Almeida Ludmila Santiago, de Souza Stephan Pinheiro Macedo, de Souza Fernando Vieira Pericole, Reis Fabiano, Ramos Celso Dario
Department of Radiology, Division of Nuclear Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
Department of Internal Medicine, Division of Hematology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
Indian J Nucl Med. 2022 Jul-Sep;37(3):290-292. doi: 10.4103/ijnm.ijnm_205_21. Epub 2022 Nov 2.
We report a patient with multiple myeloma (MM) and polyarthritis of large joints. During the staging of the disease, bone marrow diffusely involved by MM was clearly demonstrated by 99mTc-2-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) but not by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT images. On the other hand, a very intense uptake of 18F-FDG was detected in periarticular tissues of multiple joints, with nonabnormal 99mTc-MIBI accumulation. Rheumatology tests were negative. A subsequent bone scintigraphy demonstrated radiolabeled bisphosphonate accumulation in periarticular tissues, suggesting amyloid arthropathy.
我们报告了一名患有多发性骨髓瘤（MM）和大关节多关节炎的患者。在疾病分期过程中，99mTc-2-甲氧基异丁基异腈（MIBI）单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）清晰显示骨髓被MM广泛累及，而18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/CT图像则未显示。另一方面，在多个关节的关节周围组织中检测到18F-FDG摄取非常强烈，而99mTc-MIBI积聚无异常。风湿病学检查结果为阴性。随后的骨闪烁显像显示放射性标记的双膦酸盐在关节周围组织中积聚，提示为淀粉样关节病。
