sodium-pertechnetate-tc-99m and Hodgkin-Disease

To comparatively assess the capabilities of currently available instrumental studies in the diagnosis of early cardiac performance changes in patients with lymph tumors at different stages of treatment and to study the myocardial histomorphological pattern in relation to the intensity of the therapy performed (as evidenced by sectional studies).. 44 patients, including 26 with various types of lymphogranulomatosis (LGM) and 18 with lymphosarcomas were examined at different stages of antitumor treatment. Radionuclide equilibrium ventriculography (REVG), echocardiography (EchoCG), and electrocardiography (ECG) were used. Postmortem studies of the myocardial histological pattern were conducted in 20 patients (archive data).. No significant pathological REVG, EchoCG, and ECG changes were found in 10 patients examined prior to treatment. In a group of 17 patients receiving a total dose of doxorubicine of 240 +/- 30 mg/m2, there was a significant decrease in diastolic duration, a reduction in diastolic volume, end systolic volume, stroke volume, stroke index, filling fraction over 1/3 diastole. In a group of 17 patients receiving a total dose of doxorubicine of 250 +/- 30 mg/m2 and radiotherapy applied to the mediastinum, the above changes were more marked. There were myocardial histomorphological changes whose magnitude progressed as therapy became more intensive. CONCLUSION. The findings have indicated that by using relatively small cumulative dose of anthracyclines, cardiovascular dysfunction can occur at the early stages of programmed treatment for LGM and lymphosarcomas. REVG has the greatest advantage in their detection.

Topics: Adult; Anthracyclines; Antibiotics, Antineoplastic; Cardiomyopathies; Diagnosis, Differential; Echocardiography; Electrocardiography; Female; Heart; Hodgkin Disease; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Myocardium; Radionuclide Ventriculography; Sodium Pertechnetate Tc 99m; Time Factors

The actuarial risk for developing benign or malignant thyroid disease following radiation therapy (RT) is controversial, but may be as high as 50% at 20 years. An effective screening modality should be specific but not overly sensitive, a limitation of ultrasound. We questioned whether Technetium-99 m pertechnetate ((99m)Tc TcO(4)(-)) scanning could detect clinically significant disease in ostensibly disease-free cancer survivors.. Eligibility criteria included an interval of at least 5 years after RT to the cervical region, a thyroid gland that was normal to palpation, euthyroid status determined by clinical examination, free T4 and TSH. The 34 patients scanned included 16 children (<18 years old) and 18 adults at the time of RT, 16 females and 18 males. The mean age at RT was 20 years (range, 2.1-50.3 years), and the mean age at (99m)Tc TcO(4)-scanning was 33 years (range, 13.6-58 years), providing a mean interval of 13 years (range, 5.3-26.6 years). The mean RT dose to the thyroid was 36.4 Gy (range, 19.5-52.5). Thyroid scanning was performed with a 5 mCi dose of (99m)Tc TcO(4)(-) obtaining flow, immediate and delayed static, and pinhole collimator images.. Seven patients (21.6%) had abnormal scans, and the percentage was higher among children (25%) and females (25%) compared to adults (16.7%) and males (16.7%), respectively. Two of 34 patients (5.9%) were discovered to have a thyroid cancer; histopathologies were papillary and follicular carcinoma.. In this population of clinically normal cancer survivors who had been irradiated to the cervical region, subclinical thyroid disease, of potential clinical significance, was detected by (99m)Tc TcO(4)(-) in about 20%. Children may be more commonly affected. Although the cost effectiveness of screening will require a larger sample number, we propose a surveillance schema for this patient population.

Topics: Adolescent; Adult; Carcinoma; Cerebellar Neoplasms; Child; Child, Preschool; Female; Hodgkin Disease; Humans; Male; Medulloblastoma; Neoplasms, Radiation-Induced; Neoplasms, Second Primary; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyroid Neoplasms

A 53-yr-old man with hypercalcemia was referred after an unsuccessful operative attempt to find a parathyroid adenoma. Metabolic evaluation showed relatively suppressed levels of parathyroid hormone with an elevation of serum 1,25-dihydroxyvitamin D. Thallium-technetium dual isotope imaging revealed localized mediastinal thallium uptake. A vascular mediastinal lesion was then demonstrated by arteriography, with subsequent surgical removal of a mass that proved to be lymphocyte predominant Hodgkin's disease. This case is noteworthy for the finding of isolated lymphocyte predominant Hodgkin's disease in the chest, the association of elevated serum 1,25-dihydroxyvitamin D with hypercalcemia that resolved postoperatively, and the uptake of thallium by the tumor.

Topics: Calcitriol; Calcium; Hodgkin Disease; Humans; Hypercalcemia; Male; Mediastinal Neoplasms; Middle Aged; Parathyroid Neoplasms; Radioisotopes; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thallium