We present the findings of a [99mTc]Tc-DMSA scan conducted on a 6-month-old girl who was experiencing fever and recurrent urinary tract infections. The scan revealed crossed fused kidneys on the right side with no radiotracer uptake in the left renal site. Additionally, the scan showed an incidental finding of radiotracer uptake in the left hemithorax, which was initially suspected to be an ectopic thoracic kidney. However, fused SPECT/CT images clarified that this uptake was a lung clot embolus. This case underscores the importance of considering the possibility of radioactive lung clot when encountering incidental intrathoracic uptake especially following traumatic catheterization. Doing so can enhance patient comfort by reducing the need for further diagnostic procedures while minimizing unnecessary radiation exposure.
Vali R, Armstrong IS, Bar-Sever Z, Biassoni L, Borgwardt L, Brown J, Grant FD, Mandell GA, Majd M, Nadel HR, Ng TS. SNMMI procedure standard/EANM practice guideline on pediatric [99mTc] Tc-DMSA renal cortical scintigraphy: an update. Clin Transl Imaging. 2022 Apr;10(2):173-84.
Hermi A, Bibi M, Mrad Dali K, Hadj Alouane H, Ben Rhouma S, Nouira Y. A case report of non-functional ectopic left kidney obstructing the right kidney in crossed fused kidneys: A rare entity. Int J Surg Case Rep. 2021 Sep;86:106321.
Parthiban K, Jesudas VV. A retrospective study of crossed fused pelvic kidney. World J Pharm Sci. 2019 Feb 28:152-5.
Babu C, Sharma V, Gupta OP. Renal fusion anomalies: a review of surgical anatomy. Anat Physiol. 2015;5:S5-001.
Hajji F, Moufid K, Ghoundale O, Touiti D. A rare case of pelviureteric junction obstruction in the uncrossed kidney of a crossed fused renal ectopia. Ann R Coll Surg Engl. 2018 Aug 16;100(8):e1-3.
Loganathan AK, Bal HS. Crossed fused renal ectopia in children: a review of clinical profile, surgical challenges, and outcome. J Pediatr Urol. 2019 Aug;15(4):315-21.
Silveira NA, Ribeiro FP, do Amaral KM, dos Santos DF, Tineo RN, Heringer VC, de Oliveira Santos A, Brunetto E, Amorim BJ, de Camargo Etchebehere EC, Ramos CD. DMSA-99mTc SPECT/CT and DTPA-99mTc images in cross fused renal ectopia: a case report. Hematol Transfus Cell Ther. 2024 Apr;46:S33-4.
Norouzi G, Amoui M, Ghodsi Rad MA. Rare finding of right ectopic thoracic kidney on 99mTc-DMSA scan. Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Mar-Apr;41(2):122-3.
Rondogianni P, Koniaris G. Tc-99m DMSA uptake by metastatic colorectal carcinoma. Clin Nucl Med. 2004 Aug;29(8):485-7.
Shetewi SG, Alyami J, Al Mutairi BS, Bafaraj SM. Sensitivity and specificity of nuclear medicines (DTPA and DMSA) with magnetic resonance imaging in diagnosing bone metastasis. Nucl Med Rev Cent East Eur. 2022;25(2):85-8.
Turgut B, Erselcan T, Ozdemir S, Hasbek Z, Tosun HB, Topaktas S. A large renal pelvic diverticulum, presenting incomplete excretion during tc-99m MAG-3 scintigraphy and tracer accumulation on tc-99m DMSA scintigraphy; a case report. Ann Nucl Med. 2004 Dec;18(8):689-93.
Barai S, Bandopadhayaya GP, Rathi M, Singh NG. Accumulation of Tc99m-DMSA-3 in the spleen in a case of multiple myeloma with associated amyloidosis. J Postgrad Med. 2005 Apr-Jun;51(2):119-21.
Raman V, Kapse N, Karugaba R, Sharp DG, Stirling S, Hall M, Clarke S. An unusual presentation of abdominal aortic aneurysm on static renal Tc-99m DMSA scintigraphy. Clin Nucl Med. 2007 May;32(5):418-20.
Jóźwik-Plebanek K, Saracyn M, Kołodziej M, Kamińska O, Durma AD, Mądra W, Gniadek-Olejniczak KA, Dedecjus M, Kucharz J, Stec R, Kamiński G. Theranostics in renal cell carcinoma-a step towards new opportunities or a dead end-a systematic review. Pharmaceuticals (Basel). 2024 Dec 19;17(12):1721.
Dirlik A, Ozcan Z, Sureyya Ozbek S, Karapinar B, Ozyurt O, Cura A. Tc-99m DMSA localization in infantile hemangioma. Clin Nucl Med. 2002 Mar;27(3):225-6.
Telli T, Kaya G, Işik Z, Tuncel M. Colonic visualization of 99mTc-DMSA due to enterovesical fistula. Clin Nucl Med. 2021 Jan;46(1):66-8.
Zanglis A, Andreopoulos D, Baziotis N. Trapping of technetium-99m albumin macroaggregate and other four radiopharmaceuticals by blood clots in vitro. Hell J Nucl Med. 2007 Jan-Apr;10(1):24-5.
Chen Y, Ning Y, Liu X, Cai M, Li S. A case of accidental local pulmonary 99mTc-MDP uptake on bone SPECT/CT. Clin Case Rep. 2022 Dec 2;10(12):e6656.
Eberlé MC, Fersing C, Guillemard S, Ilonca D, Guiu S, Deshayes E. Unusual focal lung uptake without CT Abnormality on a bone scan: what might it mean? Diagnostics (Basel). 2022 Apr 8;12(4):934.
Sharma A, Kaushik P, Singh TP, Patel C. Focal pulmonary uptake on myocardial perfusion scintigraphy due to iatrogenic microembolism. J Nucl Cardiol. 2019 Dec;26(6):2133-5.
Fathinul Fikri A, Lau W. An intense F-FDG pulmonary microfocus on PET without detectable abnormality on CT: A manifestation of an iatrogenic FDG pulmonary embolus. Biomed Imaging Interv J. 2010 Oct-Dec;6(4):e37.
Ahmadi, M. , Samadi, M. H. , Ardeshirzadeh, A. , Taheri, F. and Sadeghi, R. (2025). [99mTc]Tc-DMSA uptake in the thoracic region mimicking ectopic kidney in a case of crossed fused renal ectopia. Iranian Journal of Nuclear Medicine, 33(2), 179-181. doi: 10.22034/irjnm.2025.129968.1672
MLA
Ahmadi, M. , , Samadi, M. H. , , Ardeshirzadeh, A. , , Taheri, F. , and Sadeghi, R. . "[99mTc]Tc-DMSA uptake in the thoracic region mimicking ectopic kidney in a case of crossed fused renal ectopia", Iranian Journal of Nuclear Medicine, 33, 2, 2025, 179-181. doi: 10.22034/irjnm.2025.129968.1672
HARVARD
Ahmadi, M., Samadi, M. H., Ardeshirzadeh, A., Taheri, F., Sadeghi, R. (2025). '[99mTc]Tc-DMSA uptake in the thoracic region mimicking ectopic kidney in a case of crossed fused renal ectopia', Iranian Journal of Nuclear Medicine, 33(2), pp. 179-181. doi: 10.22034/irjnm.2025.129968.1672
CHICAGO
M. Ahmadi , M. H. Samadi , A. Ardeshirzadeh , F. Taheri and R. Sadeghi, "[99mTc]Tc-DMSA uptake in the thoracic region mimicking ectopic kidney in a case of crossed fused renal ectopia," Iranian Journal of Nuclear Medicine, 33 2 (2025): 179-181, doi: 10.22034/irjnm.2025.129968.1672
VANCOUVER
Ahmadi, M., Samadi, M. H., Ardeshirzadeh, A., Taheri, F., Sadeghi, R. [99mTc]Tc-DMSA uptake in the thoracic region mimicking ectopic kidney in a case of crossed fused renal ectopia. Iranian Journal of Nuclear Medicine, 2025; 33(2): 179-181. doi: 10.22034/irjnm.2025.129968.1672