The Netherlands journal of medicine
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In the past decade, 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (18F-FDG PET-CT) scans have been increasingly implemented in the diagnostic process of several haemato-oncological conditions. Accurate assessment of bone marrow activity observed on 18F-FDG PET-CT is crucial for a correct diagnostic conclusion, subsequent treatment decision, and follow-up strategies. By systematically considering the arguments of the level of 18F-FDG uptake, distribution pattern, coinciding changes of the bone structure, and the clinical context, interpretation and validity may improve. This review aims to give a comprehensive overview of the different patterns of 18F-FDG uptake on PET/CT in common benign, clonal, and malignant haematological conditions, accompanied by illustrative cases.
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Outcomes of vascular surgery for patients with primary antiphospholipid syndrome (APS) presenting with acute limb ischaemia (ALI) are poor, with a high rate of postoperative arterial thrombosis and limb amputation. A primary antiphospholipid syndrome 42-year-old male patient presented with acute limb ischaemia. Timely endovascular thrombectomy successfully prevented irreversible tissue damage but failed to maintain this due to recurrent thrombosis. ⋯ Two weeks post-discharge, thrombotic arterial reocclusion led to readmission and repeated management. Following successful reperfusion, intensive immunosuppressive therapy and anticoagulant agents ensured that the patient was free from recurrent events during the next eight months. This case highlights the combination of endovascular thrombectomy and intensive plasma exchange for limb salvage in such cases.