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Journal of Nuclear Cardiology

, Volume 25, Issue 6, pp 1903–1905 | Cite as

What is this image? 2018: Image 3 result

Extramedullary hematopoiesis at unusual site detected with 99mTc-labeled RBC imaging and 18F-FLT PET/CT
  • Ganesh Kumar
  • Alka Khadwal
  • Ashwani Sood
  • Harmandeep Singh
  • Vaishnavi Dasagrandhi
  • Sonia Kashyap
  • Bhagwant Rai Mittal
WHAT IS THIS IMAGE?
  • 128 Downloads

Clinical History

A 29-year-old beta-thalassemic major woman on almost three weekly blood transfusions since her childhood presented with features of bicytopenia suggested by reduced RBC (3.3 million/µL), platelet (127,000/µL), and normal total leucocyte counts (5400/µL). T2* MRI performed in this patient showed iron deposition in myocardium (0.6 mg/g of dry myocardium) and liver (10.5 mg/g of dry liver).

Imaging

99mTc-labeled RBC equilibrium radionuclide angiocardiography (ERNA) for left ventricular function followed by whole-body imaging was done as part of departmental protocol. ERNA showed normal function (left ventricular ejection fraction of 58% and normal wall motion) with splenomegaly. 99mTc-labeled RBC whole-body imaging showed hypercellular marrow within the skeletal system and incidental finding of an ill-defined focus of tracer activity in the pelvis adjacent to urinary bladder (Figure  1).

Notes

Disclosure

Drs Ashwani Sood, BR Mittal, Ganesh Kumar, Alka Khadwal, Sonia Kashyap, Harmandeep Singh, Vaishnavi Dasagrandhi have nothing to disclose. No financial support was received for the publication of this manuscript.

References

  1. 1.
    van der Bruggen W, Glaudemans AWJM, Vellenga E, Slart RHJA. PET in benign bone marrow disorders. Semin Nucl Med 2017;47:397-407.CrossRefGoogle Scholar
  2. 2.
    Zade A, Purandare N, Rangarajan V, Shah S, Agrawal A, Ashish J, et al. Noninvasive approaches to diagnose intrathoracic extramedullary hematopoiesis: 18F-FLT PET/CT and 99mTc-SC SPECT/CT scintigraphy. Clin Nucl Med 2012;37:788-9.CrossRefGoogle Scholar
  3. 3.
    Agool A, Dierckx RA, de Wolf JT, Vellenga E, Slart RH. Extramedullary haematopoiesis imaging with 18F-FLT PET. Eur J Nucl Med Mol Imaging 2010;37:1620.CrossRefGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Ganesh Kumar
    • 1
  • Alka Khadwal
    • 2
  • Ashwani Sood
    • 1
  • Harmandeep Singh
    • 1
  • Vaishnavi Dasagrandhi
    • 1
  • Sonia Kashyap
    • 2
  • Bhagwant Rai Mittal
    • 1
  1. 1.Department of Nuclear MedicinePGIMERChandigarhIndia
  2. 2.Department of Internal MedicinePGIMERChandigarhIndia

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