Abstract

We report diffuse intense FDG uptake in the bone marrow in a patient who had undergone surgery for gastric antral gastrointestinal stromal tumor unrelated to the primary malignancy. The FDG-PET demonstrated diffusely enhanced uptake of the radiotracer in the vertebrae, pelvis, and the proximal long bones. The history revealed coexistent polycythemia rubra vera and multiple therapeutic phlebotomies in the past. There was no previous history of administration of chemotherapy or marrow stimulants, and bone marrow biopsy was negative for disease involvement. Bone marrow uptake of FDG in polycythemia rubra vera can be explained by bone marrow stimulation related to the clonal expansion of multipotent hematopoietic progenitor cell in this disease. Hence, such an entity should be considered in the differential diagnosis of marrow uptake of FDG in the absence of an attributable etiology.

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