INFERIOR VENA-CAVA OBSTRUCTION AND DIFFUSE HEPATIC-UPTAKE ON LOWER-EXTREMITY RADIONUCLIDE VENOGRAM

Two patients with dissimilar but advanced malignancies and lower extre mity swelling underwent bilateral lower extremity radionuclide venogra ms, several months apart. Both patients' scintigrams showed multiple c ollaterals in the abdomen and pelvis, consistent with inferior vena ca va obstruction, and hepatic uptake in a diffuse pattern. One patient a lso had multiple bilateral pulmonary emboli on a rung scan. Although d iffuse hepatic uptake has been mentioned before with inferior vena cav a obstruction, it has usually been incidental to focal hepatic uptake near the ports hepatis. The case results in this study demonstrated th at inferior vena cava obstruction can manifest itself solely as diffus e hepatic uptake on nuclear venograms. The authors believe that either pattern can be corroborative of inferior vena cava obstruction on a n uclear venogram.