Scintigraphic evaluation of secondary myelofibrosis associated with prostatic cancer before and after hormone therapy

A patient with secondary myelofibrosis associated with prostatic cancer gained hematologic remission after hormone therapy. Before treatment, a bone scan with Tc-99m MDP showed diffuse, increased uptake in the axial skeleton without visualization of the appendicular skeleton; a bone marrow scan with In-111 chloride revealed decreased uptake in the central marrow. Following hormone therapy, a bone scan showed an almost normal distribution with visualization of the appendicular skeleton and bone marrow scan indicating improved uptake of the central marrow. Radionuclide bone and bone marrow imaging was thus useful not only in diagnosing secondary myelofibrosis but also in evaluating the effects of therapy.