Pleuropericardial Cyst Mimicking a Metastasis of Differentiated Thyroid Carcinoma on Whole-Body Iodine-131 Scan: a Case Report

O. Bourogianni1, K. Pagonidis2, M. Stathaki1, A. Tsaroucha1, E. Papadaki1, S. Koukouraki3
1Department of Nuclear Medicine, University Hospital, Crete, Greece
2Department of Radiology, University of Crete Medical School, Heraklion, Greece
3Department of Nuclear Medicine, University of Crete Medical School, Heraklion, Greece

Tóm tắt

Post-therapeutic whole-body scan (WBS) with I-131 has been widely used for the follow-up of patients with well-differentiated thyroid cancer (DTC). Although the sensitivity of WBS with I-131 in detection of functioning thyroid tissues is high, its specificity is low. So, a further evaluation is required in cases of unexpected findings. The purpose of the study was to demonstrate that awareness of the potential pitfalls of WBS in DTC, knowledge of physiology and characteristics of radioiodine uptake, and correlation with other imaging modalities are needed to avoid incorrect management of patients with DTC. This is a case report of a 49-year-old woman with an unexpected area of increased I-131 uptake in the posterior lower chest, which was finally diagnosed as a pleuropericardial cyst. Due to the false-positive uptake of I-131 in the chest, an accurate interpretation of the scintigraphic findings should be made.

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Tài liệu tham khảo

Song HC, Chong A Post-therapeutic I-131 whole body scan in patients with differentiated thyroid cancer. In: Ali G editor. 12 chapters on nuclear medicine. IntechOpen; 2011. pp 231–250.

Oh J-R, Ahn B-C. False-positive uptake on radioiodine whole-body scintigraphy: physiologic and pathologic variants unrelated to thyroid cancer. Am J Nucl Med Mol Imaging. 2012;2:362–85.

Jeung MY, Gasser B, Gangi A, Bogorin A, Charneau D, Wihlm JM, et al. Imaging of cystic masses of the mediastinum. Radiographics. 2002;22:S79–93.

Jia C, Moadel R, Freeman LM. Focal thoracic uptake mimicking lung metastasis on 131I post-therapy whole-body scan in patients with thyroid carcinoma. Clin Nucl Med. 2014;39:360–2.

Francese C, Schlumberger M, Travagli JP, Vera P, Caillou B, Parmentier C. Iodine 131 uptake in a pleuropericardial cyst: case report of a false-positive radioiodine total body scan result in a patient with a thyroid cancer. Eur J Nucl Med. 1991;18:779–80.

Buton L, Morel O, Gault P, Illouz F, Rodien P, Rohmer V. False-positive iodine-131 whole-body scan findings in patients with differentiated thyroid carcinoma: report of 11 cases and review of the literature. Ann Endocrinol. 2013;74:221–30.

Kar SK, Ganguly T. Current concepts of diagnosis and management of pericardial cysts. Indian Heart J. 2017;69:364–70.

Lippert KM, Potozky H, Furman IK. Clinical significance of pleuropericardial cyst. AMA Arch Intern Med. 1951;88:378–86.

Carlisle MR, Lu C, McDougall IR. The interpretation of 131I scans in the evaluation of thyroid cancer, with an emphasis on false positive findings. Nucl Med Commun. 2003;24:715–35.

Shapiro B, Rufini V, Jarwan A, Geatti O, Kearfott KJ, Fig LM, et al. Artifacts, anatomical and physiological variants, and unrelated diseases that might cause false-positive whole-body 131-I scans in patients with thyroid cancer. Semin Nucl Med. 2000;30:115–32.

Bakheet SM, Powe J, Hammami MM. Radioiodine uptake in the chest. JNM. 1997;38:984–6.

Ranade R, Pawar S, Mahajan A, Basu S. Unusual false positive radioiodine uptake on (131)I whole body scintigraphy in three unrelated organs with different pathologies in patients of differentiated thyroid carcinoma: a case series. World J Nucl Med. 2016;15:137–41.

Hannoush ZC, Palacios JD, Kuker RA, Casula S. False positive findings on I-131 WBS and SPECT/CT in patients with history of thyroid cancer: case series. Case Rep Endocrinol. 2017;2017:8568347.