Indian Journal of Nuclear Medicine
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CASE REPORT
Year : 2015  |  Volume : 30  |  Issue : 4  |  Page : 347-349

Hiatal hernia uptake of iodine-131 mimicking mediastinal metastasis of papillary thyroid carcinoma


Department of Nuclear Medicine and Molecular Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence Address:
Mahdi Haghighatafshar
Department of Nuclear Medicine and Molecular Imaging Research Center, Shiraz University of Medical Sciences, Shiraz
Iran
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Source of Support: Nil., Conflict of Interest: None declared.


DOI: 10.4103/0972-3919.164020

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There are a few case reports of hiatal hernia demonstrating thoracic uptake on I-131 scintigraphy. In this case, high thyroglobulin levels in combination with misinterpretation of I-131 uptake in the mediastinum, leaded to mismanagement of the patient. Here we present a case of focal I-131 uptake within a hiatal hernia initially mimicking an isolated mediastinal metastasis. There are many potential causes of false-positive I-131 scan result. In this case, adjunctive chest computed tomography and gastroesophageal barium study helped to elucidate the true nature of this I-131 uptake. False-positive findings may be caused by a wide variety of nonthyroidal carcinomas, which can concentrate radioiodine or from skin contamination. Several organs, such as the gastric, salivary glands, renal cyst, pericardial effusion, and ovarian can accumulate I-131. It should be borne in mind as a potential source of false-positive whole-body I-131 imaging.


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