technetium-tc-99m-sulfur-colloid and Dilatation--Pathologic

Lymphoscintigraphy, along with triangulated patient body marking, can serve as a guide for surgeons during sentinel lymph node harvesting. Unique drainage patterns have been noted, especially with areolar or intradermal based injections, which are becoming increasingly popular. The images lymphoscintigraphy provide have been invaluable in delineating these patterns. The authors present a case that simultaneously illustrates two separate points in the same patient, a reverse echelon node and a lymphatic ectasia. To our knowledge, this combination has never been described in the same patient. Perilesional and areolar-cutaneous junction injections were performed sequentially and generated these patterns that could potentially have resulted in added morbidity and a false-negative sentinel node if not realised before surgery. Lymphoscintigraphy added valuable information in the management of this patient, which can occasionally present with complex patterns of activity during sentinel node harvesting.

Topics: Adult; Breast Neoplasms; Dilatation, Pathologic; Female; Humans; Injections; Lymph Nodes; Lymphatic Metastasis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid

Caroli's disease (congenital dilatation of the intrahepatic bile ducts) is a rare condition which is usually diagnosed postoperatively. Scintigraphic evaluation of this entity is very limited. We report here a patient with Caroli's disease in whom a dichotomy in hepatic uptake of 99mTc-HIDA (hot spots) and 99mTc-colloid (cold spots) was observed, leading to a correct preoperative evaluation of the disease.

Topics: Adult; Bile Ducts, Intrahepatic; Biliary Tract; Cysts; Dilatation, Pathologic; Female; Humans; Imino Acids; Liver; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid