Wild-Type Transthyretin Amyloidosis With 99mTc-PYP Uptake in the Extracardiac Soft Tissues But Not in the Myocardium

Clin Nucl Med. 2024 Dec 1;49(12):1136-1138. doi: 10.1097/RLU.0000000000005521.

Abstract

Wild-type transthyretin amyloid (ATTRwt) deposits in most organs, mainly the heart, ligaments, and tenosynovium. Orthopedic diseases due to ATTRwt deposits often precede overt ATTRwt cardiomyopathy. 99mTc-PYP scintigraphy is highly sensitive in detecting myocardial and extracardiac ATTRwt deposits. However, there are few reports of extracardiac ATTRwt deposits before myocardial deposits confirmed by imaging modalities. We report a case of atrial fibrillation-related heart failure in which 99mTc-PYP scintigraphy showed tracer uptake in extracardiac soft tissues but not in the myocardium, and a biopsy of soft tissues with tracer uptake confirmed ATTRwt deposits. 99mTc-PYP scintigraphy can image extracardiac ATTRwt deposits before myocardial deposits.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloid Neuropathies, Familial* / diagnostic imaging
  • Amyloid Neuropathies, Familial* / metabolism
  • Biological Transport
  • Female
  • Humans
  • Male
  • Myocardium* / metabolism
  • Myocardium* / pathology
  • Radionuclide Imaging
  • Technetium Tc 99m Pyrophosphate

Substances

  • Technetium Tc 99m Pyrophosphate

Supplementary concepts

  • Amyloidosis, Hereditary, Transthyretin-Related