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Acute myelofibrosis mimicking multiple bone metastases on Tc-99m MDP bone imaging
W J Oyen1, J M Raemaekers, F H Corstens
1University Hospital Nijmegen, Department of Nuclear Medicine, The Netherlands.
Purpose:
Tc-99m bone scintigraphy is widely used for evaluation of osseous spread of malignant tumors.
Patient:
A 60-year-old man had multiple areas of increased uptake on a bone scan in a pattern considered characteristic for extensive metastatic disease. However, a primary neoplasm could not be identified. Finally, acute myelofibrosis--a rare, fatal myeloproliferative syndrome--was diagnosed.
Conclusion:
To avoid delays and extensive diagnostic procedures, acute myelofibrosis should be considered in the differential diagnosis of bone scans showing multiple hot spots. In such cases, a diagnosis can be made on an a tissue sample.