A 48-year-old woman, chronic hepatitis B virus carrier, was presented with a 3.2-cm hepatic tumor accidentally noted 1 month ago by regular sonography. Serum α-fetoprotein level was within reference range, and tumor biopsy showed lymphoepithelioma-like carcinoma. She was referred for F-FDG PET/CT for whole-body survey. FDG PET/CT revealed a 3.2-cm FDG PET/CT in S5 to S6 of the liver, as well as lymphadenopathy in the left supraclavicular fossa and between the inferior venous cava and the common bile duct. Lymphoepithelioma-like carcinoma in the liver is extremely rare, and the expression of FDG uptake has never been discussed.

Aim and BackgroundDipyridamole-induced stress myocardial perfusion scans (MPS) has been widely used for management of coronary artery disease. The adverse effects of dipyridamole and other stress agents have been evaluated. The aim of this research is to confirm the dynamic data on dipyridamole side effects during MPS.MethodsWe collected data of 183 patients who underwent dipyridamole-induced stress MPS by retrospectively reviewing their clinical records, which included the severity of dipyridamole side effects in 3 min, 10 min, and 20 min after infusion. The incidence and severity at all three points, including the effect of age and gender, were obtained.ResultsAdverse effects occurred in 96 patients (69.6%). The most frequent symptoms were dizziness (42.8%), chest tightness (24.6%), abdominal pain (18.1%), and headache (15.2%). Most symptoms were Grade 1 to 2, according to the grading system for common terminology criteria. The median duration of symptom persistence was 36 min, not significantly different among age and gender.ConclusionThis study demonstrates that the adverse effects of dipyridamole were generally minimal and its duration was acceptable for clinical usage.

Rationale:Page kidney is an uncommon condition that hypertension occurs secondary to microvascular ischemia and alternation of small-vessel hemodynamics due to external compression of renal parenchyma and activation of the renin-angiotensin–aldosterone system. There are no specific guidelines for the management of Page kidney in the literatures.Patient concerns:A 17-year-old teenager who had Fontan procedure for tricuspid and pulmonary atresia in early childhood suffered from sudden onset of severe left flank pain during cardiac catheterization procedure. Left renal artery active bleeding with renal parenchyma compression in association with renin-mediated hypertension led to the diagnosis of Page kidney.Diagnoses:Page kidney was diagnosed in this case.Interventions:Urgent embolization was performed to treat left renal artery active bleeding. Because of decreased renal function with elevation of serum creatinine, inadequate blood pressure control with antihypertensive medication, and poor renal blood flow of left kidney, open drainage of perirenal hematoma was done 5 days after catheterization procedure.Outcomes:After the operation, glomerular filtration rate improved immediately, and left flank pain and hypertension resolved at discharge.Lessons:The choice of the therapies for Page kidney depended on the clinical presentation of each case. This case pointed out the significance of renoscintigraphy and surgery in the management of Page kidney.

We report a case of a 61-year-old man who had recurrent hepatocellular carcinoma admitted for series evaluation before Y selective internal radiotherapy (SIRT). Intra-arterial hepatic Tc macroaggregated albumin scan before Y-SIRT revealed a 2.7-cm incidental low-density thyroid nodule with hot uptake. TcO4 scan revealed corresponding hot uptake in the thyroid nodule with near background uptake of normal thyroid tissue, favored autonomous nodule. After Y-microsphere SIRT, bremstrallung imaging revealed no Y-microsphere deposition to thyroid.