COVID-19 pneumonia detected by parathyroid scintigraphy

Abstract

We report a case of incidental diagnosis of COVID-19 pneumonia by parathyroid scintigraphy. A 53-year-old woman who had severe fatigue, and mild dyspnea underwent parathyroid scintigraphy due to increased serum parathyroid hormone (PTH) and serum calcium levels. Parathyroid scan was negative for abnormal parathyroid tissue. Although the patient had three negative results of COVID-19 PCR tests, significant 99m Tchexakis-2-methoxyisobutylisonitrile ([99mTc]MIBI) uptake is noticed in both lungs that was suspicious for Covid-19 pneumonia. The patient underwent CT scan of the chest for further evaluation. Diffuse groundglass opacities were identified in both lungs which were interpreted as typical feature for COVID-19 pneumonia.

We report a case of incidental diagnosis of COVID-19 pneumonia by parathyroid scintigraphy. A 53-year-old woman who had severe fatigue, and mild dyspnea underwent parathyroid scintigraphy due to increased serum PTH and serum calcium levels.The parathyroid scan was negative for abnormal parathyroid tissue. Although the patient had three negative results of COVID-19 PCR tests, significant 99mTc-hexakis-2-methoxyisobutylisonitrile ([99mTc]MIBI) uptake is noticed in both lungs that were suspicious for Covid-19 pneumonia (Fig. 1, 2) [1, 2]. The patient underwent computed tomography (CT) scan of the chest for further evaluation (Fig. 3) [3–5]. Diffuse ground-glass opacities were identified in both lungs which were interpreted as a typical feature of COVID-19 pneumonia (Fig. 3) [6–8].

Figure 2. Parathyroid single photon emission computed tomography (SPECT) images, revealed diffuse bilateral lung uptake

Figure 3. Transaxial computed tomography (CT) scan of the chest. Due to the primary involvement of the respiratory system, chest computed tomography is strongly recommended in suspected COVID-19 cases, for both initial evaluation and follow-up evaluation [3]. Recent studies addressed the importance of chest CT examination in COVID-19 patients with false-negative RT-PCR results [4]. Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features, such as Bilateral ground-glass opacities characterized by multilobe involvement with posterior and peripheral distribution; parenchymal consolidations with or without air bronchogram; interlobular septal thickening; crazy paving pattern, represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities; subsegmental pulmonary vessels enlargement (> 3 mm) [5]. The CT scan in this patient is demonstrating multiple peripherally distributed ground-glass opacities and some other typical features in both lung fields which are in favor of pneumonia induced by COVID-19 [6–8]

Conflict of interest

The authors have no conflicts of interest to declare.