Symmetrically increased uptake of Ga-67 citrate in the breasts: A patient with liver cirrhosis

Abstract

A 63-YEAR-OLD man presented with liver cirrhosis with ascites and splenography. He was referred to our department for performance of a whole body scan of gallium (Ga-67) citrate. In addition to bilateral diffusely increased radioactivity in the lung fields, liver atrophy, and splengography, the gallium scan revealed 2 symmetrically round foci with intense radioactivity in the anterior aspects of the lower chest (Fig 1). His chest x-ray revealed no active lung lesion. The patient had marked breast hypertrophy, but no breast mass or inflammatory signs were noted on the physical examination. This incidental finding on the gallium scan was thought to be caused by gynecomastia, presumably because circulating estrogens are not inactivated in patients with liver cirrhosis. Common 1) Physiological conditions a) Postpartum 1-7 b) Pregnancy 8,9 c) Puberty I,l~ 2) Drug induced a) Estrogen TM ~,~ b) Oral contraceptives containing estrogens 2 c) Reserpine 2 d) Tofranil 2 e) Meprobamate 2 f) Prochlorperazine 2.13,14 g) Phenothiazines 8 h) Metoclopramide 13,14 i) Chlorpromazine 14,2s 3) Gynecomastia a) Orchiectomy 8,12,16,17 b) IdiopathiO s c) Liver cirrhosis Uncommon 1) Renal Failure 2 2) Obesity 2 3) Postabortion 4 4) Idiopathic galactorrhea 8,19 Rare 1) Breast augmentation with silicon 2~ 2) Choriocarcinoma 22 3) Non-African Burkitt's lymphoma 23 4) Neonate with breast feeding 24 5) Hypothalamic granuloma 25