99m Tc-Sulfur Colloid Bone Marrow Scintigraphy in Diagnosis of Diffuse Pulmonary Extramedullary Hematopoiesis Secondary to Myelofibrosis.
| Autor: | Yang M; Department of Radiology, Mayo Clinic in Arizona, Scottsdale, Arizona yang.ming@mayo.edu., Covington MF; Mallinckrodt Institute Radiology, Washington University in St. Louis, St. Louis, Missouri., Nguyen BD; Department of Radiology, Mayo Clinic in Arizona, Scottsdale, Arizona., Johnson GB; Department of Radiology, Mayo Clinic in Rochester, Rochester, Minnesota; and., Mesa RA; Division of Hematology, Mays Cancer Center at UT Health San Antonio, MD Anderson Cancer Center, San Antonio, Texas., Roarke MC; Department of Radiology, Mayo Clinic in Arizona, Scottsdale, Arizona. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of nuclear medicine technology [J Nucl Med Technol] 2018 Dec; Vol. 46 (4), pp. 368-372. Date of Electronic Publication: 2018 Jun 08. |
| DOI: | 10.2967/jnmt.118.210534 |
| Abstrakt: | Our objective was to define the role of combined 99m Tc-sulfur colloid bone marrow (SC BM) scintigraphy, SPECT or SPECT/CT, and chest CT in diagnosing diffuse pulmonary extramedullary hematopoiesis (PEMH) in patients with myelofibrosis. Methods: We retrospectively reviewed 99m Tc-SC BM scintigraphy scans performed at our institution for the diagnosis of diffuse PEMH, as well as accompanying chest CT and SPECT/CT imaging findings. Relevant clinical information, including respiratory manifestations, pulmonary hypertension, and subjective response to whole-lung radiation therapy, was also summarized. Results: Twenty-two myelofibrosis patients with 27 99m Tc-SC BM scintigraphy scans were diagnosed with diffuse PEMH. In 21 patients (95%) with accompanying chest CT and SPECT/CT scans, the most common CT findings were ground-glass opacity, interstitial infiltration, and pleural effusion. Of 20 patients (91%) who underwent 2-dimensional echocardiography studies, 12 (55%) were diagnosed with pulmonary hypertension. All 12 patients exhibited the aforementioned nonspecific CT imaging findings, with 8 (66%) of them presenting with respiratory symptoms, including dyspnea, shortness of breath, and cough. In the remaining 8 patients, without pulmonary hypertension, half had similar respiratory symptoms. Fourteen patients (64%) of this cohort received whole-lung radiation therapy, of whom 7 (50%) experienced symptom relief after therapy. Conclusion: Nonspecific respiratory symptoms should raise concern about pulmonary hypertension and diffuse PEMH in patients with advanced-stage myelofibrosis. Combined 99m Tc-SC BM scintigraphy and SPECT/CT is a promising noninvasive imaging tool to diagnose this rare clinical entity. Key Words: hematology; respiratory; SPECT/CT; pulmonary hematopoiesis; Tc-99m sulfur colloid scintigraphy; myelofibrosis. (© 2018 by the Society of Nuclear Medicine and Molecular Imaging.) |
| Databáze: | MEDLINE |
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