Ectopic thyroid is a rare entity resulting from developmental defect migration of thyroid gland during its embryogenesis. The circumstances and the age of ectopic thyroid discovery depend on the size and the functional character of ectopic focus. We are presenting the case of a 13-year-old boy who was followed for a growth delay with biological hypothyroidism. Planar Tc-99m scan and SPECT-CT have shown two foci of increased tracer uptake, one at the base of tongue and the second in prehyoid region. There was no tracer uptake in the thyroid bed. The two ectopic foci could not be visualized on ultrasonograpy and only one of them was detected at CT. This affirms the superiority, in terms of sensitivity and specificity, of morpho-functional imaging compared to purely morphological explorations in the detection of functional ectopic thyroid tissue to an optimal diagnosis approach, and therefore, a better orientation of the therapeutic strategy. (C) 2013 Elsevier Masson SAS. All rights reserved.

Langerhans' cell histiocytosis is a non-malignant proliferative disease of unknown etiology. It is a rare illness affecting mainly children and young adults with a male predominance. It can affect one or many organs. The bone locations are the most frequent. We present one case of multifocal Langerhans' cell histiocytosis in a 22-year-old male patient followed for diabetes insipidus with an enlargement of the pituitary stalk at the magnetic resonance imaging (MRI), and a lytic bone lesion revealed in lumbar spine (L2) by Tc-99m-HMDP scintigraphy conducted in planar mode, and then in Single Photon Emission Computed Tomography coupled to Computed Tomography (SPECT/CT) in hybrid mode. To this end, we propose to highlight diagnostic gain of SPECT/CT compared with SPECT and planar scintigraphy to characterize radiotracer uptake abnormalities in bone in Langerhans' cell histiocytosis. (C) 2012 Elsevier Masson SAS. All rights reserved.

Cervical lymph nodes represent one of the most frequent clinical symptoms of extrapulmonary tuberculosis. Their appearance in a neoplastic suggests lymph node metastasis. We report an atypical tuberculous lymphadenetis mimicking lymph node metastasis in a 42-year-old patient followed for papillary thyroid carcinoma operated and treated by iodine 131 therapy. Evolution was marked by the appearance of left cervical adenopathies suggesting lymph node metastatic extension on echographic criteria. A lymph node excision was undertaken and the pathologic study revealed a tuberculous lymphadenitis. The patient was put under antibacillary treatment and evolution was satisfactory. We also expose, through this work, a certain number of techniques of exploration likely to ascertain the diagnosis of a tuberculous lymphadenitis and to monitor the therapeutic strategy. (C) 2012 Elsevier Masson SAS. All rights reserved.

Objective. The main aim of this study was to evaluate the contribution of bone scintigraphy with 99mTc-HMDP in the staging of lung cancer.Patients and methods. One hundred and thrity-six patients with lung cancer, histologically confirmed, all patients underwent whole body 99mTc-HMDP to detect bone metastases each focal uptake of 99mTc-HMDP was considered benign or malignant, leading to positive or negative diagnosis for bone involvement.Results. Among the 136 cases studied sixty-six patients had a positive bone scan (bone lesion was considered malignant. The incidence of positive bone scan in patients with small cell carcinoma was 52.38%, those with adenocarcinoma were 52.08% and those with squamous cell carcinoma were 48.27%. The predilection sites of bone metastases were predominant in the spine (53.03%) and in the rib cage (48.48%).Conclusion. Our data contributes to clarify the place of bone scintigraphy in the management of lung cancer especially small cell carcinoma and in advanced stages of disease. The spine and rib cage were found as the predilection sites of bone metastases. (C) 2011 Elsevier Masson SAS. All rights reserved.

Iodine 131 whole body scan and serum thyroglobulin rate constitute often useful and valuable tools in the follow-up of patients differentiated thyroid carcinoma after primary therapy. For this purpose, the detection of radioiodine uptake foci outside the thyroid bed and the physiological sites of collecting are often allotted to the presence of metastatic localizations. However, the description of false-positives can induce an expensive and inadequate diagnostic and therapeutic complement. The authors report the observation of a patient followed for a treated follicular thyroid carcinoma, at which the iodine 131 whole body control had shown an aspect of metastasic miliary contrasting with an undetectable serum thyroglobulin. The tuberculin skin test and microscopic examination of sputum was positive. The patient was put under anti-tuberculous antibiotherapy and the evolution was very favorable. The identification of false-positives to the 131 iodine whole body scan appears necessary to improve the follow-up of patients and for ousting an iterative and completely useless therapeutic doses. (C) 2011 Elsevier Masson SAS. All rights reserved.

La dégénérescence maligne sur reliquats du tractus thyréoglosse est un phénomène très rare. Elle représente 1 % des kystes opérés où le carcinome papillaire représente le type histologique le plus fréquent. Les auteurs rapportent une observation de carcinome papillaire développé sur reliquats du tractus thyréoglosse concomitant à un carcinome micropapillaire multifocal de la thyroïde découvert chez une patiente de 21 ans. Une thyroïdectomie totale avait été réalisée. Un traitement complémentaire par l’iode 131 radioactif (3,7GBq) à visée stérilisatrice a été entrepris. Après deux ans de recul, la patiente va bien et ne présente aucun signe de récidive. À la lumière de cette observation, les auteurs se proposent de relater les aspects diagnostiques et thérapeutiques des kystes du tractus thyroglosse dégénérés.

Introduction. - The renal scintigraphy using 99mTc-DMSA constitutes a non-invasive and functional method that is of appreciable interest in the qualitative study of renal parenchyma and the evaluation of the separate renal function.Materiel and methods. - We report, through this work, the observation of 20 patients presenting a unilateral renal muteness to the intravenous urography (IVU). A 99mTc-DMSA scintigraphy was carried out among all our patients by means of a gamma-camera with large field equipped with a parallel collimator of weak energy and high-resolution. The evaluation of images obtained consisted of a qualitative study of parenchyma as well as an estimate of the functional value separated from the two kidneys obtained by the calculation of geometric mean.Results. - On the 20 studied cases, the sex-ratio was equal to 1.16; the average age was 29.72 years with extremes spanning from 18 months to 70 years. The renal muteness reported on intravenous urography was due among 12 patients (60% of cases) to a lithiasic origin, in six patients (30% of cases), to an ureteral-pelvic junction, in one patient (5% of cases), to a chronic pyelonephritis and in another patient (5% of cases) to a megauretera. The separated renal function of the non functional kidneys to the IVU, obtained from the renal 99mTc-DMSA scintigraphy varied from 11% to 31% with an average of 20.6%.Discussion. - Through our series, 99mTc-DMSA scintigraphy allowed to alleviate the limits of IVU in the evaluation of the precise functional value of pathologic kidneys. Indeed, in the 20 studied cases where the IVU had reported a renal muteness, the 99mTc-DMSA scintigraphy allowed a better appreciation of the renal function which varied from 11% to 31% thus calling into question the accuracy of IVU in the exploration of renal function at an advanced stage of uropathy. (c) 2008 Elsevier Masson SAS. All rights reserved.