Arora Saurabh, Avinash Damle Nishikant, Passah Averilicia, Ray Animesh, Soneja Manish, Banerjee Sayantan, Kaushal Seema, Jana Manisha, Tripathi Madhavi, Bal Chandrasekhar
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Asia Ocean J Nucl Med Biol. 2019 Spring;7(2):185-187. doi: 10.22038/AOJNMB.2019.37888.1253.
F-labeled fluoro-2-deoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is an important imaging modality in the clinical workup of patients with chronic inflammatory disorders which present quite often with a fever of unknown origin. Sarcoidosis is a multisystem chronic inflammatory disorder with a wide clinical spectrum that can involve different organs. The diagnosis of sarcoidosis is usually based on the observation of noncaseating granulomas in biopsy specimens and exclusion of other granulomatous diseases. Skin involvement can occur in 20-25% of sarcoidosis cases. However, scar involvement in sarcoidosis is a rare condition. Herein, we present a case of multisystem sarcoidosis in a 45-year-old woman, who was previously treated with steroids and was in remission for 8 months. The patient presented with multiple skin nodules on the chest and back, a history of intermittent fever, headache, and mild itching at the abdominal scar site for 3 months. Blood investigations revealed elevated serum angiotensin-converting enzyme levels. The F-FDG PET/CT revealed a metabolically active involvement of the cutaneous tissue (posthysterectomy scar), apart from other sites of involvement. Biopsy of the scar site revealed multiple epithelioid cell granulomas with giant cells surrounding the collagenous fibers of the scar tissue.
18F标记的氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）是慢性炎症性疾病患者临床检查中的一种重要成像方式，这类疾病常表现为不明原因发热。结节病是一种多系统慢性炎症性疾病，临床谱广泛，可累及不同器官。结节病的诊断通常基于活检标本中观察到非干酪样肉芽肿并排除其他肉芽肿性疾病。20%-25%的结节病病例可出现皮肤受累。然而，结节病累及瘢痕是一种罕见情况。在此，我们报告一例45岁女性的多系统结节病病例，该患者此前接受过类固醇治疗，已缓解8个月。患者胸部和背部出现多个皮肤结节，有间歇性发热、头痛病史，腹部瘢痕部位轻度瘙痒3个月。血液检查显示血清血管紧张素转换酶水平升高。18F-FDG PET/CT显示除其他受累部位外，皮肤组织（子宫切除术后瘢痕）有代谢活跃的受累情况。瘢痕部位活检显示多个上皮样细胞肉芽肿，巨细胞围绕瘢痕组织的胶原纤维。
