Functional Asplenia and Portal Hypertension in a Patient with Primary Splenic Hemangiosarcoma

• Published in: Clinical nuclear medicine 1990-05, Vol.15 (5), p.324-326
• Main Authors: YÜCEL, A EFTAL, DURAK, HATICE, BERNAY, IREM, BAYRAKTAR, YUSUF, BEKDIK, COSKUN, TELATAR, HASAN
• Format: Article
• Language: English
• Subjects: ANIMALS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; Biological and medical sciences; BIOLOGICAL MATERIALS; BLOOD; BLOOD CELLS; BODY; BODY FLUIDS; CARBOXYLIC ACID SALTS; CARDIOVASCULAR DISEASES; CITRATES; COLLOIDS; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSIS; DIGESTIVE SYSTEM; DISEASES; DISPERSIONS; ELECTRON CAPTURE RADIOISOTOPES; ERYTHROCYTES; GALLIUM 67; GALLIUM ISOTOPES; Gallium Radioisotopes; GLANDS; Hemangiosarcoma - complications; Hemangiosarcoma - diagnostic imaging; Hemangiosarcoma - secondary; HOURS LIVING RADIOISOTOPES; Humans; HYPERTENSION; Hypertension, Portal - diagnostic imaging; Hypertension, Portal - etiology; INTERMEDIATE MASS NUCLEI; ISOMERIC NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LIVER; Liver Neoplasms - complications; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Male; MAMMALS; MAN; MATERIALS; Medical sciences; METASTASES; Middle Aged; NEOPLASMS; NUCLEI; ODD-EVEN NUCLEI; ORGANS; PATIENTS; PRIMATES; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY AND NUCLEAR MEDICINE; Radionuclide Imaging; SARCOMAS; SPLEEN; Splenic Diseases - diagnostic imaging; Splenic Diseases - etiology; Splenic Neoplasms - complications; Splenic Neoplasms - diagnostic imaging; SYMPTOMS; TECHNETIUM 99; TECHNETIUM ISOTOPES; Tumors; ULTRASONOGRAPHY; VASCULAR DISEASES; VERTEBRATES; YEARS LIVING RADIOISOTOPES 550601 > Medicine-- Unsealed Radionuclides in Diagnostics
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/00003072-199005000-00010

A 60-year-old man with primary splenic hemangiosarcoma (PSH) presented with weakness, weight loss, abdominal pain, and anemia. Physical examination reveaied hepatomegaly, ascites, and firm, huge splenomegaly. Ultrasonography showed many nodular structures characterized by hypoechogenic and hyperechogenic areas. The patient also had portal hypertension, which was confirmed by physical findings and by measurement of portal vein pressure during operation. A liver-spleen scan using Tc-99m sulfur colloid and Tc-99m labeled heat denatured erythrocytes failed to demonstrate any splenic uptake, a reliable feature of functional asplenia. Although on a total body scan with Ga-67 citrate there was no splenic uptake, there was gallium uptake in the liver, where the presence of the metastatic lesion was histopathologically verified and confirmed by operation. There was also uptake in the middle zones of the lungs. Ga-67 citrate imaging appears to be helpful in the diagnosis of metastasis of PSH, and PSH can rarely cause portal hypertension.