Incidental massive Ga-67 uptake in the thorax and abdomen for the diagnosis of lumbar osteomyelitis

Ga-67 uptake in lung carcinoma was first described by Edwards and Hayes in their original reports on Ga-67 uptake in tumors. Ga-67 scintigraphy has subsequently become a widely used method of defining the extent of tumoral disease. Uptake of Ga-67 in the primary lesion is reported to occur in 64%- 100% of patients. The authors report a case of a 59-year-old man with low back pain who had an MRI with a lesion in L3-L4. Delayed images on the three- phase bone scan showed uptake in L3-L4 consistent with diskitis. Ga-67 scintigraphy showed multiple diffuse foci of increased uptake throughout the chest and abdomen. The biopsy results of one of the lymph nodes confirmed the diagnosis of metastatic adenosquamous carcinoma of the lung. This case confirms the importance of considering malignancy in the differential diagnosis of Ga-67 scintigraphy.