Iodine-123-MIBG imaging in pheochromocytoma with cardiomyopathy and pulmonary edema.
We encountered a patient with pheochromocytoma associated with a catecholamine-induced cardiomyopathy that developed recurrently bilateral and unilateral pulmonary edema. The diagnosis of pheochromocytoma was made by elevated plasma catecholamine levels and the intense tumor [123I]MIBG uptake and was confirmed at the time of surgery. The patient showed reduced myocardial [123I]MIBG uptake with left ventricular dysfunction, and endomyocardial biopsy findings were consistent with the diagnosis of catecholamine-induced cardiomyopathy. After tumor resection, plasma levels of catecholamine were normalized, and pulmonary edema never recurred, although cardiac dysfunction did not show an improvement on echocardiography. Myocardial and lung [123I]MIBG uptake increased when compared to uptake levels on preoperative scans, but myocardial uptake was still below normal. These findings indicated that over-secreted catecholamines influenced both the heart and lungs. Pheochromocytoma can induce cardiac and lung injuries, and [123I]MIBG scanning may contribute not only to tumor characterization but also to assessing and monitoring the influence of catecholamines on the heart and lungs.
Suga
K
K
Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan.
Tsukamoto
K
K
Nishigauchi
K
K
Kume
N
N
Matsunaga
N
N
Hayano
T
T
Iwami
T
T
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D003287:Contrast Media; D004837:Epinephrine / Q000097:blood; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D009638:Norepinephrine / Q000097:blood; D010673:Pheochromocytoma / Q000150:complications / Q000000981:diagnostic imaging*; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology
D003287:Contrast Media; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013668:Technetium Tc 99m Aggregated Albumin; D019797:3-Iodobenzylguanidine; D009638:Norepinephrine; D004837:Epinephrine