Four cases of skeletal photon-deficient areas in In-111 white blood cell (In-111 WBC) images are reported. These were found in patients with lymphoma, vertebral osteomyelitis, and following radiotherapy and extensive surgical procedures. We emphasize that these photopenic lesions, although uncommon, may represent tumor involvement or benign processes, including osteomyelitis. Possible mechanisms to explain this phenomenon are discussed.

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