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False-Positive Radioactive Iodine Uptake Mimicking Miliary Lung Metastases in a Patient Affected by Papillary Thyroid Cancer and IgA Deficiency

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Abstract

A 42-year-old female with immunoglobulin A deficiency and recurrent sinopulmonary infections underwent thyroidectomy for papillary thyroid cancer (PTC). Follow-up 123I scintigraphy demonstrated diffuse pulmonary uptake, suggesting metastatic disease. However, subsequent pathologic, biochemical and radiographic testing proved that she was in fact disease free, and the initial 123I pulmonary uptake was identified as a false positive. Inflammatory conditions may rarely cause iodine uptake in non-thyroidal tissues due to local retention, organification, and/or immunologic utilization. To avoid exposing patients to unnecessary treatments, it is critical for clinicians to recognize that comorbid pulmonary conditions may mimic metastatic PTC on radioiodine scintigraphy.

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Acknowledgments

Andrew Demidowich and Amartya Kundu contributed equally to this work and should be considered co-primary authors. This research was supported by the Division of Intramural Research of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH.

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Authors and Affiliations

  1. Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 9000 Rockville Pk, Building 10/1-3330, Bethesda, MD, 20892-1613, USA

    Andrew Paul Demidowich

  2. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA

    Amartya Kundu

  3. Nuclear Medicine Division, Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA

    James C. Reynolds

  4. Division of Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, VA, USA

    Francesco S. Celi

Authors
  1. Andrew Paul Demidowich
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  2. Amartya Kundu
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  3. James C. Reynolds
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  4. Francesco S. Celi
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Corresponding author

Correspondence to Andrew Paul Demidowich.

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Conflict of Interest

Andrew P. Demidowich, Amartya Kundu, James C. Reynolds, and Francesco S. Celi declare that they have no conflict of interest.

Ethical Statement

The study was approved by an institutional review board or equivalent and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects in the study gave written informed consent or the institutional review board waived the need to obtain informed consent.

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Demidowich, A.P., Kundu, A., Reynolds, J.C. et al. False-Positive Radioactive Iodine Uptake Mimicking Miliary Lung Metastases in a Patient Affected by Papillary Thyroid Cancer and IgA Deficiency. Nucl Med Mol Imaging 50, 270–272 (2016). https://doi.org/10.1007/s13139-015-0375-8

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  • DOI: https://doi.org/10.1007/s13139-015-0375-8

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