title: Diffuse and intense Tc-99m HMDP localization in the liver due to hypoxia secondary to respiratory failure.
abstract: After left lower lobe lobectomy for lung carcinoma, a patient had acute respiratory failure secondary to pneumonia and pulmonary embolism requiring a ventilator. Tc-99m HMDP bone scan showed diffuse, intense hepatic uptake. Concurrent liver enzymes indicated hepatic necrosis. Two weeks later the patient died and a limited chest autopsy confirmed acute adult onset respiratory distress syndrome. Etiologic factors of massive hepatic necrosis in relation to hepatic localization of bone imaging agent and its prognostic outcome are discussed.
authors.affiliation: Nuclear Medicine Service, Department of Veterans Affairs Medical Center, Lexington, KY 40511.
authors.forename: W J
authors.initials: WJ
authors.lastname: Shih
authors.forename: J
authors.initials: J
authors.lastname: Coupal
mesh_terms: D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D009336:Necrosis; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications; D011877:Radionuclide Imaging; D012128:Respiratory Distress Syndrome / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications*; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
chemical_list: C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate