Yago Yuzo, Yukihiro Masashi, Kuroki Hirofumi, Katsuragawa Yuzo, Kubota Kazuo
Division of Nuclear Medicine, Department of Radiology, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
Ann Nucl Med. 2005 Sep;19(6):515-8. doi: 10.1007/BF02985581.
We report FDG PET of two cases of cold abscess due to Mycobacterium tuberculosis. Case 1 had colon cancer; FDG PET showed high FDG uptake in the colon lesion and low uptake in the inguinal lesion. The latter was a tuberculous cold abscess confirmed by CT/MRI and biopsy. Case 2 received radiotherapy for lung cancer and presented with suspected vertebral metastasis. Further studies revealed tuberculosis of the vertebra and a tuberculous cold abscess in the iliopsoas muscle. FDG PET showed moderate uptake in the third lumbar spine and low uptake in the abscess center of iliopsoas lesion. Both tuberculous cold abscesses showed moderate FDG uptake in the capsule and low uptake in the center. These features are unique compared with non-tuberculous abscess and typical tuberculosis lesions, which are characterized by high FDG uptake. Pathologically, tuberculous cold abscess is not accompanied by active inflammatory reaction. Our findings suggested that the FDG uptake by tuberculous lesion varies according to the grade of inflammatory activity. The new diagnostic features of tuberculous cold abscess may be useful in the evaluation of such lesions by FDG PET.
我们报告了两例由结核分枝杆菌引起的寒性脓肿的FDG PET检查结果。病例1患有结肠癌；FDG PET显示结肠病变处FDG摄取高，腹股沟病变处摄取低。后者经CT/MRI及活检证实为结核性寒性脓肿。病例2因肺癌接受放疗，出现疑似椎体转移。进一步检查发现椎体结核及髂腰肌结核性寒性脓肿。FDG PET显示第三腰椎有中度摄取，髂腰肌病变脓肿中心摄取低。两个结核性寒性脓肿在包膜处均有中度FDG摄取，中心摄取低。与非结核性脓肿和典型结核病变（其特征为FDG摄取高）相比，这些特征是独特的。病理上，结核性寒性脓肿不伴有活跃的炎症反应。我们的研究结果表明，结核病变的FDG摄取根据炎症活动程度而有所不同。结核性寒性脓肿的新诊断特征可能有助于通过FDG PET对此类病变进行评估。
