Perfusion Lung Scanning With Tc-99m MAA in the Assessment of Churg-Strauss Syndrome

Burroni, Luca; Bertelli, Paolo; Vella, Alessandra; Volterrani, Duccio; Coniglio, Giovanni; Vattimo, A

doi:10.1097/00003072-199504000-00019

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“…These patients probably presented the disease in its advanced stage, since radiological and functional respiratory findings indicated a characteristic profile of PLC. Nowadays high resolution gamma cameras and pulmonary perfusion scintigraphy with 99m Tc-MAA are able to detect small areas of focal hypoperfusion corresponding, for example, to praecox eosinophilic infiltrations in the allergic vasculitis of Churg-Strauss [17]. The characteristic scintigraphic pattern showing a 'fragmented' lung appearance in our cases may help increase the suspicion of PLC and lead to carrying out additional diagnostic procedures.…”

Section: Discussionmentioning

confidence: 66%

The ‘Fragmented’ Scintigraphic Lung Pattern in Pulmonary Lymphangitic Carcinomatosis Secondary to Breast Cancer

Vattimo

Burroni²,

Bertelli³

et al. 1998

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Pulmonary lymphangitic carcinomatosis (PLC) is an unusual presentation of diffuse infiltrative lung disease. In this report we present two cases secondary to breast cancer; the diagnosis was made by means of transbronchial lung biopsy or postmortem examination. The goal of this study was to analyze the scintigraphic pattern of pulmonary perfusion performed with technetium-99m macroaggregated albumin (^99mTc-MAA) in the hope of achieving improved recognition of PLC and its subsequent diagnosis. Upon admission, both patients underwent routine clinical exams followed by chest X-rays. The second patient also underwent CT examination, and both were ultimately examined using pulmonary perfusion scintigraphy with ^99mTc-MAA. In the various exams performed, the most reliable and easily identified diagnostic finding turned out to be a characteristic ‘fragmented’ lung pattern revealed with the perfusion lung scan. Unfortunately, in both cases the patients’ conditions rapidly worsened and death occurred shortly following scintigraphy. We were able to conclude that the recognition of the mentioned fragmented scintigraphic lung pattern may be useful in suspected PLC, whereas the nonspecific clinical presentation of this pathology makes diagnosis extremely difficult, with the most significant results being achieved through a comparison of scintigraphic and high resolution CT data.

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Section: Discussionmentioning

confidence: 66%