Tuberc Respir Dis.  2011 Jun;70(6):504-510.

Pattern Analysis of 67Gallium Scintigraphy in Sarcoidosis

• Kang YH
• Lim ST
• Moon EH
• Kim DW
• Jeong HJ
• Sohn MH

Abstract

BACKGROUND
67Ga scintigraphy has been used for years in sarcoidosis for diagnosis and to determine the extent of the disease. The present report is a study of various findings of 67Ga scintigraphy in patients with sarcoidosis.
METHODS
Between 1998 and 2007, 16 patients (male:female, 6:10; age, 35.9+/-15.3 years) with histologically proven sarcoidosis underwent clinical evaluation and 67Ga scintigraphy. According to the site of involvement, they were divided into subtypes and analyzed.
RESULTS
Sixteen patients with sarcoidosis had involvement of various organs, including lymph nodes (13/16, 81.3%), lung (3/16, 18.8%), muscle (1/16, 6.3%), subcutaneous tissue (1/16, 6.3%), glands (1/16, 6.3%), and bone (1/16, 6.3%). Sites of involved lymph nodes were thorax (12/13, 92.3%), supraclavicular area (5/13, 38.5%), inguinal area (2/13, 15.4%), abdomen (2/13, 15.4%), and pelvis (1/13, 7.7%).
CONCLUSION
Because sarcoidosis frequently involves multiple organs, 67Ga scintigraphy is a useful method in for evaluating the whole body. Nuclear medicine physicians should be familiar with the various findings of gallium uptake in sarcoidosis.

Keyword

Sarcoidosis; Gallium Radioisotopes; Scintigraphy

MeSH Terms

Abdomen
Gallium
Gallium Radioisotopes
Humans
Lung
Lymph Nodes
Muscles
Nuclear Medicine
Pelvis
Sarcoidosis
Subcutaneous Tissue
Thorax
Gallium
Gallium Radioisotopes

Figure

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  Figure 1 Sarcoidosis in a 32-year-old man with the lambda sign at 67Ga imaging. (A) A Chest radiograph shows both hilar enlargement. (B) Whole body 67Ga imaging shows increased tracer uptake in bilateral hilar and right paratracheal (lambda sign) and bilateral supraclavicular lymph nodes. (C) CT images (upper, preenhancement; lower, postenhancement) show multiple mediastinal lymphadenopathies with lower attenuation and mild enhancement. CT: computed tomography.

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  Figure 2 Sarcoidosis in a 27-year-old man with acute uveitis. Whole body 67Ga imaging shows lambda sign and focal uptake of tracer in the nasopharynx, parotid gland and lacrimal gland (panda sign).

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  Figure 3 Sarcoidosis in a 59-year-old woman with involving lung, muscle and bones. (A) Whole body 67Ga imaging showed increased tracer uptake in multiple mediastinal lymph nodes. (B) Two years later, repeat 67Ga imaging (planar whole body and lower extremities imaging, SPECT scan for head) showed decreased uptake in multiple mediastinal lymph nodes compared with previous scan. However, new lesions were shown at both lung, lower extremities and skull. (C) The patient was treated with low-dose oral glucocorticoid. Six months later, repeat 67Ga imaging showed improvement.

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  Figure 4 Sarcoidosis in a 28-year-old man with involving lung, subcutaneous tissue, and pelvic lymph nodes. Whole body 67Ga imaging shows increased tracer uptake in both lung and both inguinal lymph nodes. Multiple subcutaneous activities are also identified in upper extremities, abdomen and back.

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  Figure 5 Sarcoidosis in a 37-year-old woman with involving multiple lymph nodes. Whole body 67Ga imaging shows increased tracer uptake in left supraclavicular, paraaortic, iliac, and inguinal areas corresponding to enlarge lymph nodes on enhanced CT images. CT: computed tomography.

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