ArticleEJNMMI research2026
Dialysis-related amyloidosis mimicking metastatic bone disease: a scintigraphic pitfall of non-MDP-avid osteolytic lesions on bone SPECT/CT.
Article in EJNMMI research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDialysis-related amyloidosis (DRA) is a recognized complication of long-term dialysis caused by progressive deposition of β2-microglobulin amyloid in osteoarticular and periarticular tissues. Although its musculoskeletal manifestations are well described, bone lesions from DRA may be misidentified as malignant disease on imaging, posing a diagnostic challenge. CASE PRESENTATION: We describe a 70-year-old woman on long-term dialysis who presented with a pathologic femoral neck fracture and adjacent osteolytic lesions initially suspicious for metastatic disease or brown tumor. Bone SPECT/CT showed uptake only at the fracture site with background activity in the lytic lesions. Histopathological examination confirmed the diagnosis of amyloidosis by Congo red staining.
conclusionsThis case illustrates that DRA may present as non-MDP-avid osteolytic lesions on bone scintigraphy, potentially mimicking malignant bone disease. Awareness of this scintigraphic pitfall is essential when evaluating dialysis patients with atypical skeletal lesions.
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