COVID-19 pneumonia detected by parathyroid scintigraphy

Mehrosadat Alavi; Yalda Moafpourian

doi:10.5603/NMR.a2022.0029

Nuclear Medicine Review
Vol 25, No 2 (2022) #87333 COVID-19 pneumonia detected by parathyroid scintigraphy

Vol 25, No 2 (2022)

Clinical vignette

Published online: 2022-07-11

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Clinical vignette

Nuclear Medicine Review 2022, 25, 2: 134–135

DOI: 10.5603/NMR.a2022.0029

ISSN 1506–9680, e-ISSN 1644–4345

COVID-19 pneumonia detected by parathyroid scintigraphy

Mehrosadat Alavi12

Yalda Moafpourian2

1Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran

2Nuclear Medicine Department, Medical School, Shiraz University of Medical Science, Shiraz, Iran

[Received 7 XII 2021; Accepted 27 IV 2022]

Correspondence to: Yalda Moafpourian, Nuclear Medicine Department, Medical School, Shiraz University of Medical Science, Shiraz, Iran, e-mail: moafpourian@gmail.com

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

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 ground-glass opacities were identified in both lungs which were interpreted as typical feature for COVID-19 pneumonia.

KEY words: COVID-19; [99mTc]MIBI; primary hyperparathyroidism

Nucl Med Rev 2022; 25, 2: 134–135

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.

REFERENCES

Madkhali T, Alhefdhi A, Chen H, et al. Primary hyperparathyroidism. Ulus Cerrahi Derg. 2016; 32(1): 58–66, doi: 10.5152/UCD.2015.3032, indexed in Pubmed: 26985167.
Moralidis E. Radionuclide parathyroid imaging: a concise, updated review. Hell J Nucl Med. 2013; 16(2): 125–133, doi: 10.1967/s002449910083, indexed in Pubmed: 23687643.
Jin YH, Cai L, Cheng ZS. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version) . Mil Med Res. 2020; 7(1): 4, doi: 10.1186/s40779-020-0233-6 , indexed in Pubmed: 32029004.
Xie X, Zhong Z, Zhao W, et al. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020; 296(2): E41–E45, doi: 10.1148/radiol.2020200343, indexed in Pubmed: 32049601.
Caruso D, Polidori T, Guido G, et al. Typical and atypical COVID-19 computed tomography findings. World J Clin Cases. 2020; 8(15): 3177–3187, doi: 10.12998/wjcc.v8.i15.3177, indexed in Pubmed: 32874972.
Stasiak CE, Cardoso FR, de Almeida SA, et al. Incidental finding of COVID-19 infection after [ 68Ga]Ga-PSMA-11 PET/CT imaging in a patient with prostate cancer . Eur J Nucl Med Mol Imaging. 2021; 48(2): 653–654, doi: 10.1007/s00259-020-04932-6, indexed in Pubmed: 32710224.
Malek H, Maghsudi M, Yaghoobi N. Extra-cardiac multifocal lung uptake of Tc-sestamibi in myocardial perfusion imaging: An asymptomatic case with coronavirus infection features. J Nucl Cardiol. 2020 [Epub ahead of print], doi: 10.1007/s12350-020-02393-w, indexed in Pubmed: 33083980.
Albano D, Bertagna F, Bertoli M, et al. Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region. J Nucl Med. 2020; 61(5): 632–636, doi: 10.2967/jnumed.120.246256, indexed in Pubmed: 32238429.