Japanese
Title骨髄シンチグラフィで局所性欠損像を呈した骨梗塞とfat islandの二例
Subtitle症例報告
Authors湯浅貢司*, 杉村和朗*, 起塚裕美*, 三原裕美子*, 杉原正樹*, 石田哲哉*
Authors(kana)
Organization*島根医科大学放射線科
Journal核医学
Volume28
Number1
Page91-96
Year/Month1991/1
Article報告
Publisher日本核医学会
Abstract「要旨」前立腺癌, 多発性骨髄腫等の骨転移診断における, 骨髄シンチグラフィの有用性が知られている. そこで転移診断に骨髄シンチグラフィを併用する場合, 転移以外に局所欠損を呈する疾患を知っておく必要がある. 今回骨髄シンチグラフィで局所欠損を呈し, ガリウムシンチグラフィ, MRIでも骨髄浸潤を疑ったが骨髄生検で骨梗塞と診断され骨髄浸潤が否定された悪性リンパ腫の1例, および骨髄シンチグラフィで局所欠損を呈したが, MRIでFat Islandと診断された1例を経験したので報告する. 「I. 緒言」転移性骨腫瘍診断における骨シンチグラフィの有用性は高く評価されている. しかしながら骨吸収が主体の多発性骨髄腫, false negativeの多い前立腺癌では転移診断に骨髄シンチグラフィを併用することが推奨されている. そこで骨転移診断に骨髄シンチグラフィを併用する場合, false positive例を減少させるために転移以外に局所欠損を呈する疾患を知っておく必要がある.
Practice臨床医学：一般
KeywordsBone marrow imaging, MRI, Malignant lymphoma, Lung cancer, Bone infarction, Fat island.
English
TitleBone Infarction and Fat Island Appearing as Local Defects in Radionuclide Bone Marrow Imaging
Subtitle
AuthorsKouji YUASA, Kazurou SUGIMURA, Hiromi OKIZUKA, Yumiko MIHARA, Masaki SUGIHARA, Tetsuya ISHIDA
Authors(kana)
OrganizationDepartment of Radiology, Shimane Medical University
JournalThe Japanese Journal of nuclear medicine
Volume28
Number1
Page91-96
Year/Month1991/1
ArticleReport
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Parallel studies of radionuclide bone marrow imaging and bone scanning are helpful in the early diagnosis of skeletal metastasis. In bone marrow imaging, most lesions are observed as a local defect. We had two cases of nonmetastatic lesions which appeared as local defects in bone marrow imaging. The first case was a male Hodgkin's disease patient, aged 48, who had been treated with frequent chemotherapy, including the administration of a large quantities of steroids. He complained of slight pain in the left shoulder. Without increased uptake in bone scanning, abnormal accumulation of 67Ga-citrate and a local defect in bone marrow imaging appeared, corresponding to localization of the pain. Suspecting bone marrow metastasis, we performed magnetic resonance imaging (MRI). An area of slightly decreased intensity in T1-weighted spin-echo images and lower intensity than fat tissue in T2-weighted images were observed, although it was slightly enhanced by Gd-DTPA. This lesion was diagnosed by biopsy as a bone infarction. The second case was that of a 69-year-old male lung cancer patient. Though no abnormality was revealed by bone scanning or 67Ga-citrate scintigraphy, an apparent defect at the 10th thoracic vertebra was observed in bone marrow imaging. It was not accompanied by pain. MRI was also performed in this case. This was depicted as a clearly defined high intensity area. This was diagnosed as a fat island, and no change has been seen in the seven months of follow up. In conclusion, it is necessary to consider the possibility of nonmetastatic lesions, when local defects appear in bone marrow imaging performed on cancer patients.
PracticeClinical medicine
KeywordsBone marrow imaging, MRI, Malignant lymphoma, Lung cancer, Bone infarction, Fat island.

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