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Tuberculosis - The spoil sport.

Govindarajan M - Indian J Radiol Imaging (2008)

View Article: PubMed Central - PubMed

Affiliation: Bangalore Institute of Oncology- Health Care Global-Bangalore, Teleradiology Solutions, Bangalore, India. E-mail: revathigovind@gmail.com.

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An FDG PET/CT scan revealed [Figure 1] metabolically active, extensive lymphadenopathy in the axilla, mediastinum, abdomen, pelvis, and in the inguinal regions; there was also diffuse omental thickening with enhancement, a few faintly enhancing peritoneal soft tissues, right pleural effusion, and ascites... An FDG PET/CT scan revealed [Figure 2] metabolically active, extensive skeletal osteolytic lesions in the calvarium, in the vertebral column at multiple levels, including the body and posterior elements and in the sternum, scapulae, ribs, and pelvic bones... No metabolically active lymphadenopathy was identified... A large metabolically active soft tissue mass was associated with the sternal lesion... A maximum SUV of 3.7 was seen in some of the skeletal lesions... Multiple metabolically active lung nodules were seen in both upper lobes and in the apical segment of the left lower lobe, with a maximum SUV of 1.5... On delayed images, there was significant increase in the SUV value of the majority of the lesions... Tuberculosis can have a varied presentation... There are reports of metabolically active breast masses with extensive axillary, cervical, and mediastinal lymphadenopathy that were initially mistaken for breast cancer with extensive lymph nodal metastasis but were later confirmed to be of tuberculous etiology... The above cases demonstrate the inadequacy of PET in the presence of tuberculosis... The associated diagnostic CT scan, though still not very specific, can be very useful in demonstrating the morphological details, particularly when used with intravenous contrast... Necrotic lymph nodes on contrast-enhanced CT scan (CECT), centrilobular lung nodules on high-resolution CT scan of the lungs, and soft tissue calcifications etc., can help in arriving at a confident diagnosis of tuberculosis... In high-prevalence geographic regions like India, tuberculous etiology should always be considered in the differential diagnoses and must be ruled out before a diagnosis of malignancy is made.

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Related in: MedlinePlus

FDG-PET/CT demonstrates metabolically active retroperitoneal adenopathy (white arrows), ascites, metabolically active peritoneal deposits and extensive metabolically active omental thickening (red arrows)
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Figure 0001: FDG-PET/CT demonstrates metabolically active retroperitoneal adenopathy (white arrows), ascites, metabolically active peritoneal deposits and extensive metabolically active omental thickening (red arrows)

Mentions: A 56-year-old woman presented with ascites and lymphadenopathy, which were suggestive of metastases. An FDG PET/CT scan revealed [Figure 1] metabolically active, extensive lymphadenopathy in the axilla, mediastinum, abdomen, pelvis, and in the inguinal regions; there was also diffuse omental thickening with enhancement, a few faintly enhancing peritoneal soft tissues, right pleural effusion, and ascites. There was a maximum Standard Uptake Value (SUV) of 3.2 in the periportal, perigastric, peripancreatic, retrocaval, and retrocrural lymph nodes. The delayed PET/CT images demonstrated a slight increase in the SUV. A probable diagnosis of lymphoma was considered. Biopsy from a metabolically active retroperitoneal lymph node ruled out lymphoma and confirmed tuberculosis.


Tuberculosis - The spoil sport.

Govindarajan M - Indian J Radiol Imaging (2008)

FDG-PET/CT demonstrates metabolically active retroperitoneal adenopathy (white arrows), ascites, metabolically active peritoneal deposits and extensive metabolically active omental thickening (red arrows)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747427&req=5

Figure 0001: FDG-PET/CT demonstrates metabolically active retroperitoneal adenopathy (white arrows), ascites, metabolically active peritoneal deposits and extensive metabolically active omental thickening (red arrows)
Mentions: A 56-year-old woman presented with ascites and lymphadenopathy, which were suggestive of metastases. An FDG PET/CT scan revealed [Figure 1] metabolically active, extensive lymphadenopathy in the axilla, mediastinum, abdomen, pelvis, and in the inguinal regions; there was also diffuse omental thickening with enhancement, a few faintly enhancing peritoneal soft tissues, right pleural effusion, and ascites. There was a maximum Standard Uptake Value (SUV) of 3.2 in the periportal, perigastric, peripancreatic, retrocaval, and retrocrural lymph nodes. The delayed PET/CT images demonstrated a slight increase in the SUV. A probable diagnosis of lymphoma was considered. Biopsy from a metabolically active retroperitoneal lymph node ruled out lymphoma and confirmed tuberculosis.

View Article: PubMed Central - PubMed

Affiliation: Bangalore Institute of Oncology- Health Care Global-Bangalore, Teleradiology Solutions, Bangalore, India. E-mail: revathigovind@gmail.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

An FDG PET/CT scan revealed [Figure 1] metabolically active, extensive lymphadenopathy in the axilla, mediastinum, abdomen, pelvis, and in the inguinal regions; there was also diffuse omental thickening with enhancement, a few faintly enhancing peritoneal soft tissues, right pleural effusion, and ascites... An FDG PET/CT scan revealed [Figure 2] metabolically active, extensive skeletal osteolytic lesions in the calvarium, in the vertebral column at multiple levels, including the body and posterior elements and in the sternum, scapulae, ribs, and pelvic bones... No metabolically active lymphadenopathy was identified... A large metabolically active soft tissue mass was associated with the sternal lesion... A maximum SUV of 3.7 was seen in some of the skeletal lesions... Multiple metabolically active lung nodules were seen in both upper lobes and in the apical segment of the left lower lobe, with a maximum SUV of 1.5... On delayed images, there was significant increase in the SUV value of the majority of the lesions... Tuberculosis can have a varied presentation... There are reports of metabolically active breast masses with extensive axillary, cervical, and mediastinal lymphadenopathy that were initially mistaken for breast cancer with extensive lymph nodal metastasis but were later confirmed to be of tuberculous etiology... The above cases demonstrate the inadequacy of PET in the presence of tuberculosis... The associated diagnostic CT scan, though still not very specific, can be very useful in demonstrating the morphological details, particularly when used with intravenous contrast... Necrotic lymph nodes on contrast-enhanced CT scan (CECT), centrilobular lung nodules on high-resolution CT scan of the lungs, and soft tissue calcifications etc., can help in arriving at a confident diagnosis of tuberculosis... In high-prevalence geographic regions like India, tuberculous etiology should always be considered in the differential diagnoses and must be ruled out before a diagnosis of malignancy is made.

No MeSH data available.


Related in: MedlinePlus