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Bone scan follow-up of prostatic cancer. No current complaints.
Delayed phase bone scan
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There is increased uptake of Tc99m-MDP in bilateral humeral heads, femoral heads, the left distal femur, proximal tibiae, and distal tibiae.
The kidneys, bladder , hands, and feet are still visible.
This bone scan was misdiagnosed as a superscan from prostate cancer metastases, and the patient stage was incorrectly raised to stage IV. Prostate cancer superscans typically demonstrate increased tracer accumulation in the bones of the axial and proximal appendicular skeleton which can be heterogenous. The kidneys, soft tissues and the small bones of the hands and feet are not typically well seen on a superscan.
Patients with myelofibrosis may demonstrate increased uptake of Tc99m-MDP at the metaphyseal ends of long bones on bone scan. While increased uptake of Tc99m-MDP usually denotes the increased activity of osteoblasts, in myelofibrosis increased uptake at the epiphyses is thought to relate to increased bone blood flow in the setting of red marrow expansion.
- Epstein D, Alter A, Levin E, Washington A. Bone Scintigraphy in Myelofibrosis. Clinical Nuclear Medicine. 1976; 1 (2): 51-55.