Detection of Parathyroid Hyperplasia, Lymph Node Metastasis From Thyroid Cancer, and Thyroid Adenomatous Hyperplasia Using Tc-99m MIBI

摘要

A 49-year-old woman who had undergone a living renal transplantation became aware of a mass in the anterior region of her neck. Because her blood parathyroid hormone level was markedly increased (as high as 6420 pg/dL), she was suspected of having secondary hyperparathyroidism. After the intravenous administration of Tc-99m 2-methoxy isobutyl isonitrile, areas of increased activity were observed in both inferior poles of the thyroid gland and below the left lobe during the early phase of imaging. These accumulations were also visualized on delayed images. On the other hand, enhanced computed tomography revealed only 1 lesion in the left lobe of the thyroid gland. During surgery, 3 nodules were resected. Histopathologic examination revealed that 1 of the nodules represented hyperplasia of the parathyroid gland, the second nodule was a lymph node metastasis from thyroid cancer, and the last nodule was thyroid adenomatous hyperplasia.