Cíl: Prezentovat neobvyklý případ 49leté ženy s pozitivní anamnézou metastazujícího maligního melanomu, u které se při 18F-FDG PET/CT vyšetření po léčbě zobrazil enchondrom v hlavičce fibuly napodobující solitární metastázu maligního melanomu. Metodika: Pacientka v rámci kontroly efektu léčby absolvovala celotělové PET/ CT zobrazení, a to 60 minut po intravenózní aplikaci radiofarmaka 18F-FDG o aktivitě 386 MBq. Akviziční čas PET skenu byl 2,5 minuty na 15 cm projekci, celkem 14 projekcí. Kontrastní (i.v. + per os kontrast) CT sken byl proveden ve venózní fázi. Výsledky: 18F-FDG PET/CT prokázalo osteolytické ložisko s jemným sklerotickým lemem v hlavičce levé fibuly s zvýšenou akumulaci 18F-FDG. Vzhledem k pozitivní anamnéze metastazujícího maligního melanomu bylo vysloveno podezření na solitární metastázu a doporučena biopsie. Následně pacientka podstoupila resekci hlavičky fibuly a histologické vyšetření zjistilo přítomnost enchondromu. Závěr: Enchondrom může vykazovat zvýšenou ložiskovou akumulací 18F-FDG v kosti, a tudíž má schopnost napodobovat solitární metastázu maligního melanomu při PET/CT zobrazení a tím způsobit potenciální obtíže při hodnocení nálezu., Aim: To present a rare case report of the fibular head enchondroma mimics a solitary malignant melanoma metastasis on 18F-FDG PET/CT imaging. Method: The 49-year-old woman with positive history of the metastatic malignant melanoma after treatment underwent 18F-FDG PET/CT. The whole body PET/CT scan was obtained 60 minutes after intravenous injection of 18F-FDG (386 MBq). The PET scan acquisition time was 2.5 minutes per bed position for whole body imaging and fourteen bed positions were necessary. Contrast-enhanced CT (venous phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenuation correction. Results: The examination revealed 18F-FDG avid bone lytic lesion with the mild sclerotic border in the left fibular head. The PET/CT finding was suspected for solitary melanoma metastasis. The patient underwent surgery and enchondroma was proven by histopathology. Conclusion: Benign enchondroma shows increased 18F-FDG uptake in bone lesion and can mimic solitary malignant melanoma metastasis on PET/CT imaging and can cause potential pitfall in the PET/ CT evaluation., Jiří Doležal, Martin Slanina, and Literatura
Sunītā Jain´s short stories discussed in this article deal with the life of Indians in the United States. Usually the question is raised as to what a particular character has gained and lost in the new environment. The writer´s attention focuses on the experiences and feelings of the characters, on their perception of the environment, not on the environment itself. In a way, she warns her readers,: the independence and individuality that many of her characters have won are similar to loneliness.
Based on the data series of the annual reference crop evapotranspiration (ET0) and the amount of irrigation water (IR) from 1970 to 2013 in the Luhun irrigation district, the joint probability distribution of ET0 and IR is established using the Gumbel-Hougaard copula function. Subsequently, the joint probability, the conditional joint probability, and the conditional return period of rich−poor encounter situations of ET0 and IR are analysed. The results show that: (1) For the joint probabilities of rich−poor encounter situations of ET0 and IR, the asynchronous encounter probability is slightly larger than the synchronous encounter probability. (2) When IR is in rich state or ET0 is in poor state, the conditional joint probability is larger, and the conditional return period is smaller. (3) For a certain design frequency of ET0, if the design frequency decreases, the conditional joint probability of the amount of irrigation water will decrease, therefore the encounter probability of them will decrease. (4) For a certain design frequency of the amount of irrigation water, if the design frequency decreases, the conditional joint probability of ET0 will increase, thus the encounter probability of them will increase.