Unexpected Pyelonephritis Incidentally Revealed on 99mTc MDP Bone Scintigraphy

Large Renal Cysts on Bone Scintigraphy in a Patient With Lower Back Pain

Bone scintigraphy is often utilized to detect the osseous etiology of lower back pain. Here we report a 70-year-old man with lower back pain who was referred a Tc-MDP bone scan to identify possible vertebral compression fracture. The images did not detect any osseous lesion. However, the images revealed photopenic regions in the both kidneys, which were confirmed as renal cysts on the CT images. The patient received laparoscopic unroofing of renal cysts, and his symptoms improved. Our case illustrated that back pain is not always due to osseous etiology, it might be caused by urinary disorder.

Incidental Detection of Ovarian Thecoma by 99mTc-MDP Whole-Body Bone Scan: Contribution of Hybrid SPECT/CT

Ovarian thecoma is a benign and rare neoplasm that accounts for 0.5% to 1% of all ovarian tumors. A 55-year-old woman with known breast cancer underwent a metastatic workup before surgery. The Tc-MDP whole-body bone scan revealed intense uptake in the left pelvic region. Hybrid SPECT/CT imaging showed that the elevated Tc-MDP activity was in a tumor with calcification in the left adnexa. Dynamic enhanced MRI revealed marked enhancement of the tumor. Resection of the tumor was subsequently performed, and pathologic analysis confirmed the diagnosis of an ovarian thecoma.

Extramedullary Infiltration of Acute Lymphoblastic Leukemia in Multiple Organs on FDG PET/CT

Concurrent extramedullary infiltration in multiple organs is uncommon in adults with acute lymphoblastic leukemia. A 21-year-old woman who presented fatigue had a new diagnosis of acute lymphoblastic leukemia underwent FDG PET/CT. The images demonstrated extramedullary infiltration in multiple organs, including the liver, pancreas, kidney and the bone. However, no clinical signs or laboratory tests were suggestive of the involvement of these organs. After four cycles of chemotherapy, the patient's symptoms were relieved and all previously visualized abnormal activity disappeared on the follow-up FDG PET/CT.