, Volume 17, Issue 5, pp 937-938
Date: 14 Apr 2010

Unusual incidental findings by SPECT myocardial perfusion imaging and CT in the same patient

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Case report

A 66-year-old African-American woman with history of end-stage kidney disease, type 2 diabetes mellitus, hypertension, and obstructive sleep apnea presented to the emergency department with sudden onset of substernal chest pain and shortness of breath. The physical examination was normal except for hypertension. The electrocardiogram (EKG) showed left ventricular hypertrophy and the cardiac biomarkers were negative. She underwent pharmacologic gated Single Photon Emission Computed Tomography (SPECT) stress/rest Myocardial Perfusion Imaging (MPI) with Tc-99m sestamibi. The perfusion images (FigureĀ 1) showed mild lateral wall ischemia. Incidentally, the anterior planar image revealed an extra cardiac activity in the right anterior hemithorax (FigureĀ 2A). The chest x-ray was reported as normal. A month later, a contrast enhanced Computed Tomography (CT) of the thorax was performed, which demonstrated a smooth, uniformly enhancing mediastinal mass located to the right of the asc ...