Scintigraphic image in a case of atypical presentation of Burkitt lymphoma. The role of the scintigraphy with 67Ga SPECT in the diagnosis and post-treatment control

We present a case of Burkitt's disease with bone (thoracic wall, femur) and lymph node involvement. The patient had symptoms of fever with thoracic wall and femur pain. Lymph node involvement was detected by clinical exploration. A chest X-ray showed rib abnormalities. 99mTc-DPD scan showed thoracic wall (one rib) and femur involvement. 67Gallium SPECT and CT were performed at diagnosis. 67Gallium SPECT showed thoracic wall (one rib more) and abdominal lymph node involvement that was not detected by planar images. A CT scan did not show metastatic disease in mediastinal and abdominal lymph node chains but did show it in one rib and femur. After 6 chemotherapy sessions a new 67gallium scan and CT scan were performed. 67Gallium SPECT showed involvement in the thoracic wall (one rib) that was not detected in planar images. The CT scan was considered normal.