Figure 1. Parathyroid and thyroid scans.

Representative nuclear medicine studies indicating a lack of avidity in the peri-thyroid region (panel A) with a concomitant increase in metabolic activity around the prevascular mediastinal area (red arrows, panels B-D) overlayed on non-contrast CT imaging in coronal (panel B), sagittal (panel C), and axial (panel D) planes. Following intravenous (IV) administration of technetium-99m sestamibi, the thyroid (panel A) and mediastinum (panels B-D) were evaluated for increased uptake. The thyroid, demarcated by black (low activity) to white (high activity) shading (panel A), showed uptake within normal ranges. However, the mediastinum, demarcated by red (low activity) to yellow (high activity) shading, showed an unusual focus of increased uptake in the prevascular mediastinal area (red arrows, panels B-D).