Aseptic necrosis. A scintigraphic imitator of osseous involvement in Ga-67 avid lymphoma.
Based on the data by Armas et al, avascular necrosis, a not uncommon treatment-associated complication in patients with lymphoma, it should be easily distinguishable from osseous lymphomatous involvement in patients with Ga-67 avid lymphoma. In avascular necrosis, Ga-67 uptake will be either absent, decreased, or normal, whereas in lymphoma Ga-67 uptake will be increased. The authors present a patient with Hodgkin's disease who had new foci of simultaneously increased Ga-67 and Tc-99m MDP uptake because of avascular necrosis as proven by biopsy and long-term follow-up. The authors hypothesize that a possible-explanation for the discrepancy between this patient report and the series by Armas et al may be that increased Ga-67 is a delayed phenomenon related to healing.
Van de Wiele
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Division of Nuclear Medicine, University Hospital Gent, Belgium.
Dierckx
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RA
Noens
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L
Simons
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M
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D016026:Bone Marrow Transplantation; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005269:Femur / Q000000981:diagnostic imaging* / Q000473:pathology; D005500:Follow-Up Studies; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010020:Osteonecrosis / Q000000981:diagnostic imaging* / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D013977:Tibia / Q000000981:diagnostic imaging* / Q000473:pathology; D014945:Wound Healing
D000970:Antineoplastic Agents; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate