sodium-pertechnetate-tc-99m and Leukemia--Lymphocytic--Chronic--B-Cell

An enlarged spleen failed to accumulate Tc-99m-labeled phytate, but it showed normal perfusion and uptake of labeled and heat-denatured red blood cells. A blood cell count demonstrated moderately low hemoglobin and hematocrit levels and a markedly low platelet count, and results of direct Coombs' and antiplatelet-antibody (IgG) tests were positive. Steroid therapy resulted in normal splenic function. This case demonstrates reversible functional asplenia caused by reticuloendothelial dysfunction secondary to pure splenic chronic lymphocytic leukemia.

Topics: Anemia, Hemolytic, Autoimmune; Erythrocytes; Female; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemic Infiltration; Middle Aged; Organotechnetium Compounds; Phytic Acid; Prednisolone; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spleen; Splenomegaly; Thrombocytopenia

We present markedly decreased radioactivity in the right on a 99mTc-pertechnetate thyroid image in a patient with secondary lymphoma of the thyroid. At autopsy, the right lobe of the thyroid was replaced by lymphoma tissue. Markedly decreased radioactivity on the images may be explained by lymphoma cell infiltration or replacement of thyroid tissue with a resultant attenuation effect as well as interference of the trapping mechanism of the thyroid folicular cell. While cold areas in a radionuclide scintigram may present difficulties in interpretation, a high index of secondary lymphoma suspicion should be made by a combination of the scintigraphic findings and history of malignant lymphoma.

Topics: Aged; Aged, 80 and over; Female; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Neoplasms