ABSTRACT
This paper details the case report of a 26-year-old man who presented with a growing right-sided skull mass evaluated with ultrasound, non-contrast CT, contrast-enhanced MRI and 99mTc-MDP whole body bone scan with SPECT/CT. These studies suggested a broad differential diagnosis favoring benign osseous lesions. Given a more recent increase in the rate of growth, headache and large size, the lesion was excised via craniotomy followed by cranioplasty. Pathology confirmed fibrous dysplasia (FD) as the diagnosis. Interestingly, this report is the imaging evaluation of the exophytic subtype of FD, the so-called FD protuberance, an extremely rare variant of FD, of which only two case reports are found in the literature.
ABSTRACT
A "cold" defect or an area of decreased radiotracer deposition is the less common appearance of acute hematogenous osteomyelitis (AHO) on a Tc99 m-methylene disphosphonate (Tc99 m-MDP) bone scan. Group A beta-hemolytic Streptococcus (GABHS) is a significantly less common cause of AHO than Staphylococcus aureus, particularly when the infection involves the pelvis or flat bones such as the ribs. Here, we present a case report of isolated acute "cold" hematogenous osteomyelitis in a rib of a child with GABHS bacteremia that was detected on 99Tc-MDP bone scan, with magnetic resonance imaging correlation, and pathologic confirmation after rib resection.
ABSTRACT
A 19-year-old male military recruit presented with 3 weeks of persistent left hip and groin pain after abnormally twisting his hip during a hike. Initial radiographs were interpreted as negative. He subsequently underwent a bone scan which revealed linear left sacral uptake along or paralleling the sacroiliac joint. Differential diagnostic considerations included unilateral sacroiliitis and sacral fracture. SPECT/CT was performed which confirmed left sacral fatigue stress fracture. Transitional lumbosacral anatomy was evident on radiographs with pseudoarticulation of the transitional left S1 transverse process with the sacrum. We postulate this predisposed the recruit to sacral fracture.
Subject(s)
Fractures, Stress/diagnostic imaging , Military Personnel , Sacroiliac Joint/diagnostic imaging , Fractures, Stress/complications , Fractures, Stress/pathology , Humans , Male , Positron Emission Tomography Computed Tomography , Sacroiliitis/complications , Young AdultABSTRACT
A case of a 7-month-old white female who was referred for 18F-fluorodeoxyglucose (FDG) Positron emission tomography/computed tomography (PET/CT) initial evaluation of a lytic skull lesion with presumed diagnosis of Langerhans cell histiocytosis is described. Incidentally, she was found to have hypermetabolic nodules in the soft tissues of her anterior thighs.
ABSTRACT
Coccidioidomycosis (valley fever) is a systemic fungal infection resulting from inhalation of the Coccidioides immitis or posadasii spores. In many cases, infection causes a self-limited community-acquired pneumonia; however, in patients with risk factors, such as immunosuppression or African or Pacific Island ancestry, significant morbidity and mortality from disseminated disease may occur. Presented here are comparative images using Tc-MDP bone scan, F-FDG PET/CT, and MRI. Each demonstrates particular strengths, which aid in assessing the extent of systemic involvement of a biopsy-proven case of disseminated coccidioidomycosis.
Subject(s)
Coccidioidomycosis/diagnostic imaging , Fluorodeoxyglucose F18 , Magnetic Resonance Imaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Technetium Tc 99m Medronate , Humans , Male , Young AdultABSTRACT
We report a 37-year-old female who underwent radioiodine treatment, with subsequent scintigraphy findings suggestive of pulmonary metastatic disease. The abnormal uptake on single-photon emission computed tomography/computed tomography correlated with a focal area of the right middle lobe bronchiectasis.
ABSTRACT
This is a 66-year-old female patient being treated for diffuse large B-cell lymphoma. She reported to her physician in late January 2012 with a left flank pruritic painful rash. She was diagnosed with herpes zoster and treated with antiviral medication. Her chemotherapy regimen was delayed due to the zoster infection. In March 2012, the patient underwent a PET/CT as a lymphoma surveillance scan prior to reinstituting the chemotherapy treatment. As an incidental finding, the PET showed increased metabolic activity in a dermatomal distribution along the left flank, which corresponded to the patient's zoster infection.
Subject(s)
Fluorodeoxyglucose F18 , Herpes Zoster/diagnostic imaging , Skin/diagnostic imaging , Skin/pathology , Aged , Female , Humans , Positron-Emission Tomography , Skin/virology , Tomography, X-Ray Computed , Whole Body ImagingABSTRACT
An 18-year-old male patient with a history of Ewing sarcoma originally involving the right ilium was evaluated with an FDG PET/CT scan to evaluate the effect of salvage therapy after standard treatment failed and disease progressed to involve the right T12 pedicle. Autologous stem cell transplantation and cyberknife therapy resulted in mixed tumor response, with incidental note made of prominent areas of cortical FDG avidity in the right kidney. These regions demonstrated focal hypoenhancement on the corresponding diagnostic contrast-enhanced CT, which additionally demonstrated peripheral enhancement spanning the length of the right ureter. Clinical workup produced a diagnosis of acute pyelonephritis.
Subject(s)
Multimodal Imaging , Positron-Emission Tomography , Pyelonephritis/diagnostic imaging , Tomography, X-Ray Computed , Acute Disease , Adolescent , Contrast Media , Fluorodeoxyglucose F18 , Humans , Kidney/diagnostic imaging , Kidney/pathology , MaleABSTRACT
A 51-year-old Korean woman with a history of breast cancer underwent screening bone scintigraphy, which revealed minimal soft tissue uptake of Tc-99m methylene diphosphonate (MDP) in the right lower quadrant. CT and plain films confirmed that the uptake was due to a retained surgical sponge or gossypiboma. The incidence of gossypibomas has been reported at high as 1 in 1000 to 15,000 intra-abdominal operations. The natural progression of an aseptic gossypiboma is a foreign body reaction and granuloma formation. This inflammatory granulomatous reaction is the most likely cause of the extraosseous accumulation of Tc-99m MDP. This entity should be added to the already extensive list of etiologies of extraosseous MDP accumulation.
Subject(s)
Appendectomy/adverse effects , Appendectomy/instrumentation , Foreign-Body Reaction/diagnostic imaging , Foreign-Body Reaction/etiology , Surgical Sponges/adverse effects , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Breast Neoplasms/diagnostic imaging , Diagnosis, Differential , Female , Humans , Middle Aged , Radionuclide ImagingABSTRACT
Four years after radiation therapy to the lower extremity for a bone metastasis, persistent F-18 FDG and Tc99m MDP uptake were noted in the radiation port. Presumably ongoing inflammatory cellular processes accounts for this finding.
Subject(s)
Fluorodeoxyglucose F18 , Lower Extremity/diagnostic imaging , Osteoradionecrosis/diagnostic imaging , Technetium Tc 99m Medronate , Adult , Female , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Lower Extremity/radiation effects , Osteoradionecrosis/metabolism , Radionuclide Imaging , Radiopharmaceuticals/pharmacokinetics , Technetium Tc 99m Medronate/pharmacokineticsSubject(s)
Barium Sulfate/adverse effects , Cecal Diseases/chemically induced , Cecal Diseases/diagnostic imaging , Fecal Impaction/chemically induced , Fecal Impaction/diagnostic imaging , Gastroenteritis/chemically induced , Gastroenteritis/diagnostic imaging , Indium Radioisotopes , Leukocytes/diagnostic imaging , Aged , Female , Humans , Radionuclide Imaging , RadiopharmaceuticalsSubject(s)
Cardiomyopathies/congenital , Cardiomyopathies/diagnostic imaging , Hypertrophy, Left Ventricular/congenital , Hypertrophy, Left Ventricular/diagnostic imaging , Ventricular Dysfunction, Left/congenital , Ventricular Dysfunction, Left/diagnostic imaging , Child , Gated Blood-Pool Imaging , Humans , MaleABSTRACT
A case of bronchobiliary fistula (BBF) was demonstrated in the setting of polycystic kidney and liver disease (PCKLD) by hepatobiliary scintigraphy. High-resolution noncontrast computed tomography through the liver showed a polycystic liver. A calcified cyst adjacent to the dome of the liver appeared to have a fistulous connection with the lung on coronal reconstructions. Hepatobiliary scan confirmed the fistulous connection. In a review of the literature, BBF has been associated with hydatid cyst disease, trauma, postsurgical states, and malignancy. As demonstrated by this case, BBF is difficult to diagnose and requires a high clinical index of suspicion. Hepatobiliary scintigraphy is the imaging modality of choice to confirm BBF, and PCKLD should be added to the list of antecedent etiologies.