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We present a paraspinal amyloidoma found incidentally in a 77-year-old man during lymphoma workup by F-FDG PET/CT. A solitary FDG-avid paraspinal lesion was seen at T11-T12. MRI showed T2 hypointensity and enhancement. Lymphoma was considered the primary differential due to FDG uptake, but biopsy revealed nodules of extracellular acellular homogeneous material with apple-green birefringence on Congo red stain consistent with amyloidoma. Spinal amyloidoma is rare with few cases reported so far in literature.We present a case with an unexpected nodule in the thymus showing increased F-FDG uptake on PET/CT. The nodule was surgically removed. Histopathologic examination revealed granuloma in the thymus. This case indicates physicians and radiologists must be aware that although thymic granuloma is rare, it should be included in the differential diagnosis of the thymic lesions with F-FDG accumulation along with neoplastic and nonneoplastic conditions.A 4-day-old female neonate with raised cord blood thyroid-stimulating hormone (127 μIU/mL) underwent Tc thyroid scan to rule out thyroid dysgenesis. The images revealed midline focus of lingual thyroid as the only functioning thyroid tissue. In addition, bilateral focal and symmetrical breast uptake was seen without clinically palpable breast nodule on either side. Transplacental transfer of maternal hormones leading to stimulation of neonatal breasts explains this unusual scan finding. One should be aware of this rare pattern of focal breast uptake in Tc-pertechnetate scan in neonates with congenital hypothyroidism to avoid scan misinterpretation.Suggestions to improve the well-being in medical students include establishing learning communities, having pass-fail grading at least in the freshman and sophomore years, giving the students some control over their learning environment (such as with evaluations and serving on the curriculum committee), encouraging more protected time and more money for faculty teaching and mentoring, and eliminating mistreatment of medical students. Also, the Medical Student and Physician Well-Being Index should be freely available to the medical students and staff for both self-evaluation and for evaluating the learning environment. Oxiglutatione Burnout in medical school may continue in residency and not only causes misery to the individual, but adversely affects professionalism and patient care.FDG PET/CT was performed for staging in a 15-year-old adolescent girl with cholangiocarcinoma, which showed only mild activity in the tumor but more impressive FDG activity in right femoral fibrous cortical defect without any other hypermetabolic lesions elsewhere. Pathological examination of the resected cholangiocarcinoma revealed significant neuroendocrine differentiation, which lead to subsequent Ga-DOTATATE PET/CT study. Unexpectedly, the same femoral fibrous cortical defect also had increased Ga-DOTATATE activity.Isolated pancreatic metastasis from lung cancer is rare. We present a case of isolated pancreatic metastasis from squamous cell lung cancer. The pancreatic tumor showed hypovascularity on enhanced MRI and intense FDG uptake on FDG PET/CT mimicking primary pancreatic ductal adenocarcinoma. This case indicates pancreatic metastasis should be considered as a differential diagnosis in patients with a history of extrapancreatic cancer and hypermetabolic pancreatic lesion.The gallbladder is generally located at the anterolaterally situated gallbladder fossa on the undersurface of the liver, whereas choledochal cyst, as a dilation of the common bile duct, is located more posteromedially. We reported an ectopically located gallbladder, which appeared to be a choledochal cyst on hepatobiliary scintigraphy in a 10-year-old girl.A 66-year-old man with castration-resistant prostate cancer was evaluated with F-prostate-specific membrane antigen (PSMA) 1007 PET/CT, which revealed extensive PSMA-positive skeletal metastases in the skull, thorax, spine, pelvis, and extremities. He was then treated Lu-PSMA-617 therapy. Twenty-four-hour SPECT/CT revealed additional activity not seen with F-PSMA adjacent to his left eye. The lesion was biopsied after the first cycle due to pain. This activity was not visible on SPECT/CT after the second treatment cycle, and his eye pain has resolved.An 85-year-old asymptomatic man with suspected biochemical recurrence of prostate cancer underwent an F-fluciclovine PET/CT scan, which revealed a solitary suspicious tracer uptake in the dorsal right corporal body of the proximal pendulous penis. The patient underwent ultrasound-guided fine-needle aspiration of the penile lesion, which revealed metastatic prostate cancer. The patient had definitive external beam radiation therapy 3 years before the examination. At the time of scan, the prostatic-specific antigen (PSA) was only 1.0 ng/mL, although the PSA doubling time was 2.6 months. It is unusual to detect a solitary penile metastasis in a patient with a low level of PSA.We report a rare case of a 60-year-old man with diffuse metastases in bilateral penile corpus cavernosum after radical nephrectomy for left renal carcinoma. F-FDG PET/CT demonstrated diffuse hypermetabolic lesions in bilateral penile corpus cavernosum, hypermetabolic tumor recurrences in left renal operation region, and left pulmonary metastasis. Biopsy confirmed penile metastasis from renal clear cell carcinoma. Diffuse penile metastatic carcinoma from renal cancer is extremely rare and associated with poor prognosis. F-FDG PET/CT is helpful for diagnosis of penis metastasis and accurate staging of primary cancer.Splenogonadal fusion (SGF) is a rare congenital malformation, which can be of a continuous or discontinuous type. It is characterized by splenic tissue fused with gonadal tissue. Because it lacks characteristic features, very few cases of SGF have been diagnosed preoperatively. Herein, we present a case with left side SGF who was diagnosed by Tc-nanocolloid spleen scintigraphy.We present a case of secondary central nervous system relapse of lymphoma detected initially on PET/CT without corresponding findings on MRI. A 60-year-old lymphoma patient demonstrated an FDG-avid focus in left cerebellar hemisphere on restaging PET/CT. MRI brain showed no corresponding abnormality, and expectant management ensued. Six months later, she represented with metabolic progression of previously seen FDG-avid focus in left cerebellar hemisphere, now also manifesting as an enhancing mass on MRI. Posttreatment scan for presumed lymphoma relapse showed metabolic response. This case demonstrates the advantage of PET/CT over anatomical imaging to detect metabolic changes before structural changes become apparent.
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