Diffuse Bone Uptake of 131 I and Effect on Blood Counts in a Patient With Papillary Thyroid Carcinoma and Chronic Lymphocytic Leukemia

Clin Nucl Med. 2024 Apr 1;49(4):340-341. doi: 10.1097/RLU.0000000000005119. Epub 2024 Feb 9.

Abstract

A 57-year-old woman with history of chronic lymphocytic leukemia was referred to our center for adjuvant 131 I therapy following complete thyroidectomy for differentiated thyroid cancer. Posttherapeutic scintigraphy revealed atypical diffuse osteomedullar uptake. A major drop in lymphocyte count was observed, from 117.7 g/L to 4.8 g/L 8 weeks after 131 I therapy. Bone marrow uptake is presumed to be related to tracer sequestration in leukemic cells. White blood cell count normalization suggests a high sensitivity of leukemic cells to beta emission. This scintigraphic pattern may act as a pitfall for nuclear medicine physician.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma*
  • Biological Transport
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Leukemia, Lymphocytic, Chronic, B-Cell* / diagnostic imaging
  • Middle Aged
  • Thyroid Cancer, Papillary / diagnostic imaging
  • Thyroid Neoplasms* / diagnostic imaging
  • Thyroid Neoplasms* / radiotherapy

Substances

  • Iodine Radioisotopes