technetium-tc-99m-sulfur-colloid and Abdominal-Neoplasms

Splenosis, the heterotopic autotransplantion of splenic tissue, is a common benign condition among patients with a history of splenic trauma. Most cases of splenosis are intra-abdominal due to direct seeding of surrounding structures, although these ectopic rests may occur almost anywhere in the body, and its diffuse nature may raise the suspicion of metastatic cancer. Confirmation of splenic tissue can be made by technetium-99m (Tc-99m) sulfur colloid scintigraphy or with Tc-99m heat-damaged red blood cells; however, in some cases, biopsy may be required for definitive diagnosis. Here, the authors present a patient with a remote history of posttraumatic splenectomy who was discovered to have multiple intra-abdominal nodules by CT scan. A diagnosis of diffuse metastatic disease was initially considered before a diagnosis of intraabdominal splenosis was ultimately made with the aid of Tc-99m sulfur colloid single-positron emission computed tomography (SPECT) and computed tomography imaging.

Topics: Abdomen; Abdominal Neoplasms; Diagnosis, Differential; Humans; Male; Middle Aged; Splenosis; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The authors describe an adult patient with low index of suspicion for polysplenia. The diagnostic contribution of various investigative modalities is considered, and the key role of scintigraphy is specifically highlighted.. CT scan findings revealed multiple abdominal and retroperitoneal masses. Needle biopsy of a flank mass was nonspecific. Tc-99m sulfur colloid liver spleen scintigraphy and Tc-99m heat-denatured RBC scans showed the presence of polysplenia.. Multiple spleens can be mistaken for abdominal neoplasms on CT. Biopsy results may not always be helpful. In patients in whom there is such a diagnostic dilemma, Tc-99m heat-denatured RBC scans can successfully establish the definitive diagnosis of polysplenia.

Topics: Abdominal Neoplasms; Aged; Congenital Abnormalities; Diagnosis, Differential; Erythrocytes; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Topics: Abdominal Neoplasms; Choristoma; Diagnosis, Differential; Humans; Male; Middle Aged; Radionuclide Imaging; Spleen; Splenic Rupture; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

A case where an x-ray CT examination showed the existence of an unidentified perisplenic mass is presented. This mass was determined to be an accessory spleen after an evaluation with Tc-99m labeled sulfur colloid. This report describes a clinical indication for the use of SPECT imaging of a patient when a mass of uncertain significance is discovered.

Topics: Abdominal Neoplasms; Adult; Choristoma; Humans; Liver; Male; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed

Thirteen patients with a history of confirmed liver carcinoma were given either I131 goat polyclonal or murine monoclonal antibodies against alpha-fetoprotein (AFP), and then scanned with a gamma camera. In order to reduce background, nontarget activity, especially in the liver, blood pool, and reticuloendothelial system, 99mTc imaging agents were used for tumor image enhancement by computer-assisted subtraction. A sensitivity of 91% for the primary site, 50% for the lungs (33% for the chest area), and 75% for the abdomen and pelvis was achieved, with a specificity of 100%, 94%, and 100% for these sites, respectively. The accuracy was determined to be 93% for the liver, 86% for the lungs (77% for the chest), and 85% for the abdominal and pelvic area, resulting in an overall accuracy rate for imaging primary and metastatic hepatocellular cancer of 84% (90% if bone metastases are excluded). In two of the 13 patients, lesions that had been missed by conventional liver scintigraphy and transmission computed tomography (CT) were first shown by radioimmunodetection (RAID).

Topics: Abdominal Neoplasms; Adult; alpha-Fetoproteins; Antibodies; Antibodies, Monoclonal; Carcinoma, Hepatocellular; Child, Preschool; Female; Hemangiosarcoma; Humans; Image Enhancement; Image Processing, Computer-Assisted; Liver Neoplasms; Male; Pelvic Neoplasms; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms

Topics: Abdominal Neoplasms; Aged; Female; Humans; Spleen; Technetium Tc 99m Sulfur Colloid; Ultrasonography

The CT scans of a woman with left flank and lower abdominal pain were interpreted as showing a mass adjacent to the tail of the pancreas. Imaging with Tc-99m sulfur colloid and emission computerized tomography revealed that the CT scan abnormality represented functioning splenic tissue and thereby avoided unnecessary surgical exploration.

Topics: Abdominal Neoplasms; Diagnosis, Differential; Female; Humans; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed

Splenosis is a rare condition manifested by heterotopic autotransplantation of splenic tissue. A case of splenosis initially diagnosed with computed tomography (CT) and confirmed with radionuclide imaging is presented. This condition can be confused with other causes of peritoneal based masses and must be differentiated from them to assure optimum patient care. The clinical, pathologic, and CT features of this condition are briefly reviewed.

Topics: Abdominal Neoplasms; Adult; Choristoma; Diagnosis, Differential; Humans; Male; Radionuclide Imaging; Spleen; Splenectomy; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

The results of radionuclide (RN) liver scans, computed tomography (CT), and ultrasonography (US) were compared in 163 patients. Thirty-eight patients had all three studies, while ten were examined by CT and RN liver scans. One hundred fifteen patients had only US and RN studies. Radionuclide liver scanning demonstrated more false positive and negative studies than CT or US. Also, CT and US demonstrated more areas of metastasis during a single examination than RN liver scans. Ultrasonography displayed roughly the same accuracy of CT when a technically adequate examination was obtained. However, US was hampered by technically inadequate studies in 19% of 153 patients because of interfering intestinal gas. Computed tomography proved the most accurate and reliable modality in 48 patients.

Topics: Abdominal Neoplasms; Adolescent; Adult; Aged; Female; Humans; Liver; Liver Neoplasms; Male; Melanoma; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography