PMC10414553_01
Tracking amyloid by whole body bone scintigraphy.. Time series of bone scintigraphy imaging with 99mTc 3,3-diphosphono-1,2-propanodicarboxylic acid (DPD). (A) In 2000, multiple osseous sites of disease attributable to paraganglioma can be appreciated throughout the skeleton. Patient remained stable for another 15 years (B). In 2016, cardiac (red), intestinal (yellow), hepatic (purple), splenic (green) and thyroid (blue) accumulation of the bone-seeking radiotracer can be appreciated, supporting the notion of onset of amyloidosis (C). After initiation of anti-amyloid treatment, a significant reduction of DPD in cardiac (red arrow in D) and extra-cardiac manifestations was noted. Both amyloid manifestations and metastatic lesions in the skeleton remained stable in (E) 2018, (F) 2019 and (G) 2020.
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As long-term complication of the ongoing inflammation the patient developed rapid progressive systemic AA amyloidosis with multi-organ involvement including cardiac and renal, hepatic, gastrointestinal, spleen and thyroid gland involvement within less than one year according (Fig 1).