99mTc-PYP Uptake in an Insulin Ball

Long-term subcutaneous insulin injection causes histopathological changes, such as insulin amyloidosis resulting in poor glycemic control, at the insulin injection site. Insulin amyloidosis often leads to the formation of a nodule called the “insulin ball.” An insulin ball has not yet been documente...

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Bibliographic Details
Published in:Clinical nuclear medicine 2024-12, Vol.49 (12), p.1133-1135
Main Authors: Takahashi, Koji, Sasaki, Daisuke, Yamamura, Nobuhisa, Inoue, Katsuji, Okura, Takafumi
Format: Article
Language:English
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Summary:Long-term subcutaneous insulin injection causes histopathological changes, such as insulin amyloidosis resulting in poor glycemic control, at the insulin injection site. Insulin amyloidosis often leads to the formation of a nodule called the “insulin ball.” An insulin ball has not yet been documented on 99m Tc-PYP scintigraphy. Hereby, we describe the case of a 74-year-old man with insulin-requiring diabetes who developed heart failure with preserved ejection fraction due to new-onset atrial fibrillation. 99m Tc-PYP scintigraphy for cardiac amyloidosis screening showed no tracer uptake in the myocardium but did show uptake in the insulin ball suspected by CT and MRI scans.
ISSN:0363-9762
1536-0229
DOI:10.1097/RLU.0000000000005507