Discrepant Imaging of Nodular Hyperplasia with Pertechnetate and Radioiodine

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Abstract
A palpable nodule in the right lobe of the thyroid in a patient was found to be “cold” on a pertechnetate image with normal 131I concentration on a repeat study. At surgery, there was no evidence of neoplasm or thyroiditis. The pathological diagnosis was nodular hyperplasia. Previous reports of inconsistent images with pertechnetate and radioiodine are briefly reviewed and it is suggested that the mechanism responsible for this phenomenon is a change in the rate of trapping and organification in the thyroid.

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