technetium-tc-99m-pyrophosphate and Lung-Neoplasms

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Fractures, Bone; Humans; Lung Neoplasms; Male; Osteomyelitis; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Back pain is a common clinical syndrome that may be the expression of an uncommon pathological process. We describe an unusual case of adenocarcinoma mimicking unilateral sacroiliitis. When progressive symptoms are unresponsive to conventional therapy, diagnosis should always be reconsidered, with appropriate imaging studies. We discuss mechanisms of joint space involvement and review the literature.

Topics: Adenocarcinoma; Adult; Arthritis; Bone Neoplasms; Diagnosis, Differential; Humans; Low Back Pain; Lung Neoplasms; Male; Radionuclide Imaging; Sacroiliac Joint; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray Computed

Radionuclide bone scans were performed before and during combination chemotherapy in 119 systematically staged patients with small cell carcinoma of the lung. Before therapy, 49 patients (41%) had positive scans. Scan positivity was significantly associated with the presence of metastatic tumor in the bone marrow, positive skeletal radiographs, and elevated serum alkaline phosphatase levels. Nonosseous distant metastases were significantly more likely to be detected as the number of areas of focal abnormalities on bone scan increased. The survival of patients with documented distant metastases in bone and nonosseous sites was significantly inferior to the survival of patients with limited disease, isolated osseous extensive disease, and extensive disease occurring only in nonbony sites. Of 36 patients with initially abnormal scans and tumor regression documented by other methods, scan findings improved in 24 (67%). In 26 (36%) of 72 scans in patients demonstrating disease progression in extraosseous sites, new areas of increased radionuclide uptake appeared. Improvement or worsening in follow-up scans was associated with nonbony tumor response or progression, respectively, 70% of the time. Serial bone scans provide reasonably accurate staging and prognostic information in patients with small cell lung cancer, although they are probably not sufficiently reliable to be used as the sole parameter in therapeutic decision-making.

Topics: Antineoplastic Agents; Bone Neoplasms; Carcinoma, Small Cell; Diphosphates; Drug Therapy, Combination; Evaluation Studies as Topic; Humans; Lung Neoplasms; Prognosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Aged; Carcinoma, Bronchogenic; Diphosphates; Humans; Lung Neoplasms; Male; Pericardial Effusion; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

A case of small cell anaplastic carcinoma of the lung with hepatic secondaries has been found to accumulate Tc-99m-pyrophosphate in both lung primary and hepatic metastases and to our knowledge is the first such case reported in the literature. There was no radiographic evidence of calcification in the tumor or hepatic metastases.

Topics: Aged; Bone and Bones; Diphosphates; Humans; Liver Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate