We report the successful diagnosis of thyroid involvement by histiocytosis X due to accurate evaluation of nuclear medicine results. Methods: A total thyroidectomy specimen from our patient was initially suggestive of medullary thyroid carcinoma. However, histologic reevaluation was performed on the basis of nuclear medicine findings which were incompatible with the original histologic diagnosis. Results: Immunohistochemical and light microscopy studies were performed to obtain the correct diagnosis. Diffuse thyroid involvement by histiocytosis X was demonstrated. Conclusion: Thyroid scintigraphy was helpful in successfully diagnosing thyroid involvement by histiocytosis X. Because tracer uptake is related to increased cellularity and metabolism, none of these tracers reported here is specific for defining histiocytosis X.
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