title: Absent skeletal uptake of (99m)Tc-hydroxymethylene diphosphonate in the presence of AL-type amyloidosis associated with multiple myeloma.
abstract: A 66-year-old woman with congestive heart failure suspected to have multiple myeloma underwent bone scintigraphy. The bone scintigraphy using technetium-99m hydroxymethylene-diphosphonate showed the following interesting findings: absent skeletal uptake; increased gastrointestinal, myocardial, and soft tissue uptake; migration of radionuclide to bilateral pleural effusions. Histopathological examination revealed that the patient suffered from AL-type amyloidosis associated with multiple myeloma. Extraosseous uptake is often observed on bone scintigraphy in amyloidosis patients, but in many cases skeletal uptake is preserved. The simultaneous presentation of these findings is rare.
authors.affiliation: Department of Radiology, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa 078-8510, Japan. tomoaki3est@gmail.com
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Sasaki
authors.forename: Atsutaka
authors.initials: A
authors.lastname: Okizaki
authors.forename: Koji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mineta
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagasawa
authors.forename: Yasuomi
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Kyuhei
authors.initials: K
authors.lastname: Kohda
authors.forename: Tamio
authors.initials: T
authors.lastname: Aburano
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*
chemical_list: D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate