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UPTAKE WITHIN THE TRACHEOBRONCHIAL TREE FOLLOWING ADMINISTRATION OF I-131
Authored By: Shane Inoue and Henry Royal.
Patient: 53 year old male
History: 53-year-old male with papillary thyroid carcinoma status post thyroidectomy 09/01/2006 and I-131 100 mCi treatment dose 09/22/2006. Patient also with history of alpha-1-antitrypsin disease.
Image Size:[small][as-submitted]

Fig. 1
Whole-body I-131 images

Fig. 2
Spot images of the head and neck
Image Size:[small][as-submitted]

Findings: 1. Mild increased radiopharmaceutical activity within the thyroidectomy post-operative bed, consistent with residual thyroid tissue.

2. Increased activity within the middle mediastinum and hilar regions.  This appears to follow the course of the tracheobronchial tree.  Given the patient's history of alpha-1-antitrypsin disease, this may represent retained secretions related to poor mucus clearance.
DDx: Residual mucous contamination due to poor mucociliary clearance from alpha-1-antitrypsin deficiency.  Diffuse metastatic disease involving the tracheobronchial tree is unlikely.
Diagnosis: Residual functioning thyroid tissue within the thyroid bed.
Retained uptake within the tracheobronchial tree due to poor mucociliary clearance from alpha-1-antitrypsin deficiency.
References: Thank you to Neil Kennedy, M.D. for contributing this case.
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Additional Details:

Case Number: 122216Owner(s): Shane Inoue and Henry RoyalLast Updated: 02-07-2013
Anatomy: Face and Neck   Pathology: Neoplasm
Modality: Nuc MedAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: thyroid

Case has been viewed 13 times.
Certified by Henry Royal on 09-17-2009

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