Gallium-67 imaging in retroperitoneal fibrosis: significance of a negative result. A patient with retroperitoneal fibrosis and right peritracheal and hilar lymphadenopathy was studied using gallium-67-citrate. No abnormal uptake was seen in the regions of retroperitoneal fibrosis, while there was avid uptake in chest lesions later shown to represent small cell lung carcinoma. Retroperitoneal fibrosis which does not show gallium uptake is most likely mature, with few inflammatory elements. In patients with multiple retroperitoneal and/or mediastinal masses, gallium imaging may be useful in identifying the most active sites of disease for possible biopsy and for subsequent monitoring of response to therapy. 