106 Active Sarcoidosis

CASE 106

Clinical Presentation

A 48-year-old man with uveitis is referred by ophthalmology for suspected sarcoidosis.

image

Fig. 106.1 Whole-body planar image, anterior and posterior projections, 67Ga.

image

Fig. 106.2 Selected “whole-body” SPECT image, coronal projection, 67Ga.

Technique

• A 7.5 mCi dose of 67Ga-citrate is injected intravenously 3 days before scan.

• Whole-body imaging in anterior and posterior projections

image Dual-detector gamma camera

image Medium-energy collimators

image Energy peak at 93-, 185-, and 300-keV photopeaks

Image Interpretation

Whole-body planar images (Fig. 106.1) and “whole-body” SPECT images (Fig. 106.2) demonstrate intense right paratracheal and symmetric bilateral hilar uptake; this pattern has been termed the lambda sign because it resembles the Greek letter. Coupled with intense, symmetric uptake in the parotid glands and lacrimal glands, this is a characteristic pattern of sarcoidosis. The colon activity is physiologic.

Differential Diagnosis

• Sarcoidosis

• Lymphoma

• Inflammatory/infectious lymphadenitis

Diagnosis and Clinical Follow-Up

Active sarcoidosis. No follow-up obtained.

Discussion

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Jan 24, 2016 | Posted by in NUCLEAR MEDICINE | Comments Off on 106 Active Sarcoidosis

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