Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Kikuchi-Fujimoto Disease as A Rare Cause of Benign Lymphadenopathy and 18F-FDG PET/CT Findings(2014) Erhamamci, Seval; Reyhan, Mehmet; Kocer, Nazim Emrah; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5943-9283; 24563878; AAJ-5242-2021; AAM-5436-2021Kikuchi-Fujimoto disease (KFD) is an uncommon benign and self-limited disease, characterized by cervical lymphadenopathy. This disease is generally diagnosed on the basis of an excisional biopsy of affected lymph nodes. However, clinical presentation and histopathological findings of KFD could lead to a wrong initial diagnosis, of tuberculosis, systemic lupus erythymatosus or malignant lymphoma. Laboratory tests are not specific. Imaging modalitites give confusing results. Affected lymph nodes of patients; with KFD can exibit F-18-FDG uptake on PET/CT imaging similar to malignant lymphoma. Therefore, the differential diagnosis of KFD should be considered in patients with cervical and/or generalized lymphadenopathy. Accurate diagnosis of KFD by histology is essential in avoiding unnecessary emotional and mental distress associated with the diagnosis of lymphoma.Item Cardiac Blood Pool Activity on Postablation Radioiodine Imaging(2015) Aktas, Ayse; Kocabas, Beyza; Erhamamci, Seval; Gencoglu, Arzu; Liman, Cevdet; 0000-0003-4631-1683; 0000-0003-0149-2265; 25381484; ABG-1864-2020; AAI-8772-2021There are reports on physiologic and pathologic mediastinal uptake on radioiodine imaging in patients with thyroid carcinoma. The most commonly reported physiologic causes of mediastinal uptake are esophageal retention of salivary secretion and uptake by hyperplastic or normal thymus gland. In this study, we evaluated physiologic cardiac blood pool (CBP) activity and its associated findings on radioiodine imaging. Cardiac blood pool activity was evaluated in 186 postablation and 32 posttherapy scans. After oral radioiodine administration, imaging was initiated on day 7. Thyroglobulin, anti-thyroglobulin and TSH blood level determination was carried out in all patients. Whole-body scans were inspected with regard to residual thyroid uptake, esophageal uptake, CBP activity, hepatic activity and metastatic iodine uptake. Uptake in the residual thyroid tissue was graded visually as mild (m), moderate (M) and significant (S). Whenever CBP activity was detected on visual inspection, its intensity was graded as mild (1), moderate (2), and significant (3). Cardiac blood pool activity was detected in 61 postablation scans (33 %). Residual thyroid uptake was observed in all patients with CBP. A significant correlation existed between the intensity of uptake and the presence of CBP (p < 0.05). The mean Tg in patients with CBP was significantly higher than those without CBP (p < 0.05). Cardiac blood pool activity was not observed in any posttherapy scans and in those scans with distant metastases in the postablation group. Linear or irregular activity pattern thought to be due to esophagus was detected in 4 % of postablation scans. The results have revealed CBP to be common on postablation scans. Its presence correlated with the intensity of residual thyroid uptake and had a significant association with increased thyroglobulin levels. Its absence on posttherapy scans despite increased Tg levels suggested that this activity is due to labeled thyroid hormones released by the residual thyroid tissue. Its presence might imply a high level of blood radiation dose.Item Elastofibroma Dorsi Incidentally Detected by 18F-FDG PET/CT Imaging(2015) Erhamamci, Seval; Reyhan, Mehmet; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; Findikcioglu, Alper; Canpolat, Tuba; 0000-0003-1715-4180; 0000-0002-5597-676X; 0000-0002-5302-4386; 0000-0001-8550-3368; 25666569; AAI-8973-2021; AAE-2718-2021; R-3735-2016; AFT-2303-2022; AAK-8107-2021; AAJ-5242-2021Elastofibroma dorsi (ED) is a rare pseudotumor of the soft tissues that can also show 18F-fluorodeoxyglucose (F-18-FDG) uptake on positron emission tomography combined with computed tomography (PET/CT) imaging. The aim of this retrospectively study was to describe the metabolic characteristics of ED incidentally detected by F-18-FDG PET/CT imaging. Between November 2009 and August 2013 at our institution, 10,350 consecutive PET/CT examinations were retrospectively investigated. In 176 of these patients, ED was recorded as an incidental finding. Fifty-five of 176 patients also had follow-up scans after chemoradiotherapy. A total of 231 scans with ED in 176 patients were identified. To determine the metabolic activity of ED, the maximum standardized uptake value (SUVmax) was calculated semiquantitatively. For measurement size of ED, the longest axis of transaxial CT images was used. Seven of the 176 patients underwent surgery due to suspected metastases and/or invasion of primary malignancy and/or symptoms or incidental during surgery. The prevalence of ED in our series was 1.7 %. The lesions were located in the subscapular region in all patients, except in one case with a lesion in the infrascapular region. A total of 419 ED lesions in 231 scan of 176 patients were evaluated. Mean +/- A SD SUVmax and long axis values for these 419 lesions were 2.31 +/- A 0.61 (range 1.0-4.30) and 56.78 +/- A 17.01 mm (range 19-112 mm), respectively. Of these 176 patients, 141 (80.1 %) had bilateral lesions and 35 (19.9 %) had unilateral lesions. There were statistically significant differences in the SUVmax and long axis values between the right and left side in the bilateral lesions (p = 0.001). No significant differences in the SUVmax and long axis values of the lesion were found between pre- and posttreatment in the patients with follow-up scans. Elastofibroma dorsi located in the scapular region is usually bilateral, asymmetric and with mild or moderate metabolic activity on PET/CT imaging. In addition, the metabolic activity and size of ED remained stable after chemoradiotherapy. Awareness of these metabolic characteristics of ED is important for preventing misinterpretation during F-18-FDG PET/CT studies.Item Simultaneous Occurrence of Medullary and Differentiated Thyroid Carcinomas. Report of 4 Cases and Brief Review of The Literature(2014) Erhamamci, Seval; Reyhan, Mehmet; Kocer, Nazim Emrah; Nursal, Gul Nihal; Torun, Nese; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5943-9283; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0003-1715-4180; 24997082; AAJ-5242-2021; AAM-5436-2021; R-3735-2016; AAE-2718-2021; AAI-8973-2021Simultaneous occurence of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) in a single patient is an unusual event. The incidence, cell origin, histopathology features and prognosis of these two carcinomas are considered completely different. The aim of this retrospective study was to describe clinical, pathologic characteristics and the prevalence of diagnosing such patients in our clinic. Between October 2003 and December 2013, 1.420 consecutive patients diagnosed by histology as having differentiated thyroid carcinoma (DTC) and treated with radioactive iodide (RAI) were retrospectively investigated. Of these, 4 patients were diagnosed by histology as having simultaneous MTC and PTC. The clinical and pathology characteristics of these patients are described. The prevalence of simultaneous MTC and PTC of these 4 patients in our clinic was 0.28% of all patients with DTC.The age of the 4 patients ranged from 44 to 63 years and were three females and one male.These patients are currently alive without disease from either of the two types of cancer. In two of these patients, MTC was located in the left and PTC in the right thyroid lobe. One patient had MTC in the right lobe and PTC in both lobes. The remaining patient had both cancers in the left lobe as a mixed tumor. We are able to present the pathology of only 2 of these 4 patients. In these 2 patients MTC was located in the left and PTC in the right thyroid lobe, one of them was female and the other was male, aged 44 and 49, respectively. In conclusion, our results suggested that simultaneous occurrence of MTC and PTC had a prevalence in our clinic of 0.28% among 1420 consecutive patients with DTC or 0.14%, if only the 2 patients in whom we are able to present their pathology slides are considered. Our cases suggest that these two tumors are usually independent and coincidental events in patients.Item Metastatic Lymph Node Detected by Both Ga-68-DOTATATE and F-18-FDG PET/CT in A Patient with Merkel Cell Carcinoma(2020) Erhamamci, Seval; Aslan, Nesrin; 33640344Item A Case of a Man With Isolated Breast Metastasis From Lung Adenocarcinoma Incidentally Detected by FDG PET/CT(2016) Erhamamci, Seval; Reyhan, Mehmet; Canpolat, Tuba; Nursal, Gul Nihal; Yapar, Ali Fuat; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0003-1715-4180; 26562574; AAJ-5242-2021; AAK-8107-2021; R-3735-2016; AAI-8973-2021Breast metastases from an extramammary primary tumor are very rare, particularly in men. In this study, we present a case of a 74-year-old man with isolated breast metastasis from lung adenocarcinoma as an incidental finding on PET/CT and diagnosed concomitantly with the primary tumor. Detection of isolated incidental metastatic lesions in the breast on PET/CT imaging has a significant clinical impact on patients with known malignant disease due to change of disease stage, management, and also treatment method.Item Does the Urea Breath Test Predict Eradication of Helicobacter Pylori Infection(2016) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Gokturk, Huseyin Savas; Durukan, Elif; Erhamamci, Seval; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-8579-5564; 26852756; AAJ-8621-2021Background/Aim : Helicobacter pylori infection is common world-wide and has been linked to development of gastric and duodenal ulcers, gastric adenocarcinoma, and gastric lymphoma. However, antimicrobial resistance has decreased H. pylori eradication rates worldwide. This study aimed to evaluate the effect of-bacterial load on eradication rate. Method : This prospective study included 237 consecutive patients who presented to our institution with dyspeptic symptoms and underwent both upper endoscopy and urea breath tests (UBT). The patients were divided into three equal sized groups according to their UBT values. All subjects received a standard triple eradication regimen, followed by a bismuth-based quadruple eradication regimen if triple eradication was not successful. The three groups were compared with respect to age, endoscopic findings, sex, and eradication rates. Results : Our results were consistent with those of previous studies : higher UBT values were associated with failure of standard 14-day triple treatment (p < 0.05). However, in patients who received a quadruple eradication regimen, differences between groups were not significant (p = 0.434). There was no relationship between UBT values and gastric pathologies (p = 0.751). Age and sex also did not differ significantly between groups (p = 0.061). Conclusions : Our study and others have found that high bacterial loads are negatively associated with achievement of eradication with triple treatment. However, differences between groups were not significant in patients who received a quadruple eradication regimen. Comparisons of treatment results according to bacterial density may be informative. The importance of H. pylori density should be further evaluated with new treatment protocols.Item Primary Hepatocellular Carcinoma With Intense Ga-68-PSMA Uptake But Slight F-18-FDG Uptake on PET/CT Imaging(2020) Erhamamci, Seval; Aslan, Nesrin; 31977478Ga-68-PSMA PET/CT imaging is an emerging imaging modality in prostate cancer. PSMA expression is also reported for nonprostate malignancies, including primary hepatocellular carcinoma. Herein, we present a case of a 74-year-ald man with recently diagnosed hepatocellular carcinoma who was referred for F-18-FDG PET/CT imaging for initial staging. The patient underwent F-18-FDG PET/CT as part of staging procedure; he also underwent Ga-68-PSMA PET/CT. PET/CT images revealed only slight F-18-FDG uptake in the liver lesion, but intense Ga-68-PSMA uptake, without any metastatic lesion seen elsewhere in the body.