Bone Marrow Scintigraphy in Paget's Disease of Bone

Abstract

Sixteen patients with 20 lesions of Paget's disease of bone were studied with bone marrow scintigraphy (colloid), bone tissue scintigraphy and radiography. Bone marrow scintigraphy showed normal or increased colloid uptake in 15 of 20 pagetic lesions, and decreased uptake in 4. Bone tissue scintigraphy showed increased metabolic activity in all lesions and was useful in detecting polyostotic disease as well as the extent of the lesions. Conventional radiography most often showed the typical appearance of Paget's disease, but the changes observed were sometimes difficult to differentiate from malignant disease. However, a preserved or increased reticuloendothelial function in the pagetic lesion contradicts metastatic disease as a differential diagnosis. Bone marrow scintigraphy with radiocolloid is a valuable method in the analysis of Paget's disease of bone.

Colloid Scintigraphy Showing Red Bone Marrow Extension in Patients with Prostatic Carcinoma

“…Reconversion of yellow marrow to red marrow with hematopoietic and phagocytic function is always a pathologic phenomenon (20,27,32,33,39). Reports concerning the level of normal red bone marrow distribution in the proximal femur vary.…”

“…In unselected series of patients with prostatic cancer, the frequency of bone metastases detected by bone scintigraphy varies from 30% to 51% (22). Since the sinusoid of the red bone marrow is the site for metastatic spread and the adult red bone marrow is located in the axial skeleton, bone marrow metastases are usually located within these areas (20,32). In hematologic disease, chronic anemia, malignancy, chemotherapy, or irradiation, the red marrow may extend into the extremities (14,20,24,27,29,31), thus increasing the risk of peripheral metastases.…”