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Bone, bone marrow, and MIBI scintigraphic findings in Gaucher's disease "bone crisis"
D Blocklet1, M Abramowicz, A Schoutens
1Department of Nuclear Medicine, Hôpital Universitaire Erasme, 808 route de Lennik-1070 Brussels, Belgium. dblockle@ulb.ac.be
Purpose:
The authors report the utility of Tc-99m MIBI imaging in Gaucher's disease, which results in the accumulation of glucocerebroside in macrophages. Inflated macrophages, or Gaucher's cells, involve the reticuloendothelial organs.
Materials And Methods:
A 38-year-old man with type I Gaucher's disease, splenectomy, and early bone involvement was examined for a low back "bone crisis." He had a history of total left hip replacement. Results of pelvic radiographs were normal. Magnetic resonance imaging showed complete infiltration of the bone marrow in the lumbar spine and the sacrum. The left iliac bone, the sacrum, and the adjacent part of L5 showed heterogeneously decreased uptake on bone scintigraphs. Hematopoietic bone marrow was absent in these regions and in the left femur. No infection of the prosthesis was revealed with labeled granulocytes.
Results:
Avascular necrosis in the left iliac bone was diagnosed, which is a very unusual location. There was no uptake of MIBI in the iliac bones or the femurs.
Conclusion:
These findings suggest that MIBI may not be a good tool for the evaluation of medullary infiltration by Gaucher's cells.