Abstract
A 33-year-old, female presenting with dementia was admitted to our institution. Except for slight muscle atrophy noted on both lower extremities there were no other significant physical signs or laboratory findings. Since initial Tc-99m-HMPAO SPECT showed hypoperfusion on both temporal, parietal and occipital lobes, follow up study with the same radiotracer was done. Increase in uptake was noted in the left side of the face. There was no abnormality noted on ENT examination. CT scan and MRI showed slight nasal mucosal wall thickening. Tl-201 SPECT showed increased uptake in the nasal area. The increase in uptake could be due to nasal mucosal thickening. This could simulate nasal tumor and interfere in determining ROI for brain perfusion studies.
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Nagafuchi S, Yanagisawa H, Sato K, Shirayama T, Ohsaki E, Bundo M, et al. Dentatorubral and pallidoluysian atrophy expansion of an unstable CAG trinucleotide on chromosome 12p.Nat Genet 6: 14–18, 1994.
Yuasa T. Hereditary dentatorubro-pallidoluysian atrophy (DRPLA): clinical studies on 45 cases.Nippon-Rinsho 51: 3016–3023, 1993.
Miyashita K, Inuzuka T, Ishikawa A, Kondo H, Kawakami A, Takeda S, et al. Hereditary dentatorubropallidoluysian atrophy—clinical variants in a family and degeneration of cerebral white matter in a proband.No-To-Shinkei 44: 279–284, 1992.
Komure O, Sano A, Nishino N, Yamauchi N, Ueno S, Kondoh K, et al. DNA analysis in hereditary dentatorubral-pallidoluysian atrophy: correlation between CAG repeat length and phenotypic variation and molecular basis of anticipation.Neurology 45: 143–149, 1995.
Arai T, Mizukami K, Matsuzaka H, Iwakuma A, Shiraishi H, Koizumi J. CNS changes in DRPLA with dementia and personality changes: CT, MR and SPECT findings.Jpn J Psychiatry Neurol 47: 105–110, 1993.
Rak KM, Newell JD II, Yakes WF, Damiano MA, Luethke JM. Paranasal sinuses on MR images of the brain: significance of mucosal thickening.AJMR 11: 1211–1214, 1990.
Zinreich SJ, Kennedy DW, Kumar AJ, Rosenbaum AE, Arrington JA, Johns ME. MR imaging of normal nasal cycle: comparison with sinus pathology.J Comput Assist Tomogr 12: 1014–1019, 1988.
Shapiro MD, Som PM. MRI of the paranasal sinuses and nasal cavity.Radiol Clin North Am 27: 447–475, 1989.
McCready VR. An unusually high nasal uptake of radioactive iodine during treatment for carcinoma of the thyroid.Am J Roentgenol Radium Ther Nucl Med 96: 593–595, 1966.
Sulavik SB, Palestro CJ, Spencer RP, Swyer AJ, Goldsmith SJ, Tierstein AS. Extrapulmonary sites of radiogallium accumulation in sarcoidosis.Clin Nucl Med 15: 876–878, 1990.
Jonker ND, Peters AM, Gaskin G, Pusey CD, Lavender JP. A retrospective study of radiolabeled granulocyte kinetics in patients with systemic vasculitis.J Nucl Med 33: 491–497, 1992.
Ryu YH, Chung TS, Lee JD, Suh JH, Lee JT, Park CY. Detection of malignant melanoma by Tc-99m HMPAO.Clin Nucl Med 20: 528–530, 1995.
Andersen AR.99mTc-D,L-hexamethylene-propyleneamine oxime (99mTc-HMPAO): basic kinetic studies of a tracer of cerebral blood flow.Cerebrovasc Brain Metab Rev 1: 288–318, 1989.
Suga K, Uchisako H, Honma Y, Kuramitsu T, Itoh K, Nakagi K, et al. The assessment of99mTc-HMPAO tumor scintigraphy using VX-2 tumors in rabbits.KAKU IGAKU (Jpn J Nucl Med) 28: 1049–1056, 1991.
Suess E, Malessa S, Ungersbock K, Kit P, Podreka I, Heimberger K, et al. Technetium-99m-d,1-hexamethylpropyleneamine-oxime (HMPAO) uptake and glutathione content in brain tumors.J Nucl Med 32: 1675–1681, 1991.
Matsuda H, Tsuji S, Shuke N, Sumiya H, Tonami N, Hisada K. A quantitative approach to technetium-99m hexamethylpropylene amine oxime.Eur J Nucl Med 19: 195–200, 1992.
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Flores, L.G., Jinnouchi, S., Nagamachi, S. et al. Nasal mucosal thickening simulating a tumor: Potential for misdiagnosis in brain perfusion imaging. Ann Nucl Med 10, 343–346 (1996). https://doi.org/10.1007/BF03164743
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DOI: https://doi.org/10.1007/BF03164743