovered after investigations for worsening dyspnea. A peculiarity of this patient is the coexistence of other diseases that mutually influence each other as congenital liver shunts, thrombosis of the vena cava, right chronic heart failure and thyroid goiter. Immediately after the diagnosis of the seminoma he underwent 4 cycles of chemotherapy (CHT) with Cisplatin, Etoposide and Bleomycin (BEP), according to the standard scheme. In this case (18FDG-PET/CT), assessing the biological behaviour of the disease, has proved an essential adjunct in the clinical management of this patient. 18FDG-PET/CT has avoided that the patient performed others contrast enhancement computed tomography (CE-CT) that could further damage the kidneys and interfere with the thyroid function and the thrombogenesis. Furthermore 18FDG-PET/CT, excluding the seminoma recurrence or spread disease, allowed to choose the right therapeutic treatment and to place the patient on the transplant waiting list because of the presence of liver shunts. An assessment as accurate as possible, of remission after treatment has an important role for decision making to stop treatment or to initiate further one. 18FDG-PET/CT is actually the best predictor of active seminoma in postchemotherapy residual lesions

    Different causes of 18-Fluorine-labelled- 2-deoxy-2-fluoro-D-glucose uptake in a patient with non-Hodgkin lymphoma

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    We report the case of a 64-year-old woman affected by Non Hodgkin Lymphoma (NHL), who showed immunosuppression after chemotherapy, joint pain at the left hip joint, that will result a septic arthritis. To restage the NHL after chemotherapy 18F-FDG-PET/CT was performed, the whole-body acquisition showed increased glucose uptake in the carenal and right paratracheal lymphnodes. Other sites of increased glucose uptake have been seen in the bone tissue and soft tissues around the left femoral head and neck, in the homolateral acetabulum and also in the muscular insertions of the right hip. The 18F-FDG-PET/CT findings, the clinical history and the symptoms raised the suspect of a septic process of left hip joint. 99mTc-sulesomab (LeukoScan®, Immunomedics®, New Plains, NJ, USA) scan performed in antalgic position (flexed lower leg) showed pathological radiopharmaceutical uptake in the soft tissues around the left acetabulum cavity and homolateral femoral head and neck. Two blood cultures from samples obtained at admission were both positive for Escherichia coli, resistant to cefazolin and gentamicin and responsive to ciprofloxacin and cotrimoxazole. The patient was treated with intravenous ciprofloxacin and rest for 15 days. The fever and the left hip pain gradually resolved. After the end of antibiotic therapy, the patient restarted the NHL chemotherapy cycle and is now in follow-up. A careful anamnesis, examination and review of previous diagnostic tests, permit to assign the right meaning to every site of 18F-FDG uptake and use them for the best clinical management of the patients
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