case_images: PMC4746841_01
case_images: (a) Chest X-ray showing multiple nodular lesions in both lungs and (b) computerized tomography of the brain showing a hyperdense lesion (arrow) in the right posterior parietal lobe
case_images: IJNM-31-42-g001.jpg
case_images: PMC4746841_01_IJNM-31-42-g001.jpg
case_images: F1
case_images: A 65-year-old man, investigated at a different hospital for intermittent cough and white-colored expectoration for 4 months, was found to have multiple bilateral nodular lesions on a chest X-ray [Figure 1a] and a hyperdense lesion (arrow) in the right posterior parietal lobe of the brain on CT [Figure 1b].
case_images: 131I whole body scan (a) 48 h after administration of 2 mCi 131I showing increased tracer uptake at multiple sites in the neck, chest, abdomen, pelvis and right thigh. A small focus of radioiodine uptake is seen on the right side of the head posteriorly (arrow), adjacent to a known focus of tracer contamination (arrowhead). Single photon emission computed tomography/computed tomography of the neck and chest; (b) Localizes tracer uptake to residual thyroid, bilateral hilar lymph nodes, right 3rd and 4th ribs with lytic changes and multiple lung nodules. Single photon emission computed tomography/computed tomography of the abdomen; (c) Shows tracer uptake in multiple exophytic renal nodules
case_images: IJNM-31-42-g002.jpg
case_images: PMC4746841_01_IJNM-31-42-g002.jpg
case_images: F2
case_images: 131I WBS [Figure 2a] and SPECT/CT [Figure 2b and c] performed 48 h after oral administration of 2 mCi 131I showed tracer uptake in the head, neck (residual thyroid), bilateral hilar lymph nodes, right third and fourth ribs with lytic changes, lung nodules, S1/S2 spinal canal, right femur, acetabulum and humerus, and multiple exophytic renal nodules.
case_images: Whole body planar (a) and single photon emission computed tomography/computed tomography (b) scans 5 days after 207 mCi 131I showing increased tracer uptake in the brain (arrow), D11 vertebra, sacrum, and right acetabulum, in addition to residual thyroid and lungs
case_images: IJNM-31-42-g003.jpg
case_images: PMC4746841_01_IJNM-31-42-g003.jpg
case_images: F3
case_images: A fifth-day posttherapy whole body planar and SPECT/CT scan [Figure 3a and b] confirmed metastasis in the brain (arrow) and other sites seen in the pretherapy scan.