title: Technetium-99m-methylene diphosphonate (MDP) uptake in a sympathetic effusion: an index of malignancy and a review of the literature.
abstract: We report a patient with a sympathetic pleural effusion secondary to T-cell lymphoma that accumulated the bone imaging agent, Technetium-99m-methylene diphosphonate (99mTc-MDP). This case is significant in that malignant cells were not present on three cytologic examinations of the pleural fluid or multiple pleural biopsies. We also present a review of the published literature on pleural effusions that accumulate bone tracers. We conclude that pleural effusions that accumulate 99mTc-MDP should be considered malignant or secondary to a malignancy and further work-up is essential even if the cytologic exam of the pleural fluid is unremarkable.
authors.affiliation: Department of Radiology and Laboratory Services, Medical College of Virginia, Richmond.
authors.forename: T J
authors.initials: TJ
authors.lastname: Cole
authors.forename: J
authors.initials: J
authors.lastname: Balseiro
authors.forename: H R
authors.initials: HR
authors.lastname: Lippman
mesh_terms: D000368:Aged; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications*; D008297:Male; D016066:Pleural Effusion, Malignant / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate / Q000493:pharmacokinetics*
chemical_list: D013669:Technetium Tc 99m Medronate