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Mediastinal parathyroid localization: Possible pitfall in technetium-thallium subtraction scintigraphy


Two cases of mediastinal localization of parathyroid adenoma are presented, in which technetium-thallium subtraction scintigraphy yielded a positive result. Both patients had already undergone a negative surgical neck exploration. We suggest that, in case of negative subtraction scintigraphy and negative surgical exploration in proven primary hyperparathyroidism, subtraction scintigraphy should be repeated with emphasis on the superior mediastinum, and in all cases, the use of a non-zoom, large field of few procedure is recommended for technetium-thallium subtraction scintigraphy.

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  1. Basarab RM, Manni A, Harrison TS (1985) Dual Isotope Subtraction Parathyroid Scintigraphy in the Preoperative Evaluation of Suspected Hyperparathyroidism. Clin Nucl Med 10:300–313

  2. Ferlin G, Borsato N, Camerani M, Conte N, Zotti D (1983) New Perspectives in Localizing Enlarged Parathyroids by Technetium-Thallium Subtraction Scan. J Nucl Med 24:438–441

  3. Fogelman I, Mc Killop JH, Bessent RG, Boyle IT, Gray HW, Gunn I, Hutchison JSF (1984) Successful localization of parathyroid adenomata by thallium-201 and technetium-99m subtraction scintigraphy: description of an improved technique. Eur J Nucl Med 9:545–547

  4. Gimlette T, Brownless SM, Taylor WH, Shields R, Simkin EP (1986) Limits to Parathyroid Imaging with Thallium-201 Confirmed by Tissue Uptake and Phantom Studies. J Nucl Med 27:1262–1265

  5. Thompson NW, Eckhauser FE, Harness JK (1982) The anatomy of primary hyperparathyroidism. Surgery 92:814–821

  6. Wang CA (1976) The Anatomic Basis of Parathyroid Surgery. Ann Surg 3:271–275

  7. Winzelberg GG, Hydovitz JD, O'Hara KR, Anderson KM, Turbiner E, Danowski TS, Lippe RD, Melada GA, Harrison AM (1985) Parathyroid Adenomas Evaluated by Tl-201/Tc-99m Pertechnetate Subtraction Scintigraphy and High-Resolution Ultrasonography. Radiology 155:231–235

  8. Winzelberg GG, Melada GA, Hydovitz JD (1986) False positive Thallium-201 Parathyroidscan of the Mediastinum in Hodgkin's Lymphoma. AJR 147:819–821

  9. Young AE, Gaunt JI, Croft DN, Collins REC, Wells CP, Coakley AJ (1983) Location of parathyroid adenomas by thallium-201 and technetium-99m subtraction scanning. Br Med J 286:1384–1386

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Correspondence to J. L. Coolens.

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Coolens, J.L., De Roo, M.J.K. Mediastinal parathyroid localization: Possible pitfall in technetium-thallium subtraction scintigraphy. Eur J Nucl Med 13, 283–284 (1987).

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Key words

  • Parathyroid adenoma
  • Technetium-thallium subtraction scintigraphy