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[in Japanese]

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Pyogenic spondylodiskitis rarely originates in the facet joint. Differential diagnosis of pyogenic facet joint infection （PFJI） has not been fully discussed. We investigated CT and MRI findings in five cases of PFJI with comparing of tuberculous and non-infectious facet joint arthritis. We assessed bone destruction and calcification of soft tissue around the involved facet joint on CT, while we also assessed signal intensity changes of adjacent intervertebral disc and facet joints, extraosseous abscess formation, and extent of contrast enhancing lesion on MRI. Only unilateral facet joint was involved in the PFJI with concomitant abscess formation. Bilateral facet joints were involved in the non-infectious facet joint arthritis. Faint calcification around the joint and ill-defined contrast enhancement were observed in this arthritis. Marked bone destruction was observed in the tuberculous arthritis. Unilateral facet joint lesion accompanying with extraosseous abscess formation is characteristic of PFJI.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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76 years old woman visited department of otolaryngology in this hospital for a checkup in dizziness in January, 2013. She felt fatigue by a little movement from three years ago and underwent cerebral angiography in neurosurgery, but, without aberration, we are noted tracheal deviation in chest X-ray, and goiter and hyperthyroidism become clear, and she was introduced to our department. In the first contact, palpating showed a hard and fixed tumor about six to seven cm in diameter in anterior region of neck. The cervical lymphnode was not palpable. There was no nystagmus. Her physical finding was in 151cm tall, 39.0 kg in weight, blood pressure 163/85 mm Hg, 100 times of pulse /min. In blood examination TSH by : 0.01 μ IU/ml, FT3 : 8.69 pg/ml, FT4 : 2.56 ng/dl, Tg : 12106.0 ng/ml, anti thyroglobulin antibody : 84 IU/ml,antiTPOantibody : 249 IU/ml, TRAB3.4IU/L, TRASB : 38.9%, CEA : 3.87 ng/ml, Calcitonin : 12 pg/ml. These data meant hyperthyroidism and this lesion was considered to the tumor compounded of Basedow’s disease. In computed tomography, the tumor exclude trachea to the left direction, and trachea showed a stenosis state, too. The right common carotid artery did deviation by arteriography in the right outside and a tumor underwent blood flow of superior thyroid artery and was contrasted. We considered Plummer disease and performed Tc scintigraphy, but the tumor site was condition of defect. The judgment of aspiration cytology was class III meaning not deteminable. So we decided the operation because a tumor was clinically thought about malignant. The operation established small skin incision in anterior region of neck and arrived at thyroid gland in a midline. The trachea extremely did left side deviation. We started abscission at left lobe and performed total thyroidectomy. We kept the both recurrent laryngeal nerve and superior laryngeal nerve. The resected tumor was 107 g, 70 × 68 mm, and the postoperative diagnosis was follicular thyroid carcinoma. After the operation, the trachea gradually situated in a midline, and the daily life gets possible to become independent because dizziness disappeared. We got experience to treat a rare case of the follicular thyroid carcinoma that produced dizziness for tumor extension pressure.

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Tuberous sclerosis (TSC) is a autosomal dominant multisystem neurocutaneous syndrome characterized by the development of multiple hamartomas distributed throughout the body, skin, brain and lungs. TSC had been diagnosed by classical triad as epilepsy, mental retardation and facial angiofibromas. Multimodal imaging can depict tumor spontaneously in asymptomatic case. We report a case of subependymal giant cell astrocytoma without any symptoms of the triad.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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