Bains Sukhkarn, Reimert Matthew, Win Aung Zaw, Khan Sana, Aparici Carina Mari
Department of Radiology and Center for Molecular and Functional Imaging (CMFI) at China Basin, University of California, San Francisco, 185 Berry Street Lobby 6 Suite 350, San Francisco, CA 94107-0946 USA.
Department of Rheumatology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121 USA.
Nucl Med Mol Imaging. 2012 Jun;46(2):138-43. doi: 10.1007/s13139-012-0137-9. Epub 2012 May 3.
We describe the case of a patient with known history of psoriasis that presented with 1 year of unexplained fever, muscle weakness and marked weight loss, suspicious for B symptoms of a malignant origin. [(18)F]-Fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scans demonstrated an unusual serpiginous pattern of uptake in the fascia and muscles as well as lymph node activity. Multiple histological samples, including a final PET-probe guided lymph node surgical resection, excluded malignancy and confirmed the diagnosis of reactive inflammatory changes, with a plausible diagnosis of autoimmune lymphoproliferative syndrome with associated lymphadenitis, fasciitis and myositis, possibly mediated by tumor necrosis factor (TNF) inhibitor. To our knowledge, there is no evidence of a previously reported FDG uptake pattern of fascia and muscle involvement in psoriatic arthritis.
我们报告了一例有银屑病病史的患者，该患者出现了长达1年的不明原因发热、肌肉无力和显著体重减轻，怀疑为恶性肿瘤起源的B症状。[18F]氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（FDG-PET/CT）显示，筋膜和肌肉中存在异常的匐行性摄取模式以及淋巴结活性。多个组织学样本，包括最终的PET引导下淋巴结手术切除样本，排除了恶性肿瘤，并确诊为反应性炎症改变，合理的诊断为自身免疫性淋巴增生综合征伴相关淋巴结炎、筋膜炎和肌炎，可能由肿瘤坏死因子（TNF）抑制剂介导。据我们所知，尚无证据表明先前报道过银屑病关节炎中筋膜和肌肉受累的FDG摄取模式。
