Unusual mediastinal lymph node uptake and peritoneopleural fistula demonstrated on Technetium-99m macro-aggregated human serum albumin (Tc-99m MAA) peritoneal scintigraphy in a patient with portal hypertension.
Peritoneal radionuclide scan is an established imaging modality for evaluating peritoneopleural communications. In this case report, unusual mediastinal lymph node radiotracer uptake is seen in a patient with portal hypertension on peritoneal scintigraphy. This was suspected to be due to marked lymphatic enlargement from longstanding portal hypertension since childhood, permitting passage of the large Tc-99m MAA particle. The nodes were morphologically benign on CT. Mediastinal lymph node uptake on peritoneal scintigraphy is rare but should not raise undue clinical concern, particularly in a patient with chronic portal hypertension. Anatomic correlation with SPECT-CT can provide reassurance.
Singapore General Hospital, Department of Nuclear Medicine and PET, Outram Road, Singapore 169508. thang.sue.ping@singhealth.com.sg.
C J
CJ
Tan
Singapore General Hospital, Department of Nuclear Medicine and PET, Outram Road, Singapore 169508.
S P
SP
Thang
Singapore General Hospital, Department of Nuclear Medicine and PET, Outram Road, Singapore 169508.
W W
WW
Lam
D005402:Fistula; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D000075462:Serum Albumin, Human; D013667:Technetium; D013668:Technetium Tc 99m Aggregated Albumin / Q000493:pharmacokinetics*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D013667:Technetium; D000075462:Serum Albumin, Human