Clinical History
This is a 47-year-old female with elevated serum calcium and PTH. Evaluate for parathyroid adenoma.
There are no prior studies available for comparison.
Technique
The patient received an IV injection of 22 millicuries of 99m Tc sestamibi and anterior images were obtained
over the neck 20 minutes post injection and after a two hour delay.
Findings
The initial images demonstrate uptake of sestamibi within the salivary glands and parotid glands in addition
to the thyroid. There is a focal area of increased intensity within the inferior aspect of the right thyroid
gland. No abnormal activity is identified elsewhere in the neck or mediastinum. On the two hour delayed
images, there has been wash-out of most of the activity from the thyroid gland; however, there is a persistent
focal area of activity in the region of the lower pole of the right thyroid gland. This persistent uptake of
sestamibi is consistent with a parathyroid adenoma. Physiologic activity is again identified within the parotid
and submandibular salivary glands. No abnormal activity is identified in the region of the mediastinum on the
two hour delayed images.
Impressions
1. PERSISTENT FOCAL AREA OF ABNORMAL ACTIVITY IN THE REGION OF THE LOWER POLE OF
THE RIGHT THYROID GLAND ON TWO HOUR DELAYED IMAGES. THIS APPEARANCE OF ACTIVITY
RETENTION AT TWO HOURS IS CONSISTENT WITH A PARATHYROID ADENOMA.
2. NO ABNORMAL ACTIVITY IS IDENTIFIED ELSEWHERE IN THE NECK OR IN THE MEDIASTINUM.
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