Features of the physiological distribution of 68Ga-PSMA and its importance in the differential diagnosis of metastatic lesions of lymph nodes in patients with prostate cancer

Introduction. The appearance of new radiopharmaceuticals based on prostate-specific membrane antigen has significantly increased the accuracy of prostate cancer diagnosis. The physiological accumulation of 68Ga-PSMA in the sympathetic ganglia is important in the diagnosis of metastatic lesions of the lymph nodes. Erroneous interpretation of images can lead to an incorrect choice of tactics for the treatment of prostate cancer.Purpose: improving the diagnosis of prostate cancer with the help of updated data on the physiological accumulation of 68GaPSMA. Identify the sources of potential errors in the interpretation of PET/CT with 68Ga-PSMA.Materials and methods. In order to stage the verified prostate cancer, PET was performed in our center/CT with 68Ga-PSMA in 109 men. All patients were divided into groups by the level of prostate-specific antigen, Gleason sum, and d’Amico.Results. In all patients, we observed the accumulation of RFP in the cervical, abdominal and presacral ganglia. The capture level of the radiotracer was in the range of SUV=1,6–2,3 (median SUV=1,9). In the control PET/CT study after treatment, the accumulation of RFP in the cervical, abdominal and presacral ganglia remained at the same values, which made it possible to identify the detected changes as a variant of the physiological norm.Conclusions. It is necessary to take into account the peculiarities of the physiological distribution and accumulation of radiotracer in organs and tissues, in particular, the capture of 68Ga-PSMA by sympathetic ganglia. This will avoid false-positive cases when describing PET-CT images and will make it possible to increase the informative value of the method.

Facial Ganglia - Anatomy, Symptomatology of Lesions and Biological Relevance

The article summarizes information about the head ganglia (the sympathetic ganglia and in the sensory cranial nerves). Gives а brief historical background on the history issue and relevance of the topic. Characterized by each node with its topography and lesion clinic. The described process of treatment, and prospects for new therapies. Raised the issue of the significance of the defeat ganglia, namely, the suffering of the sick and forced treatment costs (due to the complex differential diagnosis). In a biological sense, pain first appears in chordates and during evolution, as well as transformations of the brain and spinal cord, it acquires new types, localization and significance for the performance of a living organism. And facial pain, being a nosology with a multidisciplinary approach in diagnosis and treatment, demonstrates both its complexity and importance in human life.

Satellite glia are essential modulators of sympathetic neuron survival, activity, and autonomic function

Satellite glia are the major glial cells in sympathetic ganglia, enveloping neuronal cell bodies. Despite this intimate association, how satellite glia contribute to sympathetic functions remain unclear. Here, we show that satellite glia are critical for metabolism, survival, and activity of sympathetic neurons and modulate autonomic behaviors in mice. Adult ablation of satellite glia results in impaired mTOR signaling, soma atrophy, reduced noradrenergic enzymes, and loss of sympathetic neurons. However, persisting neurons have elevated activity, and satellite glia-ablated mice show increased pupil dilation and heart rate, indicative of enhanced sympathetic tone. Satellite glia-specific deletion of Kir4.1, an inward-rectifying potassium channel, largely recapitulates the cellular defects observed in glia-ablated mice, suggesting that satellite glia act in part via extracellular K+ buffering. These findings highlight neuron-satellite glia as functional units in regulating sympathetic output, with implications for disorders linked to sympathetic hyper-activity such as cardiovascular disease and hypertension.

Neuroblastoma Soft Tissue Metastasis in a 10-Month-Old Infant with a Right Thigh Mass

Background. Neuroblastoma is a solid tumor that occurs more frequently in pediatric populations. It may originate from any part of the sympathetic nervous system, but it most commonly arises from the paraspinal sympathetic ganglia in the abdomen or mediastinum. Local lymphadenopathy and distant metastasis to the central nervous system, orbit, and liver might be detected; however, it rarely includes soft tissue or musculoskeletal involvement. Case Report. Here, we report a 10-month-old infant presented with a right thigh mass with an otherwise benign physical exam and medical history. MRI of the lower extremities suggested tumoral infiltration in the soft tissue of both thighs, predominantly on the right side. Surgical pathology of the lesion confirmed neuroblastoma. A large subhepatic mass and paraaortic lymphadenopathy in the abdominal CT scan and metaiodobenzylguanidine scan findings favored primary abdominal neuroblastoma that had spread to lower extremities. The patient has been in remission since the completion of chemotherapy. Conclusion. Neuroblastoma should be considered in infants with an abnormal mass in extremities. Due to its aggressive nature, most patients struggle with distant and local tumor spread at diagnosis. Therefore, any abnormal signs and symptoms, especially in younger pediatrics, warrant immediate evaluation to avoid tumor expansion.

Changes of sympathetic ganglia in infections. Mogilnitsky (Journal of Psychol., Neurol. and Psychiatry, 1922, 1)

On the basis of studies of sympathetic ganglia in croupic pneumonia, Spanish flu and catarrhal bronchopneumonia, the author concludes that in croupic pneumonia vascular changes are more significant than in other pulmonary inflammations, while in Spanish flu and bronchopneumonia the nerve apparatus is particularly affected.

Assessment of Two Novel Live-Attenuated Vaccine Candidates for Herpes Simplex Virus 2 (HSV-2) in Guinea Pigs

Treatment to ameliorate the symptoms of infection with herpes simplex virus 2 (HSV-2) and to suppress reactivation has been available for decades. However, a safe and effective preventative or therapeutic vaccine has eluded development. Two novel live-attenuated HSV-2 vaccine candidates (RVx201 and RVx202) have been tested preclinically for safety. Hartley guinea pigs were inoculated vaginally (n = 3) or intradermally (n = 16) with either vaccine candidate (2 × 107 PFU) and observed for disease for 28 days. All animals survived to study end without developing HSV-2-associated disease. Neither vaccine candidate established latency in dorsal root or sacral sympathetic ganglia, as determined by viral DNA quantification, LAT expression, or explant reactivation. Infectious virus was shed in vaginal secretions for three days following vaginal inoculation with RVx202, but not RVx201, although active or latent HSV-2 was not detected at study end. In contrast, guinea pigs inoculated with wild-type HSV-2 MS (2 × 105 PFU) vaginally (n = 5) or intradermally (n = 16) developed acute disease, neurological signs, shed virus in vaginal secretions, experienced periodic recurrences throughout the study period, and had latent HSV-2 in their dorsal root and sacral sympathetic ganglia at study end. Both vaccine candidates generated neutralizing antibody. Taken together, these findings suggest that these novel vaccine candidates are safe in guinea pigs and should be tested for efficacy as preventative and/or therapeutic anti-HSV-2 vaccines.

Evaluation Of The Radiofrequency Ablation Of Lumbar Sympathetic Ganglia In Lower Limb Ischemic Ulcers In Indian Population

Antecedentes: la simpatectomía lumbar mediante radioablación es un tratamiento útil de la isquemia periférica. Sin embargo, la eficacia clínica con respecto a las úlceras de las extremidades inferiores no está suficientemente establecida en la población india. El estudio se realizó para evaluar el papel de la ablación por radiofrecuencia (ARF) de los ganglios simpáticos lumbares en la cicatrización de las úlceras isquémicas del miembro inferior. Método: El estudio prospectivo con 63 pacientes registrados en el servicio de Cirugía General con úlceras isquémicas de miembros inferiores entre diciembre de 2017 y julio de 2019 fueron tratados con ARF. Se excluyó del estudio a los pacientes con enfermedad cardiopulmonar, embarazadas, malformaciones congénitas o infección cutánea en el lugar de la intervención, o que padecían trastornos hemorrágicos. Se realizó una investigación clínica de la herida y se recopilaron datos demográficos. La reducción comparativa en el tamaño de la herida se evaluó mediante el ANOVA de Friedman (P <0,001). La diferencia en la puntuación del dolor, la estancia hospitalaria y la distancia recorrida se evaluaron mediante la prueba de pares emparejados de Wilcoxon (P <0,001), la prueba t para datos no emparejados y la prueba t para datos emparejados (P <0,05). Resultado: la mayoría de los pacientes eran hombres (n = 40) con una edad media de 60,93 DE14,34 años. Se observó una reducción significativa en el tamaño de la herida, las puntuaciones de dolor y la estancia hospitalaria después del procedimiento (P <0,001). El número de sesiones de RFA se asoció significativamente con el tamaño de la úlcera y la clasificación de Fontaine 2 y 3 (P <0,0001). Conclusión: La ARF de los ganglios simpáticos lumbares es una posible modalidad de tratamiento para las úlceras isquémicas de las extremidades inferiores.

Atypical Presentation of an Adrenal Mass

Catecholamine-secreting tumours arise from chromaffin cells of the adrenal medulla, and the sympathetic ganglia referred to as pheochromocytomas and catecholamine secreting paragangliomas, respectively. The incidence of pheochromocytoma is less. This was about a 38-years-old male patient that complained of burning sensation while micturition and right loin pain. On evaluation he was found to have a right adrenal mass of size of 6 cm. The patient was found to have right ureteric caliculi and right Double J Stent (DJ) was done. He was advised for further evaluation but he was not willing at that point of time. Thus, pheochromocytoma has to be one of the differentials in a young person presenting with hypertension or with atypical presentation. Because pheochromocytoma is one of the correctable causes of hypertension and a person can have a near normal or average life span after surgery. This patient presented with urinary symptoms followed by typical features of cholelithiasis rather than symptoms of pheochromocytoma.

A Rare Case of Diffuse Intestinal Ganglioneuromatosis in a Child Presenting with Intussusception

Ganglioneuromas are benign neurogenic neoplasms commonly seen in children which are originating from neural crest cells of sympathetic ganglia or adrenal medulla. Rarely, they may arise from the visceral organs like intestine. Diffuse intestinal ganglioneuromatosis is a rare disease, caused due to abnormal proliferation of ganglion cells, nerve fibres and schwann cells in the wall of intestine. Author hereby present a case of diffuse intestinal ganglioneuromatosis in an 18-month-old male child who presented with symptoms of small bowel obstruction. Resected segment of ileocecal junction revealed ulcero-nodular areas which on microscopy showed diffuse hyperplasia of nerve bundles and ganglion cells with immunohistochemistry confirmation. Intestinal ganglioneuromatosis is a rare condition having syndromic association with MEN-2B, Neurofibromatosis-1 and Cowden syndrome. As this disease has a low clinical suspicion, very nonspecific symptoms and radiological findings, histopathological examination becomes mainstay in diagnosis. Further workup is essential to rule out presence of associated syndromes.Surgical excision is the ultimate treatment with screening for genetic abnormalities.