Metastatic pulmonary pheochromocytomas: positive I-123 MIBG SPECT with negative I-131 MIBG and equivocal I-123 MIBG planar imaging

Pulmonary metastases from malignant pheochromocytoma were seen with I-123 MIBG SPECT in a 16-year-old girl but were not visualized with I-123 MIBG planar imaging. She had a left adrenalectomy for a pheochromocytoma 7 years earlier. Two small pulmonary nodules were seen on chest X-ray and CT scans.     

False positive results in a neuroblastoma screening programme

One hundred eighty healthy subjects (90 men, 90 women; age range: 55 to 80 years) with no known cardiovascular disease were studied by ultrasonography. In each, the following measurements were obtained: the caliber and length of the abdominal aorta and inferior vena cava, and the caliber of the common iliac arteries and veins. The mean length of the inferior vena cava was found to be 95.2 mm, its mean caliber 18.4 mm. The mean length of the aorta was 83.1 mm, and its mean caliber was 15.9 mm. The mean caliber of the common iliac veins was 9.7 mm, while that of the common iliac arteries was 8.8 mm. There was a statistically significant relationship between vessel caliber and subject age; furthermore, the vessel caliber of the male subjects was found to be larger than that of the females by a statistically significant margin. There was also a statistically significant correlation between subject height and the length of the two major vessels; however, no statistically significant correlations were noted between the measured parameters and body weight. In comparison with the values reported in the standard textbooks and by contemporary cadaveric studies, our measurements of mean aortic and vena caval calibers were significantly lower. When the two side were compared, a statistically significant difference was noted only in the iliac arteries, where the right was larger than the left.     

False positive modified Widal test in acute malaria

The present study reports results of modified Widal test carried out on 96 cases of acute malaria and 25 healthy controls. Out of the 96 patients studied, 30 had complicated P.falciparum (CPF), 36 had uncomplicated P.falciparum (UPF) and 30 had P.vivax (pv) malaria. Modified widal test was done to know the Widal titers due to Igm type of anti-salmonella antibodies, which is considered very specific for diagnosis of recent enteric fever. This test was positive in 14.58% and 10.41% of malaria patients for salmonella 'o' and 'H' titers respectively. On four weeks follow up most of the positive test become negative. Non-specific polyclonal B lymphocyte stimulation due to malaria was postulated to be responsible for this phenomenon.     

False positive results: a challenge for psychiatric screening in primary care

OBJECTIVE: The goal of this study was to characterize primary care patients with false positive results on screens for mental disorders. METHOD: A sample of 1,001 primary care patients completed self-administered screens and structured interviews for DSM-IV diagnoses. RESULTS: A substantial proportion of the patients with false positive screen results for at least one diagnosis met the diagnostic criteria for other psychiatric disorders. They also had significantly greater functional impairment and higher rates of recent use of mental health services than the subjects with true negative results on the screens. CONCLUSIONS: Although the positive predictive values of screens for specific mental disorders are in line with those of other medical screens, false positive results are not uncommon. This may be due in part to the sensitivity of brief screening instruments to nonspecific symptoms. The results suggest that as with other screens used in primary care, patients with false positive results on screens for mental disorders should receive clinical attention.     

False positive pleural biopsy and high CA125 levels in serum and pleural effusion in systemic lupus erythematosus

A 23-year-old female with systemic lupus erythematosus is reported. The clinical features included fever, shortness of breath, lymphadenopathies, hepatosplenomegaly, pleural and pericardial fluids, ANA and Anti-DNA positivity. Pleural biopsy was false positive for malignancy on two occasions. High CA125 levels were detected in both serum and pleural fluid. Following prednisolone treatment, clinical and laboratory findings returned to normal.     

False rape allegations

With the cooperation of the police agency of a small metropolitan community, 45 consecutive, disposed, false rape allegations covering a 9 year period were studied. These false rape allegations constitute 41% the total forcible rape cases (n = 109) reported during this period. These false allegations appear to serve three major functions for the complainants: providing an alibi, seeking revenge, and obtaining sympathy and attention. False rape allegations are not the consequence of a gender-linked aberration, as frequently claimed, but reflect impulsive and desperate efforts to cope with personal and social stress situations.     

Three-dimensional PET emission scan registration and transmission scan synthesis

The duration of a positron emission tomography (PET) imaging scan can be reduced if the transmission scan of one patient which is used for emission correction can be synthesized by using the reference transmission scan of another patient. In this paper, we propose a new intersubjects PET emission scan registration method and PET transmission synthesis method by using the boundary information of the body or brain scan of the PET emission scans. The PET emission scans have poor image quality and different intensity statistics so that we preprocess the emission scans to have similar histogram and then apply the point distribution model (PDM) [15] to extract the contours of the emission scan. The extracted boundary contour of every slice is used to reconstruct the three-dimensional (3-D) surface of the reference set and the target set. Our registration is 3-D surface-based which uses the normal flow method [17] to find the correspondence vector field between two 3-D reconstructed surfaces. Since it is difficult to analyze internal organ using the PET emission scan imaging without correction, we assume that the deformation of internal organ is homogeneous. With the corresponding vector field between the two emission scans and the transmission scan of the reference set, we can synthesize the transmission scan of the target set.     

123I-metaiodobenzylguanidine (MIBG) scintigraphy for the staging of neuroblastoma

Nineteen children with neuroblastoma (aged 2 w.-7 y.o.) were studied to evaluate the optimal scan conditions for Iodine-123-Metaiodobenzylguanidine (MIBG) scintigraphy for accurate staging at the time of diagnosis. Six and 24 hours after an injection of 123I-MIBG, whole body image and truncal spot and SPECT images were obtained. Compared with other studies (CT or MRI and bone scintigraphy), each 123I-MIBG image was evaluated visually to investigate which image can demonstrate the extent of neuroblastoma most exactly. MIBG images demonstrated primary tumors in all patients, and metastatic lymphadenopathy in 8 of 9 patients. Twenty-four hour SPECT images gave us the most detailed information about the extent of abnormal accumulation. As to bone and bone marrow lesions, 6 hour images were superior to 24 hour images in detectability. Moreover, MIBG showed many more lesions and more extended accumulation than the bone scan. 123I-MIBG scintigraphy was very useful in detecting neuroblastomas. In order to get the most valuable information, both delayed SPECT and early whole body planar images should be obtained.