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Osseous localization of non-Hodgkin lymphoma shown on Tc-99m HMPAO-labeled leukocyte scintigraphy.

A 37-year-old man with a rectal fistula and a family history of inflammatory bowel disease (IBD) was seen because of abdominal discomfort, weight loss, and subfebrile temperature. Tc-99m HMPAO-labeled leukocyte scintigraphy was performed to determine the possible presence and extension of IBD. Scintigraphy showed no signs of inflammation, but a striking photopenic lesion was visible in the left iliac wing. Additional abdominal computed tomographic scans showed soft tissue swelling surrounding the iliac wing and permeative destruction of bone, compatible with lymphoma. Histologic examination revealed intestinal non-Hodgkin's lymphoma of the bowel with extranodal localization.