Melvin J. Spicer

Painless giant cell thyroiditis diagnosed by fine needle aspiration and associated with intense thyroidal uptake of gallium

A 52-year-old woman presented with fever, goiter, and no evidence of pain or tenderness in the thyroid. A diagnosis of silent thyroiditis was made after obtaining evidence of biochemical thyrotoxicosis, intense gallium-67 citrate thyroidal localization, and cytologic thyroiditis. Fine needle aspiration biopsy of the thyroid revealed numerous giant cells in all areas of the thyroid, typical of subacute thyroiditis. This is believed to be the first time painless thyroiditis is reported with the classic cytologic feature of painful subacute thyroiditis.

Ruptured abdominal aortic aneurysm identified incidental to bone scintigraphy

A report is presented of a man who had a ruptured abdominal aortic aneurysm identified incidental to bone scintigraphy. The bone scan revealed displacement of the left kidney to nearly a horizontal axis and indicated the need for more definitive evaluation. Renal scintigraphy and computed tomography correctly demonstrated a ruptured, but contained abdominal aortic aneurysm.

Cholelithiasis demonstrated on hepatobiliary scintigraphy as a photopenic defect within the inferior portion of the liver

A 47-year-old man presented with the clinical findings of acute cholecystitis. During hepatobiliary scintigraphy using Tc-99m DISIDA, a persistent photopenic defect was noted within the inferior portion of the liver in the region of the gallbladder. Abdominal ultrasonography revealed large gallstones with acoustic shadowing within a normal-sized gallbladder. Eleven large gallstones were found within a normal-sized intrahepatic gallbladder at surgery.

Splenic rotation as demonstrated by 99mTc SCOL

The spleen is free to move around on its pedicle, since it is not fixed in the abdomen. We describe the case of a woman who demonstrated a temporary rotation of the spleen 90° from its usual axis as shown by liver-spleen scintigraphy using technetium Tc-99m sulfur colloid (99mTc SCOL). The reason for this rotation is discussed. Other previously reported causes of splenic displacement are also reviewed.

Gallium-67 citrate scintigraphy in pulmonary embolism.

Eight cases of pulmonary embolism were evaluated with Ga-67 citrate scintigraphy. Of the eight patients, all but one showed evidence of abnormal Ga-67 citrate localization within involved regions of the lung as demonstrated by ventilation-perfusion lung scintigraphy. The sole patient who did not demonstrate Ga-67 localization within the lung had marked breast accumulation of the radiotracer which may have obscured lung parenchymal uptake. Since Ga-67 citrate is known to accumulate within inflammatory lung processes, this radiotracer would not have a specific role in differentiating pulmonary embolism from these conditions. This study disagrees with the results of other studies in the medical literature that describe such a role.

The Value of Obtaining Renal Images Following Brain Scintigraphy with Technetium-99m Glucoheptonate

The value of adding an extra view of the kidneys immediately following brain imaging with Tc-99m glucoheptonate was investigated in a two-year retrospective study at our institution. Between October 1982 and October 1984, 561 individuals underwent Tc-99m glucoheptonate brain imaging with the added renal view. Twentynine of these individuals (5.2%) demonstrated renal abnormalities. The abnormal renal findings were clinically correlated in 24 of these persons. Sixteen (67%) of these 24 individuals were unaware of any renal abnormality. Useful information can be obtained from renal images incidental to brain imaging at no added expense or radiation exposure to the patient, and at a minimal cost in time to the imaging clinic.

Myositis ossificans with Ga-67 citrate positivity.

A 16 year-old boy presented with a firm mass within the left thigh. Ga-6 7 citrate and bone scintigraphy revealed soft tissue radiotracer accumulation within the mass lesion. Radiographs and xerography of the left thigh revealed calcification within the soft tissue mass typical of myositis ossificans. The patients clinical course was uneventful.