[Diffuse pulmonary calcification in a patient with renal insufficiency]

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient's diffuse pulmonary calcification.

[Gammagraphy of somatostatin receptors in an ACTH secreting thymic carcinoid]

Ectopic ACTH secretion represent 10 to 15% in the causes of Cushing's syndrome. Carcinoid tumor of the thymus is a rare neoplasm and is currently believed to arise from population of thymic cells of neural crest origin. We present the case of a 43-year-old man with a corticotropin hormone (ACTH) secreting thymus carcinoid. 111In-octreotide scintigraphy demonstrated an intense uptaken on the lesion. The surgical specimen measured 17 x 18 x 18 cm and weighed 1. 25 kg. Postoperatively the patient was treated by chemotherapy and radiotherapy. A follow-up 111In-octreotide scintigraphy was normal. Very few scintigraphic images of these lesions have been published in the literature. Somatostatin receptor scintigraphy can be successful in the detection and follow-up of ACTH-secreting neuroendocrine tumors.

[Scintigraphy with 99MTc-HMPAO labeled leukocytes and computed tomography in the diagnosis of vascular graft infection. A comparative study]

The purpose of this work was to compare the results obtained with a scitigraphy using 99mTc-HMPAO labeled leukocyte and a computed tomography (CT) in the diagnosis of vascular graft infection (VGI). We carried out 22 studies with both scintigraphy and CT in 20 patients with vascular grafts with VGI suspicion. One patient had two grafts, thus a total of 23 grafts were analyzed. In addition, 6 control studies were performed. The persistent increase in leukocyte uptake in the graft area was considered as evidence of VGI and the scintigraphy with HMPAO-99mTc labeled leukocytes. For the CT, the presence of perigraft fluid and/or gas collection in the graft bed was also considered to be evidence of VGI. The total number of VGI was 12. The VGI diagnosis was confirmed by culture in all cases. The sensitivity and specificity of the scintigraphy in the diagnosis of VGI was 100%, while the CT has a sensitivity of 58% and specificity of 91%. Five grafts presented pseudoaneurysm in distal aorto-bifemoral graft anastomosis. All theses cases were detected with CT and only one patient with pseudoaneurysms showed scintigraphic evidence of VGI. In addition, both techniques detected two soft tissue infections associated with cutaneous fistulae, one case of abdominal abscess and another of acute diverticulitis. The scintigraphy was also pathologic in one infection of the surgical wound while that the CT was negative. In conclusion, although both techniques are useful to evaluate patients with suspicion of VGI, the scintigraphy with 99m-Tc-HMPAO labeled leukocytes has been shown to be more sensitive than the CT in the assessment of patients with VGI suspicion.

Epizootiology of sarcoptic mange in a population of cantabrian chamois (Rupicapra pyrenaica parva) in northwestern Spain

In May of 1993, an epizootic of sarcoptic mange (Sarcoptes scabiei) was detected in the chamois (Rupicapra pyrenaica parva) population of the Cantabrian Mountains in northwestern Spain. The epizootic initially spread across an area inhabited by some 1600 chamois. Mortality was lower than reported for other populations of ungulates. The maximum number of animals were affected from February to May. Four red deer (Cervus elaphus) and a roe deer (Capreolus capreolus), were diagnosed with sarcoptic mange from the same area in 1995. In these chamois mange was not correlated with host age or sex. The health and physiological status of this chamois population were not predisposing factors in the appearance of the mange epizootic. The clinical, epidemiological, serological, pathological and parasitological findings of this epizootic from May 1993 to June 1995 are described in this report.