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Pulmonary mycobacterial infections in AIDS: characteristic pattern of thallium and gallium scan mismatch
V W Lee1, T P Cooley, J D Fuller
1Department of Radiology, Boston University School of Medicine, Boston City Hospital, Mass.
Purpose:
To evaluate the diagnostic specificity of thallium and gallium scan mismatch as a sign of mycobacterial infection in immunodeficient patients.
Materials And Methods:
Thallium and gallium scans obtained in 56 immunodeficient patients between January 1989 and March 1994 were retrospectively reviewed, with special attention to the final diagnoses in all patients with thallium-gallium scan mismatch compared with those whose scans showed other scintigraphic patterns.
Results:
Fourteen patients had focal gallium uptake, but no thallium uptake, in the mediastinum and hilar nodes (thallium-gallium mismatch). Twelve of the 14 had culture-proved mycobacterial infections; one had cryptococcal infection; and in one, the diagnosis was not established. Thirty-seven of the remaining 42 patients who had different scintigraphic patterns on thallium-gallium scans had other complications of acquired immunodeficiency syndrome such as Kaposi sarcoma, non-Hodgkin lymphoma, and bacterial pneumonia. The diagnosis in five of the 42 patients was not known because follow-up data were incomplete.
Conclusion:
The thallium-gallium mismatch pattern in immunodeficient patients is specific for mycobacterial infection.