Paroxysmal nocturnal hemoglobinuria(PNH) is a rare, acquired disease involving multiple hematopoietic lines. Characteristics of PNH are intrinsic hemolytic anemia, iron deficiency anemia and venous thrombosis. report a case of PNH with characterostoc MR and CT findings. The signal intensity of renal cortex was lower than that of medulla on both T1- and T2- weighted MR imaging. On T2 weighted MR images, the liver showed very low signal intensity but the signal intensity of the spleen was normal. On precontrast CT the attenuation of renal cortex was higher than that of renal medulla and the attenuation of liver was higher than that of the spleen. These findings of MR imaging and CT were the result from the deposition of hemosiderin in the cells of proximal convoluted tubules and transfusional hemosiderosis of liver.
Anemia, Hemolytic ; Anemia, Iron-Deficiency ; Hemoglobinuria, Paroxysmal* ; Hemosiderin ; Hemosiderosis ; Liver ; Magnetic Resonance Imaging ; Spleen ; Venous Thrombosis

PURPOSE: Insular carcinoma is a rare subtype of thyroid cancer which was first described by Carcangiu in 1984. Its aggressiveness is intermediate between well differentiated and anaplastic thyroid carcinoma. But its origin, clinical features and prognosis are not yet clearly understood. We wanted to evaluate the clinical features, histologic characteristics and prognosis of insular thyroid carcinoma. METHODS: We studied 4 cases of insular thyroid carcinoma treated in Samsung Medical Center from March 1996 to April 1998. Age, sex, clinical features, treatment, pathology and follow up findings were reviewed, retrospectively. RESULTS: All patients were female and the mean age was 44 years. Three of all patients complained of anterior neck mass and one patient complained of low back pain and paresthesia of the right thigh. Two patients had metastatic bone lesions at the time of diagnosis. Preoperative fine needle aspiration cytology diagnosed follicular neoplasm in 2 cases and papillary carcinoma in 1. We performed total or completion total thyroidectomy and radioactive iodine therapy in 3 cases and radioactive iodine therapy alone in one. Extrathyroidal invasion, vascular invasion and multicentricity were noted in two cases. All four patients showed recurrence or distant metastasis in follow up over a period of 10 to 31 months and 2 of them died of distant metastasis during this follow up period. CONCLUSION: Insular carcinoma is a special type of thyroid carcinoma with aggressive clinical course. Recurrence and extrathyroidal involvements are common and the prognosis is poorer than other well differentiated thyroid carcinomas.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Iodine ; Low Back Pain ; Neck ; Neoplasm Metastasis ; Paresthesia ; Pathology ; Prognosis ; Recurrence ; Retrospective Studies ; Thigh ; Thyroid Carcinoma, Anaplastic ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: Insular carcinoma is a rare subtype of thyroid cancer which was first described by Carcangiu in 1984. Its aggressiveness is intermediate between well differentiated and anaplastic thyroid carcinoma. But its origin, clinical features and prognosis are not yet clearly understood. We wanted to evaluate the clinical features, histologic characteristics and prognosis of insular thyroid carcinoma. METHODS: We studied 4 cases of insular thyroid carcinoma treated in Samsung Medical Center from March 1996 to April 1998. Age, sex, clinical features, treatment, pathology and follow up findings were reviewed, retrospectively. RESULTS: All patients were female and the mean age was 44 years. Three of all patients complained of anterior neck mass and one patient complained of low back pain and paresthesia of the right thigh. Two patients had metastatic bone lesions at the time of diagnosis. Preoperative fine needle aspiration cytology diagnosed follicular neoplasm in 2 cases and papillary carcinoma in 1. We performed total or completion total thyroidectomy and radioactive iodine therapy in 3 cases and radioactive iodine therapy alone in one. Extrathyroidal invasion, vascular invasion and multicentricity were noted in two cases. All four patients showed recurrence or distant metastasis in follow up over a period of 10 to 31 months and 2 of them died of distant metastasis during this follow up period. CONCLUSION: Insular carcinoma is a special type of thyroid carcinoma with aggressive clinical course. Recurrence and extrathyroidal involvements are common and the prognosis is poorer than other well differentiated thyroid carcinomas.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Iodine ; Low Back Pain ; Neck ; Neoplasm Metastasis ; Paresthesia ; Pathology ; Prognosis ; Recurrence ; Retrospective Studies ; Thigh ; Thyroid Carcinoma, Anaplastic ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy