Role of Ga-67 citrate imaging in extrapulmonary Pneumocystis in HIV positive patients

Gallium-67 citrate imaging is a highly sensitive examination for early detection of Pneumocystis cariniil pneumonia in HIV infected patients. However, its role in the detection of extrapulmonary Pneumocydyod remains to be defined. Common extrapulmonary localizations of Pneumocystis carinii in AIDS patients include lymph nodes, bone marrow, liver, and spleen. Thyroid, choroid, skin, ear, and GI tract are less frequently involved. Extrapulmonary Pneumocystis carinii involvement of the thyroid causing hypothyroidism recently has been reported. Presented is an AIDS patient with a recent thyromegaly and laboratory diagnosis of hypothyroidism whose gallium scan demonstrates diffuse increased gallium uptake by the thyroid gland, which was proven to be secondary to Pneumocystis carinii