Radiotracer Accumulation in the Pyelocaliceal System of Transplanted Kidney: A Potential Pitfall in Lymphoscintigraphy of Pelvic Malignancies.

A 34-year-old woman with a history of renal transplantation and cervical cancer underwent lymphoscintigraphy using 99m Tc-phytate before surgery. Initial planar images revealed multiple foci of uptake, which were later precisely localized using SPECT/CT imaging. Notably, uptakes in the right lower quadrant were attributed to the pyelocalyceal system of the transplanted kidney, highlighting a potential pitfall in patients with ectopic or transplanted kidneys. This case report emphasizes the importance of recognizing the limitations of lymphoscintigraphy in patients with complex anatomy and the value of hybrid imaging in ensuring accurate sentinel lymph node localization.