ASEPTIC NECROSIS - A SCINTIGRAPHIC IMITATOR OF OSSEOUS INVOLVEMENT INGA-67 AVID LYMPHOMA

Based on the data by Armas et al, avascular necrosis, a not uncommon t reatment-associated complication in patients with lymphoma, it should be easily distinguishable from osseous lymphomatous involvement in pat ients with Ga-67 avid lymphoma. In avascular necrosis, Ga-67 uptake wi ll be either absent, decreased, or normal, whereas in lymphoma Ga-67 u ptake will be increased. The authors present a patient with Hodgkin's disease who had new foci of simultaneously increased Ga-67 and Tc-99m MDP uptake because of avascular necrosis as proven by biopsy and long- term follow-up. The authors hypothesize that a possible explanation fo r the discrepancy between this patient report and the series by Armas et al may be that increased Ga-67 is a delayed phenomenon related to h ealing.