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Gallium-67 Imaging of Pericardial Lymphoma in AIDS

Institute of Nuclear Medicine, University College London Medical School
Department of Medicine, University College London Medical School and Camden and Islington Community Services Trust, London, United Kingdom

Correspondence: For correspondence or reprints contact: Elizabeth Prvulovich, MD, Institute of Nuclear Medicine, University College London Medical School, Mortimer Street, London W1N 8AA, U.K.

ABSTRACT

A 33-yr-old homosexual man with acquired immune deficiency syndrome (AIDS) and Mycobacterium avium intracellulare (MAI) infection presented with fever, sweats, lethargy and dyspnea. A chest radiograph showed cardiomegaly and an echocardiograph revealed a large pericardial effusion. After pericardial aspiration, which confirmed T cell non-Hodgkin's lymphoma, he remained dyspneic. Gallium-67 imaging was performed to determine whether the patient's residual dyspnea was related to pulmonary MAI infection or lymphomatous infiltration of the heart. Planar ⁶⁷Ga scintigraphy revealed intense tracer uptake in two areas within the mediastinum and surrounding the entire heart shadow but no evidence of pulmonary MAI infection. SPECT ⁶⁷Ga scintigraphy precisely localized the two mediastinal abnormalities and demonstrated the tracer uptake around the heart to be pericardial rather than myocardial. Gallium-67 scintigraphy suggested that pericardial lymphoma was the likely basis of the patient's dyspnea.