Unusual bone scintigraphic findings of secondary myelofibrosis associated with disseminated tuberculosis before and after therapy

This case concerns a patient with secondary myelofibrosis associated with disseminated tuberculosis who manifested unusual bone scintigraphic findings. The bone images showed a generalized increased uptake in the axial skeleton, including the clavicles and mandible and the proximal long bones similar to a Superscan, and multiple hot spots similar to metastatic disease, combined with increased activity of the metaphyseal ends of the appendicular bones, including the joints. The bone scintigraphs obtained 17 months after antituberculous therapy showed progressive improvement in the known lesions, accompanied by the appearance of new lesions and the apparent visualization of some lesions that may be identical to a flare phenomenon.