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病例报告：18F-FDG PET/CT 上表现为酷似淋巴瘤的多系统播散性结核

Case report: multiple systemic disseminated tuberculosis mimicking lymphoma on 18F-FDG PET/CT.

作者信息

Hou Shasha, Shen Jie, Tan Jian

机构信息

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Heping District Department of Nuclear Medicine, Tianjin First Central Hospital, TianJin China.

出版信息

Medicine (Baltimore). 2017 Jul;96(29):e7248. doi: 10.1097/MD.0000000000007248.

DOI:10.1097/MD.0000000000007248
PMID:28723740
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5521880/
Abstract

RATIONALE

F-fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) has an important role in the diagnosis of various malignancies. However, F-18 FDG can also exhibit intense accumulation in tissues in inflammatory conditions such as active tuberculosis (TB) and sarcoidosis.

PATIENT CONCERNS

We report a case of a 52-year-old female with irritable cough. CT showed a lung mass with multiple bilateral lung nodules, and sarcoidosis was suspected. F-18 FDG PET/CT was undertaken for the diagnosis and showed intense uptake of FDG in the mass in the lower lobe of the right lung, multiple lymph nodes, liver, and spleen. The maximum standardized uptake value of F-18 FDG was 43.58. This pattern of involvement most likely represents lymphomatous involvement.

DIAGNOSES

Histopathology suggested tubercular involvement.

INTERVENTION AND OUTCOMES

The patient received anti-TB treatment and recovered.

LESSONS

Abovementioned extent and distribution of F-18 FDG in tubercular lesion is relatively rare, thus, one must be observant and aware with regards to TB being a strong mimic of lymphoma in endemic regions.

摘要

原理

氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-18 FDG PET/CT）在各种恶性肿瘤的诊断中具有重要作用。然而，F-18 FDG在炎症性疾病（如活动性肺结核（TB）和结节病）的组织中也可表现出强烈摄取。

患者情况

我们报告一例52岁女性，有刺激性咳嗽。CT显示肺部有肿块及双侧多发肺结节，怀疑为结节病。进行F-18 FDG PET/CT检查以明确诊断，结果显示右肺下叶肿块、多个淋巴结、肝脏和脾脏有强烈的FDG摄取。F-18 FDG的最大标准化摄取值为43.58。这种受累模式很可能代表淋巴瘤受累。

诊断

组织病理学提示结核受累。

干预与结果

患者接受抗结核治疗后康复。

经验教训

上述F-18 FDG在结核病变中的累及范围和分布相对罕见，因此，在地方流行区，必须警惕结核病是淋巴瘤的有力模仿者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/a98ffa59cbf9/medi-96-e7248-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/11d64a22c83e/medi-96-e7248-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/ca77aab97505/medi-96-e7248-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/a98ffa59cbf9/medi-96-e7248-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/11d64a22c83e/medi-96-e7248-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/ca77aab97505/medi-96-e7248-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e82/5521880/a98ffa59cbf9/medi-96-e7248-g003.jpg

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