Diagnosis
There is an intense focus of uptake in the right lobe of the liver posteriorly
near the dome seen on both planar and SPECT
images. There is a second focus in the posterior mediastinum seen
on the SPECT images which was not apparent on planar scintigraphy.
Biopsy of the liver lesion was consistent with Hodgkin's disease.
SPECT Gallium Scintigraphy
| Coronal |
Sagital |
Transverse |
 |
 |
 |
SPECT Gallium Scintigraphy
| Coronal |
 |
| Sagital |
| Transverse |
| arrows show liver lesion; arrowheads show
posterior mediastinal lesion |
A follow up scan in August of 1998, four months after this scan shows
the posterior mediastinal focus on both planar and SPECT images (static
SPECT images; arrows show lesion in
liver and arrowheads show lesion in the posterior mediastinum, both of
which are more intense).
Follow up Gallium Scintigraphy
 |
| Posterior |
Anterior |
|
| Coronal |
 |
| Sagital |
 |
| Transverse |
 |
|
Teaching Points
-
Some lesions can only be identified with SPECT imaging.
-
The posterior mediastinal lesion is more apparent for some observers with
cine presentation.
-
Although liver involvement is unusual in Hodgkin's disease at diagnosis,
after several relapses disease location may become atypical.
Click here to go to Joint
Program in Nuclear Medicine home page and Copyright notice.
J. Anthony Parker, MD PhD, Tony_Parker@bidmc.harvard.edu
