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Could a Bronchogenic Cyst Present as an I-131-avid, 99mTc-Non-Avid Lesion and Mimic Metastatic Thyroid Cancer?

Clinical nuclear medicine 2026

Chen KC, Chang YM, Su HH, Shen DH, Chan HP

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A 54-year-old man with papillary thyroid carcinoma after thyroidectomy underwent a 99mTc thyroid scan showing no thyroid remnants but a 3.5-cm left lung lesion with faint 99mTc uptake on SPECT/CT, sug

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APA Chen KC, Chang YM, et al. (2026). Could a Bronchogenic Cyst Present as an I-131-avid, 99mTc-Non-Avid Lesion and Mimic Metastatic Thyroid Cancer?. Clinical nuclear medicine. https://doi.org/10.1097/RLU.0000000000006353
MLA Chen KC, et al.. "Could a Bronchogenic Cyst Present as an I-131-avid, 99mTc-Non-Avid Lesion and Mimic Metastatic Thyroid Cancer?." Clinical nuclear medicine, 2026.
PMID 41949412

Abstract

A 54-year-old man with papillary thyroid carcinoma after thyroidectomy underwent a 99mTc thyroid scan showing no thyroid remnants but a 3.5-cm left lung lesion with faint 99mTc uptake on SPECT/CT, suggesting metastasis. Post-I-131 therapy scans on days 3 and 7 revealed intense I-131 avidity in the lung lesion. Surgical excision confirmed a benign bronchogenic cyst, negative for thyroglobulin, TTF-1, BRAF V600E, and PAX-8. I-131 uptake was likely NIS-mediated, but independent of PAX-8 or due to mucinous content. This case underscores that bronchogenic cysts should be considered in the differential diagnosis of I-131-avid lesions, with tissue confirmation essential to avoid misdiagnosis.

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