Atypical Presentation of Hypertrophic Pulmonary Osteoarthropathy on Tc-99m MDP Bone Scintigraphy

Narla, Vinod V.; Rajagopalan, Malolan S.; Kanderi, Tanuja; Muthukrishnan, Ashok

doi:10.1097/rlu.0b013e318184ba18

Cited by 3 publications

(1 citation statement)

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“…HPO can occur secondary to various neoplastic and non-neoplastic diseases, including primary lung cancer, metastatic pulmonary disease and cystic fibrosis (43). The ‘tram-line’ or ‘double-stripe’ sign, which represents abnormal periosteal bone formation, is the classic appearance of HPO upon bone scanning (43,44). With the exception of PIMT, CT did not identify any other pulmonary diseases in the patient with HPO in the present study.…”

Section: Discussionmentioning

confidence: 99%

Imaging observations of pulmonary inflammatory myofibroblastic tumors in patients over 40 years old

Zhu

et al. 2015

Oncology Letters

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Pulmonary inflammatory myofibroblastic tumors (PIMTs) are extremely rare in adults. If occurring in patients >40 years old, PIMT should be rapidly distinguished from lung cancer. The present study aimed to characterize the imaging features of PIMT in patients >40 years old in order to improve the diagnosis of PIMT. The imaging data of 10 patients with PIMT were reviewed retrospectively. Of the patients, eight underwent computed tomography (CT), two underwent positron emission tomography (PET)/CT and four underwent single-photon emission computed tomography (SPECT). Unenhanced CT revealed 10 lesions with a maximum diameter ranging between 5 and 57 mm located in the lower (n=6) or upper (n=4) lobe, in a peripheral (n=9) or central (n=1) region, and that were well- (n=4) or ill-defined (n=6), and round to oval (n=5) or irregular (n=5) in shape. Calcification (n=3), necrosis (n=6), cavity (n=4), air bronchogram (n=6) and obstructive pneumonia (n=1) were also observed in the patients. Contrast-enhanced CT revealed six lesions with moderate to high contrast enhancement in the arterial and venous phases, including four lesions with delayed enhancement. PET/CT identified two lesions with increased tracer uptake that were homogeneous and heterogeneous and each exhibited a maximal standard uptake value (SUVmax) of 6.0 and 5.4, respectively. The delayed PET/CT revealed foci that each exhibited an increased SUVmax of 6.9 and 5.9, respectively. SPECT demonstrated no definitive bone metastases, but did reveal atypical hypertrophic pulmonary osteoarthropathy in one patient. The combined imaging methods may lead to a more precise evaluation of PIMT in patients >40 years old.

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Section: Discussionmentioning

confidence: 99%