Serter, Selim

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Hypermetabolic Axillary Lymph Nodes Associated With Covid-19 Vaccination in Breast Cancer Management
(Galenos Publishing House, 2023-06-01) Taşçı, Cengiz; Dirican, Ahmet; Sözbilen, Ethem Murat; Pehlivan, F.S.; Serter, Selim
A 42-year-old female patient diagnosed with invasive ductal breast ca underwent18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) scan for staging, 1.5 cm diameter hypermetabolic lesion was observed in the lower inner quadrant of the right breast that was compatible with primary tumor [maximum standardized uptake value (SUVmax ): 10.5]. No pathological18F-FDG uptake was observed in lymph nodes whose fatty hilum was seen in the right axilla. However, in the left axilla and left deep axilla, hypermetabolic lymph nodes with a maksimum diameter of 19 mm and fatty hilum were observed (SUVmax: 8.0). In a detailed CT evaluation, these lymph nodes have thicker walls than the ones in the right axilla. The patient was questioned again and coronavirus disease-2019 (COVID-19) vaccination history (with BNT162b2, COVID-19 mRNA vaccine) was determined that was administrated to the left arm 5 days ago. Tru-cut biopsy was performed from the left aksillary lymph nodes and proved to be reactive lymphoid tissue and there was no primary or metastatic tumor in these axillary lymph node tissues. The patient was given neoadjuvant chemotherapy 4.5 months after the first18F-FDG PET/CT, and the second was performed for the treatment response evaluation. Significant regression was determined from the findings. The patient underwent right total mastechtomy. She was being followed up with adjuvant chemotherapy and radiotherapy. In conclusion, hypermetabolic lymph nodes in the axillas should be interrogated for vaccination in patients with breast cancer. Hypermetabolic lymph nodes observed on the same side of the vaccinated arm in the 18 F-FDG PET/CT scan may be related to vaccine-induced reactive lymph node enlargement. Lymph node metastasis may be excluded, especially if there are hypermetabolic lymph nodes with preserved fatty hilum in the contralateral axilla on the same side as the vaccinated arm. Active lymph nodes reactive to the vaccine become inactive after a while. © 2023 by the Turkish Society of Nuclear Medicine.
Diagnostic Accuracy of Kidney Shear Wave Elastography at the Diagnosis of Ureteral Stones
(2022-03-27) Serter, Selim; Yıldırım, Mahir Utku; Ors, Bumin; Şahin, Erkan; Solak, Aynur; Selim, Serter; Yıldırım, Utku Mahir
Aim: To determine the efficacy of kidney shear wave elastography (SWE) in patients diagnosed with ureteral stones Method: Both kidneys of 30 patients were evaluated prospectively with SWE. The ureteral stone size and the degree of hydronephrosis were determined by sonographic examination. The contralateral kidney was accepted as the control parameter. Stone size, grade of hydronephrosis and kidney shear wave speed changes were noted and their relations were examined for statistical significance. Results: Affected kidney group had significantly increased SWE values than the control group. (3.87+-1.22 vs 2.06+-0.72 m/sec) (p=0.01). Neither the stone size nor the kidney SWE values showed a correlation with the gender. There was a positive correlation between the grade of hydronephrosis and the stone size (p=0.047, r=0,36). Kidneys with grade 2 hydronephrosis had significantly higher SWE values than those with grade 1 hydronephrosis. Conclusion: SWE is a promising tool to observe the parenchymal elasticity changes in patients with hydronephrosis secondary to ureteral stones. Further studies are necessary to confirm the research results.

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Acta Medica Alanya	1
Molecular Imaging and Radionuclide Therapy	1

Serter, Selim

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