Vasantrao Solav Shrikant, Mahaveer Patil Abhijit, Vasant Savale Shailendra, Vishnu Salunke Deepak
Consultant, SPECT Lab, Nuclear Medicine Services, Pune, Maharashtra, India.
Director Niramaya Hospital, Chinchwad, Pune, Maharashtra, India.
Asia Ocean J Nucl Med Biol. 2020 Winter;8(1):74-78. doi: 10.22038/aojnmb.2019.38132.1255.
Pyrexia of unknown origin (PUO) is a common problem in day-to-day practice. FDG PET CT is an established investigation that aids in identifying the cause of PUO. Due to its high sensitivity PET detects an occult hypermetabolic focus in the body where CT helps in anatomical localization, vascularity, enhancement characteristics of the lesion detected on PET. It helps to differentiate benign versus malignant cause and target biopsy. Tuberculosis, lymphoma, pyelonephritis, thyroiditis appear hypermetabolic on FDG PET CT. Pericardial sarcoidosis is rare and not reported in literature as a cause of PUO. Presented here is a case of PUO secondary to pericardial granulomatosis diagnosed on PET CT. Cardiac MRI also helps in better tissue characterization and associated myocardial involvement of sarcoidosis. Histology confirmed the diagnosis of pericardial sarcoidosis in this case.
不明原因发热（PUO）是日常临床实践中的常见问题。氟代脱氧葡萄糖正电子发射断层扫描计算机断层显像（FDG PET CT）是一项已确立的检查手段，有助于明确不明原因发热的病因。由于其高敏感性，PET可检测到体内隐匿的高代谢病灶，而CT有助于对PET检测到的病变进行解剖定位、评估血管情况及强化特征。它有助于鉴别良性与恶性病因，并指导靶向活检。肺结核、淋巴瘤、肾盂肾炎、甲状腺炎在FDG PET CT上表现为高代谢。心包结节病较为罕见，文献中未报道其作为不明原因发热的病因。本文介绍一例经PET CT诊断为心包肉芽肿继发不明原因发热的病例。心脏磁共振成像（MRI）也有助于更好地对组织进行特征性分析以及评估结节病相关的心肌受累情况。组织学检查证实了该病例心包结节病的诊断。
