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在一名患有成人起病免疫缺陷的患者中，诺卡菌在F-FDG PET/CT上伪装成肺部恶性肿瘤。

Nocardia masquerading as pulmonary malignancy in a patient with adult-onset immunodeficiency on F-FDG PET/CT.

作者信息

Dharamdasani Detaram Harshil, Nguyen Phuong H D, Wong Veronica C, Loh Han, Mansberg Robert

机构信息

Nuclear Medicine and PET, Nepean Hospital, Penrith.

Sydney Medical School, The University of Sydney, Sydney.

出版信息

Radiol Case Rep. 2024 Aug 3;19(10):4517-4521. doi: 10.1016/j.radcr.2024.07.058. eCollection 2024 Oct.

DOI:10.1016/j.radcr.2024.07.058
PMID:39188623
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11345279/
Abstract

A 77-year-old man with a history of left nephrectomy for renal cell carcinoma and partial hepatectomy for cholangiocarcinoma underwent F-FDG PET/CT for assessment of an irregular lung lesion. FDG-PET demonstrated development of an intensely avid spiculated left lower lobe pulmonary lesion and intensely avid left pulmonary hilar nodes, raising suspicion for a malignancy. Eleven days following the PET study, the patient was admitted to hospital with an altered mental state. CT brain revealed diffuse round hyperdensities within the brain parenchyma. Microbiology of the lung lesion was positive for Nocardia Beijingensis and he was subsequently diagnosed with disseminated nocardiosis.

摘要

一名77岁男性，有因肾细胞癌行左肾切除术及因胆管癌行部分肝切除术史，因评估肺部不规则病变接受了F-FDG PET/CT检查。FDG-PET显示左肺下叶出现一个高度摄取FDG的毛刺状肺部病变以及高度摄取FDG的左肺门淋巴结，怀疑为恶性肿瘤。PET检查11天后，患者因精神状态改变入院。脑部CT显示脑实质内弥漫性圆形高密度影。肺部病变微生物学检查发现北京诺卡菌阳性，患者随后被诊断为播散性诺卡菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/aeba02b118a7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/c864468b90d0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/010a2b9ac3c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/aeba02b118a7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/c864468b90d0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/010a2b9ac3c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccc8/11345279/aeba02b118a7/gr3.jpg

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本文引用的文献

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Clinical characteristics, susceptibility profiles, and treatment of nocardiosis: a multicenter retrospective study in 2015-2021.2015-2021 年多中心回顾性研究：诺卡菌病的临床特征、药敏谱和治疗。
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The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Management of Nocardiosis: A Retrospective Study and Review of the Literature.18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）在诺卡菌病管理中的作用：一项回顾性研究及文献综述
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Invasive Nocardiosis: Disease Presentation, Diagnosis and Treatment - Old Questions, New Answers?侵袭性诺卡菌病：疾病表现、诊断与治疗——旧问题，新答案？
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