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A "super scan" pattern detected on bone scintigraphy usually indicates either metabolic bone disease or diffuse metastases. We report a rare case of a 45-year-old man with recurrent episodes of syncope of 10 years' duration in whom bone scintigraphy showed a super scan with an axial skeleton distribution of uptake. Bone marrow biopsy established the diagnosis of systemic mastocytosis. The few reports in the literature of super scans associated with systemic mastocytosis showed diffuse axial and appendicular increased uptake. The present case shows a super scan involving the axial skeleton, which led to the diagnosis of systemic mastocytosis.

Limping is a frequent occurrence in children and may be caused by various conditions, including trauma, inflammation, infection, and malignancy. Nontraumatic avascular necrosis of the tarsal bones should be included in the differential diagnosis. Accumulated data have supported the superiority of bone scans to radiography in the early diagnosis of avascular necrosis. Bone scintigraphy is a useful tool for investigating pain when symptoms, laboratory examinations, and radiography do not point to a specific diagnosis. In the early phase of disease, bone scans may demonstrate decreased tracer uptake (photopenic region), subsequently a hot area is seen during the reparative process. Although magnetic resonance imaging has important implications in the diagnosis of avascular necrosis, bone scintigraphy with its ready availability has a significant role as a primary tool in the evaluation of a limping child.

Sternal malformations are rare congenital malformations of the chest wall. Only a few cases have been reported. Most cases are diagnosed shortly after birth and are reported only rarely in adults. The defects are usually detected on radiographs or computed tomographic (CT) scan. Bone scintigraphy usually has no role in the diagnosis of these congenital defects. Cleft sternum is one of the most common eternal malformations. It results from failure of midline fusion of the two parts of the sternum. It is seen in two forms, complete and incomplete, and it may present as an isolated form or associated with other congenital anomalies, such as cardiac or vascular defects. The defect is corrected surgically for cosmetic purpose and to protect the underlying exposed mediastinal structures. The authors report the case of a complete cleft sternum in an adult detected on bone scintigraphy.

Primary non-Hodgkin's lymphoma (NHL) of the larynx is very uncommon. It accounts for as many as 5% of extranodal NHLs and for fewer than 1% of all NHLs. Few cases have been reported in the literature. None of these studies evaluated the role of the Ga-67 scan in staging the disease and in assessing the response to treatment. The authors describe a 77-year-old woman with NHL of the larynx who was examined with a Ga-67 scan at baseline before starting treatment and at the end of six courses of chemotherapy. The results of Ga-67 imaging and computed tomography (CT) were correlated with clinical findings at the time of initial presentation and during follow-up.

A 28-year-old man was examined because of a mass in the right side of his neck. A thyroid scan with Tc-99m pertechnetate showed an area of decreased activity in the right lower lobe that corresponded to the palpable nodule. Because the fine-needle aspiration did not provide satisfactory specimens, the patient underwent surgery. The nodule was firmly attached to the right lobe and both were excised. A histologic analysis revealed that the cystic mass was consistent with an echinococcal cyst. Thyroid involvement by hydatid cysts, especially as a primary site, is very uncommon.