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Ileal orthotopic neobladder: Our experience
417 SPLENOSLS DIAGNOSTIC ERYTHROCYTES
MIMICKING ROLE IN
A LEFT RENAL OF DENATURED COMPARISON
TO
MASS:
DIFFERENTIAL RADIOLABELLED
OTHER
MODALITIES. G Polite, G Petracca-Ciavarella. F Barbano, S Mod@ V Fnkante Nuclear Medicine Department - * Radiotherapy Department “Casa Sollievo della Sofferenza” Hospital, IRCCS San Giovanni Rotondo (FG) -ITALY
IMAGING M.
L&e*,
Splenosis is a very rare condition characterized by the presence of splenic tissue,mainly in peritoneum, after traumatic spleen rupture. It is nof a metaplasi~ as demonstrated by animal experiments, but a real autograil influenced by the gravity and facilitated by intrapetitoneal free blood, or surgeon’s gloved hands The number of splenetic nodules is influenced by splenic injury severity (the maximum number of nodules reported in literature is 400 in a single patient), We evaluated a 23-years-old male patient, who underwent, 8 yx before, in another hospital, a total splenectomy for spleen rupture after road-traffic accident; no autologous eterotopic grail was made. The patient was admitted to our hospital for a right hypochondriac pain. Ultrasonography showed an hypwchogenic mass (5x5 cm) local&d at the upper pole of letI kidney, suspicious for a neoplasm; this hypothesis was coniirmed by con~rastless CT investigation Laboratory test for liver and renal functions were norrnal;the urinary invesligation for neoplastic cells was negative. Scintigraphy was carried out by administration of 370 Mbq of 99mTc-RBC labelled by a v&-vitro method and subsequently damaged by heating at 50 “C for 20 mins Scans performed at 30 and 120 mins after the administratioq showed not only the uptake of labelled cells in the previously known site, but also multiple areas (n 9) of focal uptake linearly set in the whole left abdomen &me anterior hypochondrium to pelvis. The scintigraphic technique employng denatured labelled red cells is more sensitive and mainly more specific than 99mTc-sulphur wlloids scintigraphy (sulphur colloid particlez are pbagocytized by Kuppfer cells of liver and bone marrow); in fan in the clinical case described it confirms the splenic origin of the mass sited above the upper pole of the I& kidney.
MANAGEMENT
OF SAh-fOR,N,‘S
PLEXUS IN RADICAL PERSONAL EXPUUENCE.
UROLOGICAL
SURGERY:
TRANSITIONAL CELLS CARClNOMA OF UPPER EXCRETORY WAY: A STUDY W,TH TRAD,T,ONAL RADIOLOGY, ULTRASOUND AND CT. L. P~en*. A.Touini*. E.Onittc+, G.Morclb. R.Fe,ipctla. R. Mmcnlol. l Padiologie Clinic - Depaflment of Urnlogy. University of ,368 ,NTRODUCT,ON Uroldi.v, nmpluia u11 involve s,, the ercrclory way but they are umd~ located in the bladder The i&de= of @is ,ouhmlio~ is SO:, with respst to the bladder and pi&c llladencc is 2-3 times hi&r than the “rethera, “ae. imaging techniques impxtml for diagnastlc are “mgnpby sad ascending pielogrsphy. Ub-ogmphy =d Cf play ao essmtid m,c u) &ntify “r&h&al lesions crpgisdly on a functimully excluded kidney. PATIENTS AND METHODS. 35 p.tw”rs (27 males and 8 fermles, mull sgc 43.5 2 12.3 yrs) SR eumod fmm ,993 to ,995. Ii&y ptieah showed mpcmbuemstuna and 2 s classiut real colic, 4 patients wue being followed up for a bladder “rahelia, laio”. Ultnsormgrsphy was pzzfarmed m .I, Facnts and “rography in 28 of them. Four pwnts ynderweot discwading pislosnphy by sooography guided pucbre of dx pelvis and 16 -ding p~elognphy. A,, plier& vDdewmt CT scanning. RESULTS. We &c”mmlad 16 isolated pie&c aad I, isolated “rethera, lesims. We nlsa found 8 multiple ,eaio”s: 4 ccacemiap “nthexsl Md bladder. 1 pi&c md vesciu). 2 piebc and umber& I piclovrethen, and w&a,. Ws idmti,ied 20 lesions invdc piclocalyca uld 18 “rether., ones. Smwrachv WLP rasitwc in 13 luhenU. 12 showed
MIMICKING ROLE IN
A LEFT RENAL OF DENATURED COMPARISON
TO
MASS:
DIFFERENTIAL RADIOLABELLED
OTHER
MODALITIES. G Polite, G Petracca-Ciavarella. F Barbano, S Mod@ V Fnkante Nuclear Medicine Department - * Radiotherapy Department “Casa Sollievo della Sofferenza” Hospital, IRCCS San Giovanni Rotondo (FG) -ITALY
IMAGING M.
L&e*,
Splenosis is a very rare condition characterized by the presence of splenic tissue,mainly in peritoneum, after traumatic spleen rupture. It is nof a metaplasi~ as demonstrated by animal experiments, but a real autograil influenced by the gravity and facilitated by intrapetitoneal free blood, or surgeon’s gloved hands The number of splenetic nodules is influenced by splenic injury severity (the maximum number of nodules reported in literature is 400 in a single patient), We evaluated a 23-years-old male patient, who underwent, 8 yx before, in another hospital, a total splenectomy for spleen rupture after road-traffic accident; no autologous eterotopic grail was made. The patient was admitted to our hospital for a right hypochondriac pain. Ultrasonography showed an hypwchogenic mass (5x5 cm) local&d at the upper pole of letI kidney, suspicious for a neoplasm; this hypothesis was coniirmed by con~rastless CT investigation Laboratory test for liver and renal functions were norrnal;the urinary invesligation for neoplastic cells was negative. Scintigraphy was carried out by administration of 370 Mbq of 99mTc-RBC labelled by a v&-vitro method and subsequently damaged by heating at 50 “C for 20 mins Scans performed at 30 and 120 mins after the administratioq showed not only the uptake of labelled cells in the previously known site, but also multiple areas (n 9) of focal uptake linearly set in the whole left abdomen &me anterior hypochondrium to pelvis. The scintigraphic technique employng denatured labelled red cells is more sensitive and mainly more specific than 99mTc-sulphur wlloids scintigraphy (sulphur colloid particlez are pbagocytized by Kuppfer cells of liver and bone marrow); in fan in the clinical case described it confirms the splenic origin of the mass sited above the upper pole of the I& kidney.
MANAGEMENT
OF SAh-fOR,N,‘S
PLEXUS IN RADICAL PERSONAL EXPUUENCE.
UROLOGICAL
SURGERY:
TRANSITIONAL CELLS CARClNOMA OF UPPER EXCRETORY WAY: A STUDY W,TH TRAD,T,ONAL RADIOLOGY, ULTRASOUND AND CT. L. P~en*. A.Touini*. E.Onittc+, G.Morclb. R.Fe,ipctla. R. Mmcnlol. l Padiologie Clinic - Depaflment of Urnlogy. University of ,368 ,NTRODUCT,ON Uroldi.v, nmpluia u11 involve s,, the ercrclory way but they are umd~ located in the bladder The i&de= of @is ,ouhmlio~ is SO:, with respst to the bladder and pi&c llladencc is 2-3 times hi&r than the “rethera, “ae. imaging techniques impxtml for diagnastlc are “mgnpby sad ascending pielogrsphy. Ub-ogmphy =d Cf play ao essmtid m,c u) &ntify “r&h&al lesions crpgisdly on a functimully excluded kidney. PATIENTS AND METHODS. 35 p.tw”rs (27 males and 8 fermles, mull sgc 43.5 2 12.3 yrs) SR eumod fmm ,993 to ,995. Ii&y ptieah showed mpcmbuemstuna and 2 s classiut real colic, 4 patients wue being followed up for a bladder “rahelia, laio”. Ultnsormgrsphy was pzzfarmed m .I, Facnts and “rography in 28 of them. Four pwnts ynderweot discwading pislosnphy by sooography guided pucbre of dx pelvis and 16 -ding p~elognphy. A,, plier& vDdewmt CT scanning. RESULTS. We &c”mmlad 16 isolated pie&c aad I, isolated “rethera, lesims. We nlsa found 8 multiple ,eaio”s: 4 ccacemiap “nthexsl Md bladder. 1 pi&c md vesciu). 2 piebc and umber& I piclovrethen, and w&a,. Ws idmti,ied 20 lesions invdc piclocalyca uld 18 “rether., ones. Smwrachv WLP rasitwc in 13 luhenU. 12 showed