Introduction: Positron Emission Tomography-Computed Tomography (PET-CT) was introduced over four decades ago as an imaging tool to evaluate functional and anatomical aspects of disease such as malignancy. Besides pathological uptake, PET-CT also shows physiological uptake, especially in the gastrointestinal system, thus impacting diagnostic accuracy in these cases. There are many conditions that can attribute to increasing physiological uptake in PET-CT including microbial activity and drugs. Therefore, certain anti-spasmodic agents have been introduced to help reduce physiological uptake during scanning such as Hyoscine-n-butylbromide (Buscopan). This study aims to establish its effectiveness in reducing physiological bowel uptake on 18F-FDG PET-CT scan. Methods: 133 subjects were recruited in random for this study and divided into hyoscine (68 subjects) and control groups (65 subjects), respectively. Subjects in control group not given any anti-spasmodic medications and both groups received intravenous 18F-FDG according to body weight. PET-CT scan and images were interpreted by experienced nuclear medicine physician who scored the images according to the degree of bowel uptake and difficulty of image interpretation. Results: There were no statistical difference in bowel uptake based on SUV mean of the bowel and bowel-to-liver ratio between hyoscine and control groups. Conclusion: There was no significant effect of Hyoscine-n-butylbromide in reducing physiological bowel uptake in PET-CT scan.
malignancy

Objective: To determine the sensitivity, specificity, positive predictive value, negative predictive value and safety of endoscopic guided office-based biopsies (OBB) in diagnosing laryngeal and pharyngeal neoplasms at the St. Luke’s Medical Center in Quezon City and Global City. : Methods Design: Diagnostic Accuracy Study Setting: Two Tertiary Private Training Hospitals Participants: Records of patients with pharyngeal and laryngeal lesions who underwent endoscopic-guided OBB were included in the study describing safety. Only patients with subsequent operative biopsies were included in assessing diagnostic accuracy. Results: Thirty-six (36) patients were included: 28 (77.78%) males and 8 (22.22%) females, with median age of 61.5 (IQR 52-73 years). Nearly half (16/36; 44.44%) of the office-based biopsies yielded malignant histopathology results, 19.44% had high grade dysplasia while 36.11% had benign findings. Of 10 patients with operative biopsy for definitive diagnosis, 8 were correctly diagnosed with carcinoma while one had a change in diagnosis from benign to malignant. Office based biopsy was well tolerated and had no complications reported. Overall, the sensitivity of OBB in predicting malignancy was 88.89%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 50%. Conclusion Office-based biopsy is an accurate, reliable and safe modality for screening suspicious pharyngeal and laryngeal neoplasms, and may be part of routine screening during initial endoscopy among selected patients with suspicious pharyngeal and laryngeal neoplasms. Further investigation and larger population studies may provide more robust insights on effectiveness and safety of office-based biopsy in diagnosis of pharyngeal and laryngeal neoplasms.
Head and Neck Neoplasms ; Malignancy ; Neoplasms

Leukocytoclastic vasculitis (LCV) is a histopathologic descriptor for a prevalent type of small-vessel vasculitis (SVV) that affects arterioles, capillaries, and postcapillary venules. Although the association between vasculitis and malignancy only accounts for <5% of vasculitis cases, it has been recognized as a true paraneoplastic syndrome in several studies. A 57-year-old Filipino male presented with erythematous, nonblanching macules on his lower extremities, which rapidly progressed to violaceous lesions on his trunk, buttocks, and lower extremities. He also reported significant weight loss, decreased appetite, and vomiting. A skin biopsy confirmed LCV. Initially treated for meningococcemia, his condition did not improve. Abdominal imaging revealed an enlarged heterogeneous liver with retroperitoneal lymphadenopathy and a parenchymal nodule. He was eventually diagnosed with vasculitis secondary to an underlying hepatic malignancy and expired later from multiorgan failure.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Leukocytoclastic Vasculitis ; Erythema Elevatum Diutinum ; Malignancy ; Neoplasms ; Paraneoplastic Syndromes