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Coronavirus disease is a highly contagious disease caused by systemic acute respiratory syndrome coronavirus 2 with high mortality rates. We aimed to evaluate the relationship between serum D-dimer levels and tomography findings at the time of admission in patients diagnosed with coronavirus disease 2019 (COVID-19). This study included 94 patients, 48 women (51%) and 46 men (49%), diagnosed by PCR method. Patients without any suspicious findings on thorax tomography and having oxygen saturation above 90% at the time of presentation were included as the first group. Patients with suspicious tomography findings but having oxygen saturation above 90% were designed as the second group, and patients with both suspicious tomography findings for COVID-19 and low oxygen saturation levels ( less then 90%) at the time of admission were taken as the third group. Patients with oxygen desaturation were significantly older than the patients with normal oxygen saturations (P = 0.001). Patients with thorax tomography findings were having significantly higher D-dimer levels (P = 0.001). Patients with oxygen desaturation were having significantly higher D-dimer levels than the patients with normal oxygen saturations (P = 0.001). There was a significant negative correlation between oxygen saturation and D-dimer levels in all patients with and without tomography findings (r = -0.301, P = 0.016). Similarly, there was a significant positive correlation between the oxygen saturation and the lymphocyte count (r = 0.300, P  less then  0.017). Thorax tomography and D-dimer levels significantly correlate in patients with suspected COVID-19 admission. It should be kept in mind that patients with low oxygen saturation and high D-dimer levels may have serious lung involvement. The patients with intermediate-high risk pulmonary embolism who have acute right ventricular (RV) dysfunction and myocardial injury without overt hemodynamic compromise may be candidates for thrombolytic therapy. Alternative low-dose thrombolytic therapy strategies with prolonged infusion may further decrease the complication rates as its efficacy and safety have been previously proven in the management of prosthetic valve thrombosis. In this study, we aimed to investigate the clinical outcomes of low-dose prolonged thrombolytic therapy regimen in intermediate-high risk pulmonary embolism patients. This study enrolled 16 retrospectively evaluated patients (female 9, mean age 70.9 ± 13.5 years) with the diagnosis of acute pulmonary embolism who were treated with low-dose and slow-infusion of tissue-type plasminogen activator (t-PA). All patients underwent transthoracic echocardiography and computed tomography scan for assessment of thrombolytic therapy success. Low-dose prolonged thrombolytic therapy was successful in all patients. The mean t-PA dose used was 48.4 ± 6.3 mg. There was residual segmental thrombus in nine (56.3%) patients after thrombolytic therapy. The arterial oxygen saturation and tricuspid annular plane systolic excursion increased after thrombolytic therapy whereas heart rate, RV to left ventricular (LV) ratio, systolic pulmonary artery pressure, and the frequencies of hypotension and tachypnea significantly decreased. There was no cerebrovascular accident or major bleeding requiring transfusion. There were two minor bleedings (12.5%) including hemoptysis and epistaxis. Thrombolytic therapy in these intermediate-high risk pulmonary embolism patients was associated with excellent clinical outcomes and survival to discharge (100%) without any 60-day mortality. Prolonged thrombolytic therapy regimen with low-dose and slow-infusion of t-PA may be associated with lower complication rates without comprimising effectiveness in patients with acute intermediate-high risk pulmonary embolism.

A 3-year-old boy with high-risk neuroblastoma underwent 123I-MIBG scan to evaluate the disease status after surgery and chemotherapy. 123I-MIBG SPECT/CT demonstrated liver metastasis. In addition, mildly increased uptake in the inferior left erector spinae was noted. Contrast-enhanced CT suggested intramuscular hemangioma. The 123I-MIBG accumulation in the intramuscular hemangioma persisted during the follow-up scan, whereas the abnormal activity in the liver was resolved.

A 3-year-old boy with high-risk neuroblastoma underwent 123I-MIBG scan to evaluate the disease status after surgery and chemotherapy. 123I-MIBG SPECT/CT demonstrated liver metastasis. In addition, mildly increased uptake in the inferior left erector spinae was noted. Contrast-enhanced CT suggested intramuscular hemangioma. The 123I-MIBG accumulation in the intramuscular hemangioma persisted during the follow-up scan, whereas the abnormal activity in the liver was resolved.A 5-year-old boy presented with right testicular swelling for 1 week. Ultrasonography revealed a right testicular hypoechoic mass with increased blood flow. A malignant tumor was suspected, and further investigation with F-FDG PET/CT showed a soft tissue mass with increased FDG uptake in the right testis. Arginine glutamate Biopsy of the mass confirmed a diagnosis of myeloid sarcoma.A 74-year-old man with prostate adenocarcinoma (Gleason 7) was referred for Ga-prostate-specific membrane antigen (PSMA-HBED-CC) PET/CT scan for staging. Findings confirmed the prostate malignancy and demonstrated a solitary metastasis in the left skull base, with no evidence of regional or distant metastasis elsewhere. Solitary base of the skull metastasis may be subtle and easily overlooked, highlighting the need for thorough evaluation of the region.

Poland syndrome is a rare congenital anomaly characterized by unilateral aplasia of the sternoclavicular head of pectoralis major muscle with varying degree of same side upper limb anomalies. A 44-year-old man, with a case of adenocarcinoma of stomach, whose CECT chest revealed complete absence of pectoralis major and minor muscles on the left side, was diagnosed with Poland syndrome without presence of typical ipsilateral limb anomalies. Follow-up PET/CT revealed metabolically active recurrent disease with typical findings of Poland syndrome. It is important to be aware of oncologic association in a patient of Poland syndrome as highlighted in the present case.

Poland syndrome is a rare congenital anomaly characterized by unilateral aplasia of the sternoclavicular head of pectoralis major muscle with varying degree of same side upper limb anomalies. A 44-year-old man, with a case of adenocarcinoma of stomach, whose CECT chest revealed complete absence of pectoralis major and minor muscles on the left side, was diagnosed with Poland syndrome without presence of typical ipsilateral limb anomalies.

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