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The Journal of Nuclear Medicine Vol. 31 No. 12 1909-1914
© 1990 by Society of Nuclear Medicine
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Recognition of Distinctive Patterns of Gallium-67 Distribution in Sarcoidosis

Stephen B. Sulavik, Richard P. Spencer, David A. Weed, Howard R. Shapiro, Shyi-Tang Shiue and Richard J. Castriotta

Pulmonary Division, Department of Medicine and Department of Nuclear Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
Pulmonary Division, Department of Medicine and Department of Nuclear Medicine, Mount Sinai Hospital, Hartford, Connecticut

Correspondence: For reprints contact: Stephen B. Sulavik, MD, Pulmonary Div., Dept. of Medicine, Rm. L-2080, Univ. of Connecticut Health Center, Farmington, CT 06032.

ABSTRACT

Assessment of gallium-67 (67Ga) uptake in the salivary and lacrimal glands and intrathoracic lymph nodes was made in 605 consecutive patients including 65 with sarcoidosis. A distinctive intrathoracic lymph node 67Ga uptake pattern, resembling the Greek letter lambda, was observed only in sarcoidosis (72%). Symmetrical lacrimal gland and parotid gland 67Ga uptake (panda appearance) was noted in 79% of sarcoidosis patients. A simultaneous lambda and panda pattern (62%) or a panda appearance with radiographic bilateral, symmetrical, hilar lymphadenopathy (6%) was present only in sarcoidosis patients. The presence of either of these patterns was particularly prevalent in roentgen Stages I (80%) or II (74%). We conclude that simultaneous (a) lambda and panda images, or (b) a panda image with bilateral symmetrical hilar lymphadenopathy on chest X-ray represent distinctive patterns which are highly specific for sarcoidosis, and may obviate the need for invasive diagnostic procedures.




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