technetium-tc-99m-medronate and Respiratory-Distress-Syndrome

After left lower lobe lobectomy for lung carcinoma, a patient had acute respiratory failure secondary to pneumonia and pulmonary embolism requiring a ventilator. Tc-99m HMDP bone scan showed diffuse, intense hepatic uptake. Concurrent liver enzymes indicated hepatic necrosis. Two weeks later the patient died and a limited chest autopsy confirmed acute adult onset respiratory distress syndrome. Etiologic factors of massive hepatic necrosis in relation to hepatic localization of bone imaging agent and its prognostic outcome are discussed.

Topics: Aged; Bone and Bones; Humans; Hypoxia; Liver; Lung Neoplasms; Male; Necrosis; Postoperative Complications; Pulmonary Embolism; Radionuclide Imaging; Respiratory Distress Syndrome; Respiratory Insufficiency; Technetium Tc 99m Medronate