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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This case illustrates a pitfall associated with F-18 FDG imaging. We present the images of a 57-year-old woman with non-Hodgkin's lymphoma that shows intense accumulation of F-18 FDG in a sacrococcygeal pilonidal sinus that could indicate a lymphomatous involvement from a primary disease. MRI showed a well-defined sinus tract from skin to the sacrococcygeal region corresponding to the F-18 FDG uptake. She did not have any symptoms of a sacrococcygeal pilonidal sinus such as discharge, swelling or pain. There was no visible opening of the sinus tract on the skin. Pilonidal sinus is commonly a hair-containing sinus or abscess in the sacrococcygeal area. Hair acts as a foreign body causing an inflammatory reaction.
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PMID:F-18 FDG imaging of an asymptomatic sacrococcygeal pilonidal sinus in a patient with malignant disease. 1788 71

This unusual case of Takayasu arteritis presenting as acute myocardial infarction could be defined by ultrasonography and 18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) coregistered with computed tomography (CT). A 55-year-old male was admitted to our hospital with continuous chest pain and left-side neck pain. After primary percutaneous coronary intervention, elevation of inflammatory markers persisted and dull pain in the left side of the neck continued. Ultrasonography revealed characteristic wall thickening of the left common carotid artery and subsequent 18F-FDG PET with CT depicted positive uptake in the left common carotid artery and the vessel wall of the ascending aorta, confirming the diagnosis of Takayasu arteritis. Three months after angioplasty, follow-up cardiac catheterization was performed. Coronary angiography showed no restenosis. During the catheterization, angiography confirmed the mild stenosis in the long segment of the left common carotid artery and the left subclavian artery as well as the focal narrowing and the dilation of the abdominal aorta. This case shows that ultrasonography in the cervical region and combined 18F-FDG PET with CT may be useful in the diagnosis and evaluation of Takayasu arteritis. In addition, we should pay attention to underlying disease even in middle-aged or older male patients with acute myocardial infarction.
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PMID:Usefulness of ultrasonography in carotid arteries and combined positron emission tomography/ computed tomography for diagnosis of Takayasu arteritis with unusual presentation as acute myocardial infarction: a case report. 1804 61

A 67-year-old male with transformed diffuse large B cell lymphoma presented with severe neuropathic-type pain radiating down his posterior right thigh. Initial lumbar radiographs and MRI of the lumbar spine failed to identify a cause for his symptoms. A FDG-PET/CT scan demonstrated increased focal FDG uptake in the right sacral (S2) nerve root. Review of the lumbar spine MRI performed 6 days earlier demonstrated abnormal right S2 nerve root enhancement. The combined FDG-PET/CT and MRI findings allowed a presumptive diagnosis of neurolymphomatosis. However, the patient succumbed to his illness before planned local radiotherapy could be performed.
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PMID:Sacral nerve root neurolymphomatosis diagnosed on FDG-PET/CT and magnetic resonance imaging. 1809 53

We present the case of a 48-year-old woman who had been diagnosed with multiple myeloma a year ago. She had persistent pain in her right knee that she tended to ignore. As part of her follow-up she underwent a PET/CT scan that did not show any metastatic lesions. However, a focal rounded area of FDG uptake behind her right knee showed a fluid density on the CT scan. A presumptive diagnosis of Baker cyst was suggested. Review of her previous MRI report performed at another hospital corroborated this finding.
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PMID:Baker cyst as seen on a PET/CT scan. 1809 66

Using microPET and (18)F-fluorodeoxyglucose ((18)F-FDG) as a tracer, we investigated regional brain activation in a rat model of visceral hypersensitivity induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS). TNBS injection into the proximal colon through laparotomy resulted in a significant, sustained decrease in the pain threshold to mechanical distention of the distal colon, indicating a phenomenon referred to as visceral hypersensitivity. When TNBS-induced colonic hypersensitivity was fully developed, all the TNBS-treated rats presented characteristic pain behaviors in response to colonic distention at previously innocuous pressure (0-35 mmHg) that produced no abdominal pain in sham-operated control animals. In microPET study, colonic distention at the normally non-painful pressure produced significant increases in (18)F-FDG uptake in the thalamus and sensory cortex I of TNBS-treated rats. Since the increases in (18)F-FDG uptake in the brain regions were completely abolished by an analgesic dose of morphine (375 microg/kg, s.c.), it is most likely that the regional brain activation detected by microPET is a pain-related central event. The pharmacological and microPET data indicate that colonic distention at the normally non-painful pressure activates specific brain regions in rats with TNBS-induced visceral hypersensitivity, and the microPET protocol described here could provide an objective measure to test visceral analgesic compounds.
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PMID:MicroPET detection of regional brain activation induced by colonic distention in a rat model of visceral hypersensitivity. 1825 May 71

A 26-year-old nonleukemic woman presented with lumbosacral granulocytic sarcoma manifesting as progressive low back pain and numbness of her left lower leg persisting for 3 months. Physical examination revealed hypesthesia within the left S1 area of the sensory dermatome, decreased Achilles tendon reflex in the left lower extremity, and walking impairment due to severe pain in her left hip and leg. Magnetic resonance imaging confirmed an extradural mass in the spinal canal at the L5-S2 levels with invasion to the pelvis from the left sacral foramen. Positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) showed hyperaccumulation indicating malignant tumor. Baseline laboratory data were normal. Decompressive laminectomy and tumor removal were performed. Histological examination identified granulocytic sarcoma. Bone marrow involvement was absent. She underwent adjuvant chemotherapy and radiotherapy, resulting in reduced residual lesion and neurological improvement. Immediate diagnosis and adequate systematic treatment are recommended for spinal granulocytic sarcoma in nonleukemic patients to prevent or delay progression to leukemia. The importance of immunohistochemical staining in the differential diagnosis from other types of spinal tumor, and the efficacy of FDG-PET for evaluation of the treatment are also emphasized.
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PMID:Spinal granulocytic sarcoma manifesting as radiculopathy in a nonleukemic patient. 1836 61

We present the case of a woman with persistent dorsal pain and two solid lung lesions documented on multidetector CT which showed concomitant [18F]FDG uptake. One of the lesions proved to be adenocarcinoma at biopsy and presented a lower [18F]FDG uptake when compared to the second lesion, which was smaller in size, and was postsurgically diagnosed as tuberculoma. This case portrays the paradoxical metabolic behaviour of two lesions, leading to misdiagnosis and erroneous disease staging in an oncology patient. Incidentally, the patient also had an elastofibroma dorsi, a rare benign tumour which can also be a possible source of false results in the PET exam. We provide explanations and possible solutions to these findings in order to familiarise the physician with them, and optimise patient management.
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PMID:Carcinoma, tuberculosis and elastofibroma in one patient: is [18F]FDG-PET/CT helpful? 1923 74

(18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET/CT) was performed to evaluate a left femoral subcutaneous mass in a patient with von Recklinghausen's disease (vRd) that gradually enlarged, causing pain and numbness. The left femoral mass showed intense FDG uptake with the maximum standardized uptake value (SUVmax) of 9.0. Other subcutaneous masses considered benign and neurogenic in nature also showed FDG uptake (SUVmax around 3 or less), but the degree of FDG uptake differed considerably from the left femoral mass. This observation suggested that the degree of FDG uptake may be a useful indicator of malignant transformation. Incidentally, PET/CT also showed an asymptomatic large abdominal mass with intense FDG uptake (SUVmax 8.8). The abdominal mass was resected and confirmed as gastrointestinal stromal tumor (GIST) of the small intestine. Three months later, the left femoral mass was operated on and pathologically diagnosed as a malignant peripheral nerve sheath tumor (MPNST). Various malignant diseases are known to occur with high frequency in vRd. Therefore, vRd patients need to have periodical examinations including PET/CT. We present a rare case of a patient with vRd with a MPNST of the left femur and coincidental GIST of the small intestine. February, 2009.
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PMID:A case of von Recklinghausen's disease with coincident malignant peripheral nerve sheath tumor and gastrointestinal stromal tumor. 1926 18

A 28-year-old Japanese man presented with a 14-month history of right pelvic and lumbar pain. Despite normal findings on X-ray and CT scan at a previous hospital, sternal tumor had arisen and fever, night sweat, and weight loss developed 5 months before admission. Core needle biopsy of the sternal tumor was performed and a diagnosis of Hodgkin lymphoma (HL) (mixed cellularity) was made. FDG-PET scan demonstrated increased FDG uptake in the sternum, the right ilium, the right 9(th) rib, and the lower edge of the left scapula, but there were no other apparent lesions. Neither bone marrow biopsy nor cerebrospinal fluid examination showed infiltration of lymphoma cells. ABVD was started and the symptoms resolved immediately. After 6 cycles of ABVD, the patient achieved complete remission and local radiotherapy for the right ilium was added. Primary osseous HL confined to the bone is so rare that only 16 cases have been reported worldwide to date, with none of these cases being from Japan. Since there have not yet been any characteristic symptoms or laboratory findings identified, the diagnosis of osseous HL is difficult and may be delayed. Although systemic chemotherapy appears to have been effective in the reported cases, more cases should be reviewed to clarify its pathophysiological features.
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PMID:[Primary multifocal osseous Hodgkin lymphoma]. 1926 1

Neuroimaging studies on brain responses to acupuncture stimulations have received considerable attention recently. The majority of these studies are centered on healthy controls (HC) and neuropathy, while little work has addressed other disorders. This study aimed to investigate the influence of acupuncture stimulations on brain activities in functional dyspepsia (FD) patients. Eight FD patients and eight healthy controls (HC) were involved in this study. Each HC received an 18F-FDG PET-CT scan at baseline, while each patient received scans at baseline and after acupuncture stimulations. Manual acupuncture stimulations were performed at ST34 (Liangqiu), ST36 (Zusanli), ST40 (Fenglong) and ST42 (Chongyang) in FD patients. The images were analyzed with the Statistical Parametric Mapping software 2.0. Compared to HC, the FD patients showed a lower glycometabolism in the right orbital gyrus, the left caudate tail and the cingulate gyrus, and a higher glycometabolism in the left inferior temporal gyrus (p<0.005). After acupuncture stimulations, the FD patients showed a glycometabolism decrease in the postcentral gyrus and the cerebella, and an increase in the visual-related cortices(p<0.005). The results suggest that the anterior cingulate cortex, the prefrontal cortices and the caudate tail involve in processing gastric perceptions in FD patients and that the deactivation of the primary somatosensory area and the cerebella is contributable to acupuncture stimulation, while activation of the visual-related cortex is a response to pain or acupoint actions.
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PMID:Brain areas involved in acupuncture treatment on functional dyspepsia patients: a PET-CT study. 1942 23


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