By Kevin J. Donohoe, Annick D. Van den Abbeele
In the educating ATLAS OF NUCLEAR medication, you can find entire insurance of the total box of nuclear drugs via a sequence of essentially offered instances. Following the board examination structure, the circumstances are provided as unknowns, with a picture and short scientific description; you're then requested to reach at your personal differential analysis. entire with suggestions, pearls, pitfalls, and a quick dialogue of every case, this can be the precise publication for self-testing and maximizing your learn time.
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Extra resources for Teaching atlas of nuclear medicine
Biopsy revealed renal cell carcinoma. Embolization of the femur and lumbar metastatic lesions was performed with some relief. The patient was referred to an outside institution for follow-up. Discussion Bone metastases from renal carcinoma may not demonstrate the marked osteoblastic response seen with breast and prostate metastases. It is common to see areas of little tracer uptake surrounded by a ring of osteoblastic response, as in the skull lesion of this patient. Less than 5% of bone scans performed during the staging workup of renal carcinoma patients are positive.
The rib abnormality was found to be secondary to a lytic metastatic lesion. Discussion Soft tissue uptake of tracer is occasionally seen in bone scans for a number of reasons, including metastatic disease. One of the more common causes of soft tissue uptake is axillary nodal uptake secondary to lymphatic drainage from an infiltrated tracer injection. This is usually easily identified when the injection site is imaged. If no infiltrate is seen at the injection site or the injection site is in the contralateral arm, further investigation of the nodal uptake is warranted.
Also noted on the posterior image are relatively large kidneys and a suggestion of tracer concentration in a small, infarcted spleen, just above the left kidney. A right hip prosthesis is also noted. 33 TEACHING ATLAS OF NUCLEAR MEDICINE PEARLS/PITFALLS • Tracer uptake in an infarcted spleen may be very slight and difficult to distinguish from the kidney below. • Increased uptake on bone scan is not specific for infarct or osteomyelitis and may be caused by a number of conditions described previously.