Interesting ImagesInternal Jugular Vein and Cerebral Venous Sinus Infective Thrombophlebitis Detected With 99mTc-HMPAO White Blood Cell ScintigraphySistani, Golmehr MD∗,†; Zukotynski, Katherine A. MD, PhD‡; Akincioglu, Cigdem MD†; Romsa, Jonathan G. MD†; Warrington, James C. MD, PhD†Author Information From the Department of ∗Radiology †Nuclear Medicine, Western University, London ‡Department of Radiology, McMaster University, Hamilton, Ontario, Canada. Received for publication June 1, 2020; revision accepted September 10, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Golmehr Sistani, MD, Department of Medical Imaging, Western University, London Health Sciences Center, Victoria Hospital, 800 Commissioners Rd E Rm C2-144, London, Ontario, Canada, N6A 5W9. E-mail: [email protected]. Clinical Nuclear Medicine: February 2021 - Volume 46 - Issue 2 - p e112-e113 doi: 10.1097/RLU.0000000000003352 Buy Metrics Abstract A 35-year-old man with a history of renal transplant, congenital cystinosis, and diabetes was admitted to the hospital with fever, bilateral parotid gland swelling, and acute renal failure. He had 99mTc-HMPAO-WBC (99mTc-hexamethylpropyleneamineoxime white blood cell) imaging for the evaluation of possible parotitis. There was intense radiopharmaceutical uptake along the right internal jugular vein extending to the right sigmoid and transverse and superior sagittal sinuses, suggestive of infective thrombophlebitis or Lemierre syndrome. This study illustrates the value of 99mTc-HMPAO-WBC imaging as a tool for evaluating thrombophlebitis, particularly in patients with renal failure in whom contrast-enhanced CT may not be possible. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.