Avoid common mistakes on your manuscript.
A 30-year-old woman treated for biological hypothyroidism with L-thyroxine (LT4) presented with a suspicion of lingual thyroid when head and neck examination discovered a lump on the tongue, confirmed by cervical ultrasound (US) findings. The scintigraphic study performed under LT4 (87.5 μg/day), after injections of recombinant human thyroid-stimulating hormone (TSH), and 2 h after injection of 37 MBq of 123I, on a single photon emission computed tomography (SPECT)/CT gamma camera (Siemens Symbia T2) showed an isolated high cervical uptake corresponding to the sublingual thyroid [1]. SPECT/CT images provided anatomical details: larger diameter of 22 mm and no functional glandular tissue in central cervical position (a). Whole-body scan did not show any pathological iodine uptake, especially in the pelvic area (b). This acquisition allowed the realization of 3-D reconstructions (c).
Hypothyroidism represents the main clinical symptom of ectopic thyroid [2]. Other complications are haemorrhage and superior airway obstruction with dyspnoea and/or dysphagia.
The diagnosis of lingual thyroid relies on clinical examination and cervical US that identifies a vacant thyroid site and a lump on the tongue base with a structure similar to thyroid tissue [3]. 123I scintigraphy with a hybrid camera provides functional and anatomical images, and looks for other locations of ectopic thyroid tissue.
References
Fugazzola L, Persani L, Mannavola D, Reschini E, Vannucchi G, Weber G, et al. Recombinant human TSH testing is a valuable tool for differential diagnosis of congenital hypothyroidism during L-thyroxine replacement. Clin Endocrinol (Oxf) 2003;59(2):230–6.
Oueslati S, Douira W, Charada L. Thyroïde ectopique. Ann Otolaryngol Chir Cervicofac 2006;123:195–8.
Lai YT, Chen HS, Chang YL. Lingual thyroid. Otolaryngol Head Neck Surg 2009;140(6):944–5.
Conflicts of interest
None.
Acknowledgment
The authors are indebted to Dr A. Saltiel and Dr P. Vigneron who referred their patient to our center.
Author information
Authors and Affiliations
Corresponding author
Additional information
Laetitia Vercellino and Nadia Ismaili Alaoui contributed equally and should be considered as joint first authors.
Rights and permissions
About this article
Cite this article
Vercellino, L., Alaoui, N.I., Faugeron, I. et al. Lingual thyroid imaging with 123I SPECT/CT. Eur J Nucl Med Mol Imaging 38, 1173 (2011). https://doi.org/10.1007/s00259-011-1747-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00259-011-1747-7