Indian Journal of Nuclear Medicine

INTERESTING IMAGE
Year
: 2017  |  Volume : 32  |  Issue : 1  |  Page : 61--62

Thoraco-Abdominal duplication cyst- role tc-99m pertechnetate spect-ct scintigraphy in localising ectopic gastric mucosa


Mudalsha Ravina, Deepanksha Datta, Kasturi Rangan, Ajay Singh Suraj, Sanjay Gambhir 
 Department of Nuclear Medicine, SGPGIMS (Sanjay Gandhi Post Graduate Institute of Medical Sciences), Lucknow, Uttar Pradesh, India

Correspondence Address:
Sanjay Gambhir
Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh
India

Abstract

Thoraco-abdominal duplication cyst, a congenital malformation of the posterior primitive foregut rarely presents with anaemia. Ectopic gastric mucosa is seen in around 20%-30% of the enteric duplication cysts. We report the scintigraphic findings of one such case which helped in final diagnosis and management of the patient.



How to cite this article:
Ravina M, Datta D, Rangan K, Suraj AS, Gambhir S. Thoraco-Abdominal duplication cyst- role tc-99m pertechnetate spect-ct scintigraphy in localising ectopic gastric mucosa.Indian J Nucl Med 2017;32:61-62


How to cite this URL:
Ravina M, Datta D, Rangan K, Suraj AS, Gambhir S. Thoraco-Abdominal duplication cyst- role tc-99m pertechnetate spect-ct scintigraphy in localising ectopic gastric mucosa. Indian J Nucl Med [serial online] 2017 [cited 2020 Jan 23 ];32:61-62
Available from: http://www.ijnm.in/text.asp?2017/32/1/61/198486


Full Text

A 3-year-old child presented with history of recurrent epigastric pain for two months with anemia (5.2 g/dl) and fall in haemoglobin. Ultrasound abdomen revealed an echoic cystic lesion adjacent to pancreas and duodenum. Contrast enhanced computerised tomography thorax and abdomen revealed a cystic lesion in the posterior mediastinum extending from the level of arch of aorta through the esophageal hiatus into the lesser sac of the abdomen. Provisional differential diagnosis of pulmonary sequestration / thoraco-abdominal cyst was considered. Tc-99m pertechnetate scintigraphy was performed in view of fall in haemoglobin. Flow and delayed images identified the ectopic mucosa in the thoraco-abdominal cyst [Figure 1] and [Figure 2]. SPECT-CT was further done to confirm the findings [Figure 3]. Following the study, patient underwent posterolateral thoracotomy and exploratoary laparotomy in separate settings. The histo-pathology revealed ectopic gastric muscosa in the cyst [Figure 4].{Figure 1}{Figure 2}{Figure 3}{Figure 4}

Flow and delayed images must be taken to identify ectopic mucosa in duplication cysts as it might only be positive on delayed images in certain cases as in intestinal duplication.[1],[2],[3] Thoraco-abdominal duplication cyst is a congenital malformation of the posterior primitive foregut. Presentation of thoraco-abdominal cyst with anemia is a rare presentation. Ectopic gastric mucosa is seen in around 20%–30% of the enteric duplication cysts.[4],[6],[7]

The above-mentioned findings localized the presence of Tc-99m pertechnatate (ectopic gastric mucosa) in the thoraco-abdominal cyst. Thus, SPECT-CT played an important role in increasing the confidence level and reconfirming the planar scintigraphy findings.[1],[2] Further thoraco-abdominal location of the duplication is extremely rare.[4],[5] It emphasizes on imaging protocols and correct identification of the ectopic mucosa in this setting with SPECT-CT.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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