A Akdogan Remzi, Halil Rakici A Akdogan, Güngör Serkan, Bedir Recep, Akdogan Elif
Department of Gastroenterology, Faculty of Medicine, Recep Tayyip Erdğan University, Rize, Turkey.
Department of Nuclear Medicine Research and Training Hospital, Recep Tayyip Erdogan University, Rize, Turkey.
Euroasian J Hepatogastroenterol. 2018 Jan-Jun;8(1):93-96. doi: 10.5005/jp-journals-10018-1270. Epub 2018 May 1.
Tuberculosis (TB) infection is still a challenging health issue, especially in developing countries. Diagnosing extrapulmonary infections, especially isolated organ involvement, is difficult in most cases even with the radiological, endoscopic, and histopathological examinations done for accurate diagnosis. Here we describe a case of isolated gastric TB with specific F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings mimicking gastric cancer/ lymphoma.
A 20-year-old male patient was admitted to our hospital with abdominal pain in the epigastric region, weight loss, and fever especially at nights for 2 months. Physical examination was normal. Hemoglobin was 9.6 gm/dL; the patient had iron deficiency anemia. Upper gastrointestinal (GI) endoscopy was suggestive of gastric ulcer mimicking malignancy. F-18 FDG PET/CT revealed multiple hypermetabolic malignant lymphadenopathies in the abdomen and diffuse gastric wall thickening as linitis plastica and multiple hypermetabolic peritoneal implants in the omentum. Exploratory laparotomy was done for tissue diagnosis and exploration of the peritoneum for TB infection, lymphoma, and Crohn's disease to make differential diagnosis. Histopathology revealed granulomatous lymphadenitis with granulomas including giant cells, suspecting TB. Patient was put on antituberculosis treatment (ATT). After treatment, the complaints resolved, and he gained weight. Fusion PET/CT exhibited a complete response to ATT with no residual disease.
According to our knowledge, this is the first report about F-18 FDG PET/CT findings in the diagnosis of isolated gastric TB. F-18 FDG PET/CT may provide help in the diagnosis and follow-up of isolated gastric TB in challenging cases. Akdogan RA, Rakici H, Güngör S, Bedir R, Akdogan E. F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings of Isolated Gastric Tuberculosis mimicking Gastric Cancer and Lymphoma. Euroasian J Hepato-Gastroenterol 2018;8(1):93-96.
结核病感染仍是一个具有挑战性的健康问题，尤其是在发展中国家。在大多数情况下，即使进行了放射学、内镜和组织病理学检查以进行准确诊断，诊断肺外感染，尤其是孤立器官受累的情况仍很困难。在此，我们描述一例孤立性胃结核病例，其具有特定的F-18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）表现，酷似胃癌/淋巴瘤。
一名20岁男性患者因上腹部腹痛、体重减轻及发热（尤其是夜间发热）2个月入住我院。体格检查正常。血红蛋白为9.6克/分升；患者患有缺铁性贫血。上消化道内镜检查提示胃溃疡，疑似恶性肿瘤。F-18 FDG PET/CT显示腹部有多个高代谢的恶性淋巴结肿大，胃壁弥漫性增厚呈皮革胃，大网膜有多个高代谢的腹膜种植灶。为进行组织诊断并探查腹膜是否存在结核感染、淋巴瘤和克罗恩病以进行鉴别诊断，进行了剖腹探查术。组织病理学显示肉芽肿性淋巴结炎，伴有包括巨细胞在内的肉芽肿，怀疑为结核。患者接受了抗结核治疗（ATT）。治疗后，症状缓解，体重增加。融合PET/CT显示对ATT有完全反应，无残留病灶。
据我们所知，这是关于F-18 FDG PET/CT在孤立性胃结核诊断中的表现的首次报告。F-18 FDG PET/CT可能有助于在具有挑战性的病例中对孤立性胃结核进行诊断和随访。阿克多安RA、拉基奇H、京戈尔S、贝迪尔R、阿克多安E。酷似胃癌和淋巴瘤的孤立性胃结核的F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描表现。《欧亚肝脏胃肠病学杂志》2018年；8（1）：93 - 96。
