technetium-tc-99m-medronate and Pleural-Effusion

Topics: Adult; Bone Diseases; Female; Fever of Unknown Origin; Humans; Lung Abscess; Pleural Effusion; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Technetium Tc 99m Medronate; Thorax

Seventy-six patients with malignant or benign pleural effusion were studied to determine the incidence of accumulation of 99mTc-MDP in relation to effusion, and reveal the mechanism. Of 76 patients, 46 (61%) were found to have diffuse uptake of 99mTc-MDP in the hemithorax, with almost the same positive rate in malignant and benign effusions, i.e. 62% and 57%, respectively. Of 46 patients, 32 (70%) showed diffuse, slight accumulation in the hemithorax, and the positive rate had a tendency to be higher with the increase in the effusion volume. We are convinced that the major mechanism of unilateral intrathoracic accumulation of 99mTc-MDP in pleural effusion is a passive transudation.

Topics: Adult; Aged; Aged, 80 and over; Bone and Bones; Female; Humans; Japan; Male; Middle Aged; Pleural Effusion; Pleural Effusion, Malignant; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate

Topics: Adult; Coccidioidomycosis; Female; Humans; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Aged; Ascitic Fluid; Bone and Bones; Female; Humans; Male; Middle Aged; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Medronate

Diffusely increased radioactivity in the thoracoabdominal region (lower thorax and/or upper abdomen) occasionally has been observed when performing Tc-99m phosphonate bone studies. To assess the significance of activity in this finding, 1100 bone scintigrams were reviewed and the clinical data and other diagnostic imaging procedures were evaluated in these cases. With the exclusion of Tc-99m sulfur colloid liver-spleen scans 18 patients were found to have mild but diffuse increased radioactivity in the thoracoabdominal region either on the right or left. Clinical findings in these cases with abnormal uptakes were pleural effusions (six cases), hepatic colonic metastases (six cases), splenic metastases from bronchogenic carcinoma (one case), abdominal and peritoneal colonic metastases (one case), a massive metastatic squamous cell carcinoma (from lung) in the right lower chest (one case), and defective radiopharmaceuticals (three cases). Since the defective radiopharmaceuticals contained 5% of hydrolyzed reduced Tc-99m colloid by thin-layer chromatography, each of three patients received approximately 740 mu Ci of Tc-99m sulfur colloid. Factors to be considered in the interpretation of diffuse thoraco-abdominal activity from a bone agent should include splenic or hepatic metastases, a Tc-99m sulfur colloid splenic or hepatic metastases, a Tc-99m sulfur colloid study within the previous 24 hours, pleural effusion, faulty radiopharmaceuticals, and abdominal and peritoneal colonic metastases.

Topics: Abdomen; Aged; Bone and Bones; Colonic Neoplasms; Humans; Liver Neoplasms; Male; Pleural Effusion; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate; Thorax

Accumulation of Tc-99m labeled phosphonate bone scanning agent in a pleural effusion usually shows a mild and diffuse increase in radioactivity of the involved thorax. A malignant neoplasm was thought to account for this accumulation. The photon deficiency of the hemithorax on Tc-99m HMDP bone scintigraphy was shown in a case of massive pleural effusion, which was proved by autopsy to be due to metastatic breast carcinoma in the pleura. Two factors caused these scintigraphic findings: 1) a large amount of fluid in the pleural cavity caused photon attenuation; 2) the higher body background in the noninvolved hemithorax and other areas of the body was due to renal dysfunction resulting from chronic pyelonephritis. Whether the accumulation of the radiopharmaceutical agent in the pleural effusion was malignant or benign could not readily be distinguished.

Topics: Adult; Bone Neoplasms; Breast Neoplasms; Female; Humans; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Medronate; Thoracic Neoplasms

Technetium-99m phosphate compounds may occasionally accumulate in malignant pleural effusions. A case of metastatic pleural effusion first diagnosed by bone scan, prior to its clinical or roentgenographic detection, is reported.

Topics: Adult; Bone Neoplasms; Breast Neoplasms; Diphosphonates; Female; Humans; Pleural Effusion; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Increased accumulation of radioactivity was observed in malignant pleural and ascitic effusion as to a patient with stomach cancer and in malignant pleural effusions as to 2 patients (1 with breast cancer and another with lung cancer) during the performance of routine whole-body bone scans with 99mTc methylene diphosphonate. This finding should strongly suggest malignancy.

Topics: Adult; Ascites; Bone and Bones; Breast Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Pleural Effusion; Stomach Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Two case reports of malignant pleural effusion from breast carcinoma, with scans showing a striking accumulation of Tc-99m MDP, are presented. The Tc-99m MDP was in the pleural fluid and not in the pleura as demonstrated by shift with gravity. Possible mechanisms of malignant effusion accumulation of Tc-99m MDP are suggested. The scant literature on the subject is reviewed.

Topics: Aged; Bone and Bones; Breast Neoplasms; Diphosphonates; Female; Humans; Middle Aged; Phosphates; Pleural Effusion; Posture; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate