An [123I]MIBG-positive malignant lymphoma involving the adrenal gland with hypercatecholaminaemia

False iodine-131 MIBG scintigraphy findings in adrenal tumors: correlation with MR imaging

“…In our first falsepositive MIBG Case with histologically proven adrenal adenoma, the presence within the nodule of medullary hyperplasia associated with dense medullary granules could justify the occurrence of tracer uptake. The second falsepositive MIBG Case consisted of a huge adrenal carcinoma with necrotic degeneration reflected by diffuse heterogeneous tracer uptake; in this regard, similar MIBG findings are reported in the literature in several malignant adrenal lesions such as a huge carcinoma, an oncocytic carcinoma, an undifferentiated malignant tumor with rhabdoid features and a diffuse large B-cell-type lymphoma [23][24][25][26]. In these 1 3…”

“…The possible occurrence of false-positive MIBG findings was originally described by Shapiro et al [17] and defined as the presence of abnormal tracer uptake into tumor lesions of adrenals other than pheochromocytoma; of note, in this previous study, a case of adrenal metastasis of choriocarcinoma was reported. Successively, many cases of false-positive findings of MIBG scan have been reported in the literature [18][19][20][21][22][23][24][25][26][27][28]; other cases of adrenal adenomas with MIBG accumulation have been previously described by others and also by our group [18][19][20][21][22]; in these cases, different explanations have been provided to justify MIBG uptake by the lesions such as the coexistence within the tumor of medullary hyperplasia or the presence of dense medullary granules as well as the occurrence of collision tumors [29]. In our first falsepositive MIBG Case with histologically proven adrenal adenoma, the presence within the nodule of medullary hyperplasia associated with dense medullary granules could justify the occurrence of tracer uptake.…”

False Positive Radioiodinated Metaiodobenzylguanidine (123I-MIBG) Uptake in Undifferentiated Adrenal Malignant Tumor

“…The uptake of 123 I-MIBG into cells from chromaffin neuroendocrine tumors mainly occurs via the norepinephrine transporter and passive diffusion, which is then accumulated in the secretory granules inside cells by vesicular monoamine transporters (VMATs) [ 1 , 17 ]. False positive uptake of 123 I-MIBG has been reported in large adrenocortical carcinoma, hepatocellular carcinoma, and malignant lymphoma, which is suspected to be related to increased 123 I-MIBG uptake by passive diffusion resulting from increased blood flow [ 3 – 5 ]. Moreover, cases of false positive 123 I-MIBG uptake have been reported in mast cell-infiltrated infantile hemangioma, which is believed to be caused by increased expression of VMAT2 by mast cells [ 18 ].…”

Diffuse Large B-cell Lymphoma

“…Other reports have described other tumors that show uptake of MIBG, including adrenocortical adenoma/carcinoma, hepatocellular carcinoma, and gastrointestinal stromal tumors. [5][6][7][8] Although lymphoma involving the adrenal gland is reported to demonstrate the uptake of MIBG, 9 it is not established that lymphoma in organs other than the adrenal glands shows increased uptake of MIBG. Here, we report a case of DLBCL showing the uptake of MIBG despite the absence of adrenal involvement.…”