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患者患有弥漫性大 B 细胞淋巴瘤,18F-FDG PET/CT 示前列腺结核酷似恶性肿瘤:一例报告。

Prostate tuberculosis mimicking malignancy on 18F-FDG PET/CT in a patient with diffuse large B-cell lymphoma: A case report.

机构信息

Department of Hematology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China.

Department of PET/CT, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China.

出版信息

Medicine (Baltimore). 2024 May 31;103(22):e38296. doi: 10.1097/MD.0000000000038296.

Abstract

BACKGROUND

Prostate tuberculosis (TB) is a rare and often underdiagnosed condition due to its nonspecific symptoms and imaging features, which can mimic malignancies on 18F-fluorodeoxyglucose positron emission tomography (PET) scans. This resemblance poses a challenge in differentiating TB from prostate cancer, especially in patients with preexisting tumors such as diffuse large B-cell lymphoma. The purpose of this study is to highlight the importance of considering TB in the differential diagnosis of patients with atypical imaging findings, even in the presence of known malignancies.

CASE

We present a case of a 60-year-old man with diffuse large B-cell lymphoma who was initially misdiagnosed with a prostate tumor based on 18F-fluorodeoxyglucose PET/computed tomography scans. The subsequent ultrasound-guided prostate biopsy confirmed the presence of prostate TB, not malignancy.

CONCLUSIONS

This case report underscores the critical role of considering TB as a potential diagnosis in patients with hematological tumors and atypical imaging results. It serves as a reminder for clinicians to exercise caution when interpreting PET/computed tomography scans and to incorporate TB into their differential diagnoses, thereby avoiding misdiagnosis and inappropriate treatment.

摘要

背景

前列腺结核(TB)是一种罕见且常被误诊的疾病,因其症状和影像学特征不具特异性,在 18F-氟脱氧葡萄糖正电子发射断层扫描(PET)扫描上可与恶性肿瘤类似。这种相似性使得 TB 与前列腺癌的鉴别诊断具有挑战性,尤其是在患有弥漫性大 B 细胞淋巴瘤等先前存在肿瘤的患者中。本研究旨在强调即使存在已知恶性肿瘤,对于影像学表现不典型的患者,在鉴别诊断中考虑 TB 的重要性。

病例

我们报告了一例 60 岁男性,患有弥漫性大 B 细胞淋巴瘤,最初基于 18F-氟脱氧葡萄糖 PET/计算机断层扫描被误诊为前列腺肿瘤。随后的超声引导下前列腺活检证实为前列腺结核,而非恶性肿瘤。

结论

本病例报告强调了在患有血液系统肿瘤和影像学表现不典型的患者中,将 TB 作为潜在诊断的重要性。它提醒临床医生在解读 PET/计算机断层扫描时要谨慎,并将 TB 纳入鉴别诊断,从而避免误诊和不适当的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bd0/11142781/d990e566aa8f/medi-103-e38296-g001.jpg

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