Diffuse, Intense Lung Uptake on a Bone Scan

Strain, Jay; Hill, Thomas C.; Parker, Janet A.; Donohoe, Kevin J.; Kolodny, Gerald M.

doi:10.1097/00003072-200008000-00007

Cited by 12 publications

(11 citation statements)

References 13 publications

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“…Uremic human patients are at increased risk of pulmonary metastatic mineralization secondary to renal hyperparathyroidism and precipitation of calcium salts . The lungs are the most common site for uremia‐associated mineralizations (occurring in greater than 60% of human patients with chronic kidney failure, as well as in some patients with AKI), followed by the stomach, kidney, heart, and vessel walls . Mineralization primarily occurs in the alveolar septae, as noted in dogs in this study .…”

Section: Discussionsupporting

confidence: 58%

“…Mineralization primarily occurs in the alveolar septae, as noted in dogs in this study . Our inability to note mineralization on thoracic radiographs is typical of people with uremia, in whom scintigraphic examination is typically required for antemortem detection . In most uremic people lung mineralization is not associated with clinical signs indicative of pulmonary dysfunction; development of respiratory distress does not correlate well with macroscopic calcium salt deposition or with the calcium phosphorus product, unlike development of gastric mineralization in dogs .…”

Section: Discussionmentioning

confidence: 54%

“…4,7,17 The lungs are the most common site for uremia-associated mineralizations (occurring in greater than 60% of human patients with chronic kidney failure, as well as in some patients with AKI), followed by the stomach, kidney, heart, and vessel walls. 4,18,19 Mineralization primarily occurs in the alveolar septae, as noted in dogs in this study. 17 Our inability to note mineralization on thoracic radiographs is typical of people with uremia, in whom scintigraphic examination is typically required for antemortem detection.…”

Section: Discussionmentioning

confidence: 60%

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Pulmonary Abnormalities in Dogs with Renal Azotemia

Boedec

Heng²,

Snyder

et al. 2012

Veterinary Internal Medicne

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Background Clinical signs associated with respiratory tract disease are regularly encountered in people with kidney failure, and have been anecdotally reported in dogs. Objectives To compare clinical signs indicative of pulmonary disease, clinicopathologic findings, radiographic abnormalities, and histologic findings in dogs with acute kidney injury (AKI) or International Renal Interest Society Stage 3 or 4 chronic kidney disease (CKD) to nonazotemic dogs. To determine associations between abnormalities indicative of pulmonary disease and outcome in azotemic dogs. Animals One hundred sixty‐seven pet dogs (54 AKI dogs, 50 CKD dogs, 63 nonazotemic control dogs diagnosed with intracranial disease). Methods Retrospective cohort study comparing signalment, clinical signs, clinicopathologic variables, prevalence, and severity of pulmonary radiographic patterns, histopathologic findings, and survival times in AKI, CKD, and control dogs. Results Clinical signs of pulmonary disease were significantly more common in AKI dogs. Prevalence of an alveolar lung pattern was greater in AKI and CKD dogs. Alveolar mineralization was the most common pulmonary histologic lesion in AKI dogs (6 of 8 dogs), with concurrent alveolar concretions or mineralization of pulmonary vessels or bronchioles noted in 1 dog each; mineralization of lung tissues was not noted in control dogs. Neither clinical signs nor presence of an alveolar pattern were associated with likelihood of survival to discharge or median number of days from discharge until death. Conclusions and Clinical Importance Abnormalities indicative of pulmonary disease are more common in azotemic dogs than in control dogs; however, prognosis is not associated with presence of clinical or radiographic pulmonary dysfunction.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 60%

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Pulmonary Abnormalities in Dogs with Renal Azotemia

Boedec

Heng²,

Snyder

et al. 2012

Veterinary Internal Medicne

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“…Uptake of boneseeking radiopharmaceuticals in extraskeletal tissues can be categorized according to the underlying mechanisms: dystrophic calcification, metastatic calcification, increased ectopic osteoblastic activity, metastases from osteoidforming primary tumors, and increase of calcium-binding tissue cations [1]. The lung is a common site of bonespecific radiopharmaceutical accumulation, which is thought that the relative alkaline environment surrounding the alveoli conduct calcium precipitation [5].…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal calcium deposition in soft tissue, followed by chemisorption of Tc-99m MDP, is thought be a pathogenesis [1][2][3][4]. Diffuse lung uptake on bone scintigraphy has been reported in patients with hyperparathyroidism, hematologic malignancy and solid organ tumor, metabolic abnormality such as renal failure, vasculitis and pulmonary infection [5,6]. We report a first case of a patient with nontuberculosis mycobacterial infection who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan.…”

Section: Introductionmentioning

confidence: 99%

Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

Kwon

Chung

AbAziz

et al. 2010

Nucl Med Mol Imaging

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Extra-osseous uptake of bone-seeking radiopharmaceuticals has been reported at various sites and it is known to be induced by various causes. Diffuse pulmonary infection, such as tuberculosis, can be a cause of lung uptake of bone-scan agent. Here we report on a patient with non-tuberculosis mycobacterial infection (NTM) who demonstrated diffuse pulmonary uptake on Tc-99m MDP bone scan. After medical treatment for NTM, the patient's lung lesions improved. Extraskeletal lung Tc-99m MDP uptake on bone scan may suggest lung parenchymal damage associated with disease activity.

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Systemic lupus erythematosus-related hypercalcemia with ectopic calcinosis

Huang

Zhang

2016

Rheumatol Int

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We report a case of a 39-year-old female with active systemic lupus erythematosus who complained of lethargy and weakness with a moderate renal impairment. Hypercalcemia was confirmed by laboratory examination. Her X-ray revealed significant ectopic calcinosis in subcutaneous tissue of bilateral hands, and Tc-99(m) methylene diphosphonate bone scan revealed a remarkably intense uptake of bilateral lungs. She had no evidence suggestive of other diseases related to hypercalcemia such as hyperparathyroidism and malignancy. She had abnormally high serum parathyroid hormone-related protein (PTHrP) which fell to normal after treatment. Glucocorticoid, cyclophosphamide plus calcitonin and etidronate were administered and the patient improved greatly. Literature review demonstrated that lupus-related hypercalcemia with ectopic calcinosis is a rare complication and increased PTHrP is probably one of the main mechanisms. Lung uptake in bone scan may be a special and reliable clue suggestive of hypercalcemia.

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Diffuse, Intense Lung Uptake on a Bone Scan

Cited by 12 publications

References 13 publications

Pulmonary Abnormalities in Dogs with Renal Azotemia

Pulmonary Abnormalities in Dogs with Renal Azotemia

Diffuse Pulmonary Uptake of Tc-99m Methylene Diphosphonate in a Patient with Non-tuberculosis Mycobacterial Infection

Systemic lupus erythematosus-related hypercalcemia with ectopic calcinosis

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