We consider that further studies are necessary to establish national references thyroid volume for each country.

We aimed to evaluate the diagnostic and preoperative localization capacity of 99mTc methoxyisobutylnitrile (MIBI) parathyroid scintigraphy and ultrasonography (USG) in enlarged parathyroid glands in the primary hyperparathyroidism (pHPT) as well as the relationship between the success rate of these techniques and biochemical values. In this study, we retrospectively evaluated 39 patients with clinical and biological evidence of pHPT who referred to the university hospital for MIBI parathyroid scintigraphy. Patients were examined with USG and double-phase MIBI parathyroid scintigraphy for the detection of enlarged parathyroid glands. Preoperative serum intact parathyroid hormone (iPTH) levels, calcium (Ca), phosphate and alkaline phosphatase measurements were obtained. A total of 45 parathyroid lesions in 39 patients were reviewed. Thirty-four patients had a single adenoma and 5 patients with multi-gland disease had 11 abnormal parathyroid glands including three adenomas, whereas the remaining 8 glands showed hyperplasia. The overall sensitivities of MIBI parathyroid scintigraphy, USG and combined techniques were 85.3%, 72.5% and 90.4%, respectively; the positive predictive values (PPV) were 89.7%, 85.2% and 92.6%, respectively. The most successful approach for detection of enlarged parathyroid glands in hyperparathyroidism is the concurrent application of USG and MIBI parathyroid scintigraphy modalities. The concomitancy of thyroid diseases decreases the sensitivity of both MIBI parathyroid scintigraphy and USG in enlarged parathyroid glands.

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Primary cutaneous diffuse large B-cell lymphoma is an uncommon type of non-Hodgkin lymphomas. A 51-year-old man had 2 gradually enlarging reddish, firm, and painless cutaneous-subcutaneous masses surrounded with some erythematous patches on his back for 3 years. Skin biopsy result was consistent with diffuse large B-cell lymphoma. FDG PET/CT was performed for staging and demonstrated bilaterally increased FDG uptake in the cutaneous masses with hypermetabolic left axillary lymph nodes. After chemotherapy, FDG PET/CT demonstrated that all FDG-avid lesions resolved, and there is a complete response to therapy.

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Background: The aim of this retrospective study is to evaluate the diagnostic value of undetectable basal thyroglobulin (Tg) levels measured 6 months after ablative 131 I treatment (AIT) in patients with differentiated thyroid carcinoma (DTC). Methods: The study included 159 patients (140 women, 19 men with mean age 43.4±15.6) who had undetecable basal Tg levels (<0.2 ng/ml) and negative anti-Tg antibodies, 6 months after AIT. Histologic examination was papillary thyroid carcinoma in 151 patients and follicular thyroid carcinoma in 8 patients. To control the AIT efficacy, diagnostic whole body scan (DWBS) was planned 6 months after AIT. Before DWBS, basal and stimulated Tg levels were measured and compared. Then all patients underwent DWBS. Results: All patients (with undetectable basal Tg level) had a stimulated Tg level under 2 ng/ml. Stimulated Tg levels were undetectable (<0.2 ng/ml) in 142 (89.3%) patients and 0.58±0.26 ng/ml (range 0.3-1.3 ng/ml) in 17 (10.7%) patients. The control DWBS, 6 months after thyroid ablation, was negative in 151 (95%) patients and was positive for minimal residual uptake on the thyroid bed in 8 (5%) patients. Stimulated Tg levels of patients with residual thyroid bed uptake on control DWBS, were undetectable (<0.2 ng/ml) in 4 patients and 0.8±0.19 ng/ml (range 0.3-1.3 ng/ml) in 4 patients. Conclusion: Our data suggest that stimulated Tg level measurements may be avoided in DTC patients with undetectable basal Tg levels. Thus, unnecessary Tg stimulation with rhTSH or endogen TSH, diagnostic procedures (DWBS) and radiation exposure can be reduced.

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