Abstract
Adenocarcinoma arising from a mediastinal cyst was detected by exercise technetium-99m hexakis-2-methoxyisobuty-lisonitrile (99m)Tc-MIBI scintigraphy in a 65-year-old woman with known coronary disease. This guided further investigations and resection of the tumor which stained positive for P-glycoprotein. Three years earlier, myocardial scintigraphy was negative, probably due to down-expression of P-glycoprotein because the cells were in the early stages of carcinogenesis. After completing malignant transformation, the high P-glycoprotein expression resulted in MIBI uptake on the second myocardial scintigraphy.
MeSH terms
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ATP Binding Cassette Transporter, Subfamily B, Member 1 / analysis
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Adenocarcinoma / chemistry
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Adenocarcinoma / diagnostic imaging*
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Adenocarcinoma / surgery
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Aged
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Biomarkers, Tumor / analysis
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Biopsy, Fine-Needle
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Bronchogenic Cyst / diagnostic imaging*
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Cell Transformation, Neoplastic / metabolism
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Cell Transformation, Neoplastic / pathology*
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Coronary Artery Disease / diagnostic imaging*
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Exercise Test
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Female
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Humans
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Immunohistochemistry
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Incidental Findings
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Mediastinal Neoplasms / chemistry
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Mediastinal Neoplasms / diagnostic imaging*
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Mediastinal Neoplasms / surgery
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Predictive Value of Tests
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Radiopharmaceuticals*
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Technetium Tc 99m Sestamibi*
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Tomography, Emission-Computed, Single-Photon*
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Tomography, X-Ray Computed
Substances
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ATP Binding Cassette Transporter, Subfamily B, Member 1
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Biomarkers, Tumor
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Radiopharmaceuticals
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Technetium Tc 99m Sestamibi