Pulmonary mycobacterial infections in AIDS: characteristic pattern of thallium and gallium scan mismatch.
OBJECTIVE
To evaluate the diagnostic specificity of thallium and gallium scan mismatch as a sign of mycobacterial infection in immunodeficient patients.


METHODS
Thallium and gallium scans obtained in 56 immunodeficient patients between January 1989 and March 1994 were retrospectively reviewed, with special attention to the final diagnoses in all patients with thallium-gallium scan mismatch compared with those whose scans showed other scintigraphic patterns.


RESULTS
Fourteen patients had focal gallium uptake, but no thallium uptake, in the mediastinum and hilar nodes (thallium-gallium mismatch). Twelve of the 14 had culture-proved mycobacterial infections; one had cryptococcal infection; and in one, the diagnosis was not established. Thirty-seven of the remaining 42 patients who had different scintigraphic patterns on thallium-gallium scans had other complications of acquired immunodeficiency syndrome such as Kaposi sarcoma, non-Hodgkin lymphoma, and bacterial pneumonia. The diagnosis in five of the 42 patients was not known because follow-up data were incomplete.


CONCLUSIONS
The thallium-gallium mismatch pattern in immunodeficient patients is specific for mycobacterial infection.
Department of Radiology, Boston University School of Medicine, Boston City Hospital, Mass.
V W
VW
Lee
T P
TP
Cooley
J D
JD
Fuller
R J
RJ
Ward
H W
HW
Farber
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D005710:Gallium Radioisotopes; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*
D005710:Gallium Radioisotopes; D013794:Thallium Radioisotopes