From the Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark.
Clin Nucl Med. 2017 Mar;42(3):e175-e176. doi: 10.1097/RLU.0000000000001528.
We describe 2 cases of Ga-PSMA PET/CT in prostate cancer patients. Both cases demonstrated symmetrical bilateral involvement of mediastinal and hilar lymph nodes besides findings in relation with prostatic disease. In both cases, endobronchial ultrasound-guided biopsy showed that the involvement of the thoracic lymph nodes was caused by nonnecrotic granulomas compatible with sarcoidosis. The cases demonstrated that increased Ga-PSMA uptake can be seen in lymph nodes with active sarcoidosis, with images mimicking those well known from FDG PET/CT. Because of these findings, granulomatous disease has to be included in the differential diagnostic evaluation of patients with Ga-PSMA-positive lymph nodes.
我们描述了 2 例前列腺癌患者的 Ga-PSMA PET/CT 表现。这 2 例患者除了与前列腺疾病相关的发现外，还表现为纵隔和肺门淋巴结的双侧对称性受累。在这 2 例患者中，支气管内超声引导活检显示，胸内淋巴结受累是由非坏死性肉芽肿引起的，符合结节病。这些病例表明，活性结节病的淋巴结中可出现 Ga-PSMA 摄取增加，其图像与 FDG PET/CT 众所周知的图像相似。由于这些发现，在 Ga-PSMA 阳性淋巴结患者的鉴别诊断评估中必须包括肉芽肿性疾病。
