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Tc-99m Pertechnetate / TI-201 감영 신티그라피에서 부갑상선 선종으로 오인된 흉선종 1 예
정용안(Yong An Chung),유이령(Ie Ryung Yoo),김성훈(Seong Jang Kim),정수교(Soo Kyo Chung),왕영필(Young Pil Wang),정지한(Ji Han Jung),이교영(Kyo Young Lee),김병기(Byung Kee Kim) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.4
A large superior mediastinal mass was found incidentally by ultrasonography in a 60-year-old man. There was an abnormal accumulation of Tl-201 in the lower pole of left thyroid gland, extending into left superior mediastinum on Tc-99m pertechnetate/Tl-201 subtraction scan. Laboratory findings relating thyroid and parathyroid were all within normal range. We considered the mass as a non-functioning parathyroid adenoma tentatively. However, subsequent surgery and pathologic examination revealed the mass to be a benign mixed thymoma. We report a case of patient with thymoma showing unusual Tc-99m pertechnetate/Tl-201 subtraction imaging and laboratory findings, and suggest to consider the possibility of other mediastinal tumors rather than parathyroid adenoma. (Korean J Nucl Med 2001;35:274-279)
하공정맥 폐색에 의한 Budd-Chiari Syndrome
고용복,임석원,유승진,왕영필 대한혈관외과학회 1990 Vascular Specialist International Vol.6 No.1
Membraneous obstruction of inferior vena cava (MOVC) is one of the most common forms of hepatic outflow obstruction and the lesion is described principally in men of non-white ethnic groups (Japan, India and South Africa etc.). The symptoms are those of hypertension in the inferior vena cava, eg. Varices in legs, ascending collateral circulation in the lateral chest wall and anterior abdominal wall, hepatomeglay and ascites, followed by esophageal varices, jaundice and gastrointestinal bleeding. The diagnosis is important, because the obstruction can be surgically corrected, accompanying hepatic congestion relieved, and possible hepatocellular carcinoma are avoided. Cavography visualizes the obstruction and is the procedure of choice of the diagnosis of this lesion. Transcardiac membranotomy by blind finger fracture is effective. The authors report 4 patients (M=3) of MOVC, which were visualized by cavography. The membraneous occlusions were found at or close to the level of the diaphagm with or without thrombus. The caval obstruction was corrected by blind finger approach without using heart-lung machine in all cases. All patient survived and the clinical conditions are improved postoperatively.