Intense 99mTc-MDP Uptake of Benign Calcified Lymph Nodes in the Mediastinum

A 68-year-old woman with a suspicion of ureteral malignancy was referred for whole-body 99mTc-MDP bone scintigraphy to evaluate possible bone metastasis. Planar images showed a focal intense activity in the chest region. Additional chest SPECT/CT showed the activity was located in the enlarged conglomerate calcified lymph nodes of the mediastinum. Three years later, a second whole-body 99mTc-MDP bone scintigraphy with chest SPECT/CT showed the size, density and activity of the calcified lymph nodes had no significant changes, supporting their benignity.