Hiatal hernia in iodine-131 scintigraphy: a potential cause of false-positive midline thoracic uptake

There are occasional reports of a hiatal hernia demonstrating thoracic uptake on I-131 scintigraphy. This is a cause of a potential false-positive appearance mimicking a pulmonary or mediastinal metastasis. Hiatal hernia is 1 of a number of causes of false-positive I-131 whole-body scans. Although previous case reports have demonstrated uptake to lie to the left of the midline, this case is slightly unusual in view of the midline appearance of the uptake. Although this appearance could be seen with mediastinal, pulmonary, or prevertebral metastases, hiatal hernia should be considered in the differential diagnosis of uptake in the thoracic midline on I-131 scintigraphy.