核医学と放射線治療

Radiation therapy in breast cancer patients has been shown to reduce local recurrence and improve survival rates. Nevertheless, recent concerns have been raised regarding an increase in cardiac mortality, especially in patients who had been treated with radiation for left-sided breast tumors. Hence, the aim of this study is to estimate doses of irradiation to the heart, LAD coronary artery, and lungs in 2D (SAD) and 3D conformal radio therapy techniques, and to compare the two. Out of 32, 18 to 75 years old females with a diagnosis of non-metastatic breast cancer, who referred from surgery department, went through irradiation in the conventional 2D (SAD) and then 3DCRT using multi-slice CT scans to contour vital organ. Nearly all of the dosimetrical indexes were higher in 3DCRT method. This shows that 2D technique lacks a decent scale to measure cardiac toxicity since its mid-plane CT slice did not give a reliable assessment of cardiac irradiation.

Mucinous noncystic (colloid) carcinoma (MNCC) of the pancreas is considered an uncommon variant of ductal adenocarcinoma of the pancreas with specific histopathological and molecular features. We report the CT findings of large area of hypoattenuation and intratumoral calcification in a pathologically proven case of mucinous non-cystic carcinoma of the pancreas. MNCC of the pancreas is a distinct entity that needs to be radiologically differentiated from the ductal adenocarcinoma as usually it has more favorable outcome when compared to the rapidly fatal course of ductal adenocarcinomas. But in our index case, it was associated with a large solitary hepatic metastasis with similar calcific foci, which to the best of our knowledge has not been described in the English literature till date.c

Anthracotic and anthracosilicotic spindle cell proliferation (AASCP) is a rare reactive proliferative entity of phagocytic histiocytes which can affect hilar and mediastinal lymph nodes. Fluorodeoxyglucose-positron emission tomography (FDG-PET) has been used for the clinical diagnosis and staging of oesophageal adenocarcinoma. We report the first case of AASCP exhibiting false positivity on FDG-PET imaging. A 76-year-old man with distal esophageal adenocarcinoma underwent PET/CT for staging revealing a positive mediastinal lymph node involvement. The patient underwent Endobronchial Ultrasound Fine Needle Aspiration Biopsy (EBUS-FNA) followed by an oesophagectomy with lymph node dissection. The histological diagnosis of the mediastinal lymphadenopathy was AASCP. In mediastinal lymph nodes of esophageal adenocarcinoma, AASCP could be a cause of false-positivity on FDG-PET imaging.

Introduction: Malignant parotid tumors are rare. They are characterized by their histological diversity dominated by muco-epidermoid tumors and adenocarcinomas; squamous cell carcinomas are much rarer. Result: We report a case of carcinoma not very differentiated from the parotid evolving for 6 years to reach 15 cm of major axis at the time of its diagnosis in a 35-year-old woman. Conclusion: Epidermoid carcinomas, although rare, are not exceptional. Their management is based on total parotidectomy provided that the diagnosis is early. Population education is required for a first-line use of health services in front of any indolor swelling in the parotid region.