technetium-tc-99m-sulfur-colloid and Carcinoid-Tumor

Assessment of sentinel nodes to predict metastases in a regional nodal basin is valuable for staging patients with melanoma and breast carcinoma. This study tested whether injection of isosulfan blue and technetium-99 could identify mediastinal sentinel nodes in patients with lung carcinoma and determine whether sentinel node histology predicts distal nodal metastases.. Isosulfan blue and technetium-99 were injected into the tumor and pulmonary resection performed. The hilum and mediastinum were assessed visually and with the gamma probe, and a mediastinal nodal dissection was performed.. Thirty-one patients were evaluated. Three patients had positive sentinel nodes and positive distal mediastinal nodes. Twenty-two patients had negative sentinel nodes and negative distal nodes. No sentinel node was identified in 6 patients and 2 patients had two sentinel nodes.. These data demonstrate that this rapid, simple technique can identify sentinel nodes in the mediastinum and that the sentinel node is an accurate predictor of distal nodal metastases in patients with lung cancer.

Topics: Aged; Carcinoid Tumor; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Female; Humans; Injections, Intralesional; Lung Neoplasms; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Pneumonectomy; Prognosis; Rosaniline Dyes; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid

This is a case report of a patient with an initial diagnosis of chronic pancreatitis who actually had metastatic carcinoid tumor. His symptoms of abdominal pain, weight loss, and diarrhea were manifestations of the large tumor bulk within the liver as well as carcinoid syndrome. Although abdominal CT scans showed multiple liver lesions, the primary lesion was not identified by conventional imaging studies. However, the mid-gut primary lesion was visualized on in-111 labeled octreotide scintigraphy; where the liver lesions were better delineated and seen to be separate from the normal pancreas when the Tc-99m sulfur colloid images were compared to the octreotide images.

Topics: Abdominal Pain; Adult; Antineoplastic Agents, Hormonal; Carcinoid Tumor; Chronic Disease; Diagnosis, Differential; Diarrhea; Humans; Indium Radioisotopes; Intestinal Neoplasms; Liver Neoplasms; Male; Malignant Carcinoid Syndrome; Octreotide; Pancreatitis; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Weight Loss

Carcinoid liver metastases may be more easily detected by radionuclide liver-spleen studies (RN imaging study) than by computed tomography (CT). While multiple studies have suggested that CT is a more sensitive test than the Tc-99m sulfur colloid study for the detection of most types of liver metastases, carcinoid tumors appear to be an exception. The results of 23 pairs of CT and RN imaging studies that were obtained within one month of each other in patients with proven carcinoid tumors are reported. Comparison of the initial reports of the studies as well as a blinded reinterpretation of the studies suggest that in this group of patients the RN imaging study appeared to be superior to CT in the evaluation of the response to therapy.

Topics: Carcinoid Tumor; Humans; Liver; Liver Neoplasms; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Single photon emission computerized tomography coupled with Tc-99m MAA hepatic-arterial perfusion scintigraphy has been used to examine the density of the functional microcirculation of hepatic tumors relative to normal liver in 24 patients. In both colorectal and carcinoid tumors we have demonstrated an average three-fold greater arteriolar-capillary density in areas of tumor proliferation. The depth of the evoked tumor hypervascularity was found to extend about 4 cm. Tumors greater than 8-9 cm in diameter were uniformly found to have a central hypovascular core. These observations are of importance in the design of selective strategies utilizing therapeutic microspheres directed against the hypervascular proliferating regions of human tumors.

Topics: Adult; Aged; Biopsy; Carcinoid Tumor; Carcinoma, Hepatocellular; Colonic Neoplasms; Female; Humans; Liver Neoplasms; Male; Microcirculation; Middle Aged; Particle Size; Serum Albumin; Sulfur; Technetium; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed