Marrow visualization on an abdominal blood pool scan

A Tc-99m RBC gastrointestinal bleeding study was performed on a 65- year-old woman with acute promyelocytic leukemia who had thrombocytopenia and anemia due to chemotherapy. Striking visualization of the lumbar vertebral bodies and lilac bones were apparent throughout the entire 90 minutes that the study was initially performed. A delayed 20-hour image showed sacroiliac activity. At approximately 50 minutes into the study, a new focus of activity appeared over a right lilac vessel, which may represent a site of intramural bleeding. The osseous visualization likely represents enhanced bone marrow circulation and uptake secondary to the blood dyscrasia. This finding previously has been described on renal perfusion studies, but net on delayed blood pool images.