title: Acute myelofibrosis mimicking multiple bone metastases on Tc-99m MDP bone imaging.
abstract: OBJECTIVE
  Tc-99m bone scintigraphy is widely used for evaluation of osseous spread of malignant tumors.
  
  
  METHODS
  A 60-year-old man had multiple areas of increased uptake on a bone scan in a pattern considered characteristic for extensive metastatic disease. However, a primary neoplasm could not be identified. Finally, acute myelofibrosis--a rare, fatal myeloproliferative syndrome--was diagnosed.
  
  
  CONCLUSIONS
  To avoid delays and extensive diagnostic procedures, acute myelofibrosis should be considered in the differential diagnosis of bone scans showing multiple hot spots. In such cases, a diagnosis can be made on an a tissue sample.
authors.affiliation: University Hospital Nijmegen, Department of Nuclear Medicine, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Oyen
authors.forename: J M
authors.initials: JM
authors.lastname: Raemaekers
authors.forename: F H
authors.initials: FH
authors.lastname: Corstens
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013669:Technetium Tc 99m Medronate
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013669:Technetium Tc 99m Medronate