Dual pathologic findings on heat-denatured Tc-99m erythrocyte scintigraphy with computed tomographic correlation

Abstract

A 70-year-old man with a 3-year history of chronic lymphocytic leukemia and resistant immune thrombocytopenia underwent splenectomy after an episode of life-threatening gastrointestinal bleeding. Recurrent thrombocytopenia, abdominal pain, and further gastrointestinal blood loss ensued. Radiologic (via computed tomographic scan [CT]) and colonoscopic assessment confirmed metastatic colon carcinoma. The ongoing blood loss was caused by severe thrombocytopenia. A heat-denatured Tc-99m erythrocyte study was performed. Results of that study not only confirmed the presence of residual or regenerated splenic tissue but also revealed several defects in hepatic uptake. These corresponded to the CT scan findings and were consistent with the known hepatic metastases.