1.Hepatic basidiobolomycosis masquerading as cholangiocarcinoma: a case report and literature review
Roopali SEHRAWAT ; Nalini BANSAL ; Ajitabh SRIVASTAVA ; Dharmender MALIK ; Vivek VIJ
Journal of Liver Cancer 2023;23(2):389-396
Basidiobolus ranarum is known to cause subcutaneous mycoses; however, rare cases of hepatic and gastrointestinal involvement by basidiobolomycosis have been reported. Hepatic basidiobolomycosis may be confused with a carcinoma on imaging, and histological examination and fungal culture can help distinguish between these two. We report a rare case of basidiobolomycosis in a 16-year-old male with liver and gastrointestinal involvement.
2.Langerhans' Cell Histiocytosis Masquerading as Metastatic Papillary Thyroid Cancer on F-18 FDG PET/CT: Diagnostic Dilemma Solved by PET/CT-Guided Biopsy
Dharmender MALIK ; Rajender KUMAR ; Bhagwant Rai MITTAL ; Gaurav PARKASH ; Amanjit BAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):394-397
We present a case of papillary thyroid cancer (post-thyroidectomy status) on regular treatment with suppressive Levothyroxine therapy. On follow-up at 6 months after radioactive iodine ablation for remnant thyroid tissue, her thyroglobulin, and anti-thyroglobulin levels were 0.06 ng/ml and 670 IU/ml, respectively. Low-dose whole-body I-131 scan was negative. To look for the cause of isolated increased anti-thyroglobulin level, a whole-body ¹⁸F-FDG PET/CT was done which revealed multiple FDG-avid lytic skeletal lesions suggestive of metastases. For confirmation of diagnosis, ¹⁸F-FDG PET/CT-guided metabolic biopsy was done, which revealed Langerhans' cell histiocytosis on histopathological examination.
Biopsy
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Diagnosis
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Follow-Up Studies
;
Histiocytosis
;
Iodine
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Neoplasm Metastasis
;
Positron-Emission Tomography and Computed Tomography
;
Thyroglobulin
;
Thyroid Gland
;
Thyroid Neoplasms
;
Thyroxine
3.Langerhans' Cell Histiocytosis Masquerading as Metastatic Papillary Thyroid Cancer on F-18 FDG PET/CT: Diagnostic Dilemma Solved by PET/CT-Guided Biopsy
Dharmender MALIK ; Rajender KUMAR ; Bhagwant Rai MITTAL ; Gaurav PARKASH ; Amanjit BAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):394-397
We present a case of papillary thyroid cancer (post-thyroidectomy status) on regular treatment with suppressive Levothyroxine therapy. On follow-up at 6 months after radioactive iodine ablation for remnant thyroid tissue, her thyroglobulin, and anti-thyroglobulin levels were 0.06 ng/ml and 670 IU/ml, respectively. Low-dose whole-body I-131 scan was negative. To look for the cause of isolated increased anti-thyroglobulin level, a whole-body ¹â¸F-FDG PET/CT was done which revealed multiple FDG-avid lytic skeletal lesions suggestive of metastases. For confirmation of diagnosis, ¹â¸F-FDG PET/CT-guided metabolic biopsy was done, which revealed Langerhans' cell histiocytosis on histopathological examination.
4.Radioguided Surgery in Insulinoma Using 68Ga Labeled Exendin-4: a Case Report
Subha Shankar DAS ; Parul THAKRAL ; Divya MANDA ; Virupakshappa CB ; Dharmender MALIK ; Ishita SEN
Nuclear Medicine and Molecular Imaging 2021;55(5):253-256
Laparoscopic resection of tumor is often performed for benign and small insulinomas, or for those located in the body or tail of the pancreas. The precise preoperative and intraoperative localization of the insulinoma is critical to minimize the surgical intervention. Conventional imaging studies, i.e., MRI, CT, and endoscopic ultrasound have limited sensitivity due to the small size of the insulinomas. Angiography, intraarterial calcium stimulation, and venous sampling are invasive procedures with concomitant risk for complications. Exendin-4 PET/CT scan has shown to be of great value in preoperative localization of insulinomas. In the absence of the traditional gold standard, i.e., intraoperative ultrasound with manual palpation, in laparoscopic surgery, a simple enucleation procedure might not be possible. Gamma probe-assisted surgery is a new method of diagnosis and treatment which allows a small area of tissue to be identified and removed, while a large area of the organ or the system remains unaffected. We present a case of a 34-year-old man with clinical suspicion of insulinoma with negative conventional imaging and successful lesion localization with 68Ga-Exendin-4 PET/CT scan in the pancreatic body, who underwent laparoscopic enucleation of the lesion with the aid of a hand-held gamma detecting probe.
5.Incremental Role of ¹⁸FDG PET/CT in Assessment of Testicular Viability
Venkata Subramanian KRISHNARAJU ; Dharmender MALIK ; Rajender KUMAR ; Giridhar S BORA ; Bhagwant Rai MITTAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):377-379
Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.
Diagnosis, Differential
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Fluorodeoxyglucose F18
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Humans
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Male
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Middle Aged
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Positron-Emission Tomography and Computed Tomography
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Radionuclide Imaging
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Spermatic Cord Torsion
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Testis
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Ultrasonography
6.Incremental Role of ¹â¸FDG PET/CT in Assessment of Testicular Viability
Venkata Subramanian KRISHNARAJU ; Dharmender MALIK ; Rajender KUMAR ; Giridhar S BORA ; Bhagwant Rai MITTAL ; Anish BHATTACHARYA
Nuclear Medicine and Molecular Imaging 2018;52(5):377-379
Testicular torsion is a common differential diagnosis of acute scrotal pain along with acute epididymo-orchitis, which may lead to testicular non-viability. Doppler ultrasound and testicular scintigraphy are two routinely used modalities for the assessment of testicular viability. However, in some cases, these investigations may prove inadequate in differentiating between the two entities with widely differing management. Here, we present a case of a 52-year-old male with questionable viability of testis, who was investigated initially using testicular scintigraphy and was further subjected to a regional 18F-FDG PET/CT scan, in view of inconclusive findings with the conventional modalities.