Whole body bone scintigraphy correlation in a case of multiple extramedullary plasmacytoma

Multiple extramedullary (soft tissue) plasmacytoma is a rare neoplasm of plasma cells. This is a case of a 63-year-old male who presented with back pain and a one month history of a painful, progressively growing mass at the right anterior chest wall. Since radiographs and computed tomography of the chest showed lytic lesions on the ribs and L4 compression deformity, the patient was referred for whole body bone scintigraphy to evaluate the remainder of the skeleton. Bone scintigraphy revealed osteoblastic lesions and osteolytic lesions in the thoracic cage. Diagnosis of plasmacytoma was established by biopsy and confirmation of microscopic characteristics and immunohistochemical staining.

Anomalous origin of the left coronary artery arising from the pulmonary artery: Myocardial perfusion scintigraphy findings

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac disease with serious complications. This is a case of a three-year-old female who was initially diagnosed and managed as a case of dilated cardiomyopathy. A 2-D echocardiogram showed the left main coronary artery to be coming from the pulmonary artery. The patient was referred for myocardial perfusion scintigraphy (MPS) to determine viability prior to surgical revascularization. MPS showed absent myocardial perfusion in the apex and apical anterior segments and thinned-out perfused myocardium in the midventricular to basal anterior segment and apical to basal inferior and lateral walls. This is consistent with markedly reduced perfusion in the segments supplied by the anomalous left coronary artery distribution. While echo cardiography and angiography are used to diagnose ALCAPA, the roles of MPS are to provide information regarding the viability of the areas supplied by the anomalous left coronary artery and to assess postoperative myocardial perfusion.