18F-FDG PET/CT in a case of multifocal skeletal tuberculosis without pulmonary disease and potential role for monitoring treatment response.

Abstract

A 39-year-old man presented with left shoulder and interscapular pain. 99mTc-MDP bone scan demonstrated multiple active bone lesions including scapula, spines, ribs, and pelvis. Chest X-ray showed no active lung lesion, and MRI demonstrated infiltrative enhancing lesions in the T-spines and ribs, indicating skeletal metastasis. 18F-FDG PET/CT performed to search for hidden malignancy revealed multiple osteolytic lesions with intense FDG uptake, supporting metastasis. Tissue obtained from the T1 lesion showed no malignant cells but was positive for Mycobacterium tuberculosis. After 18 months of antituberculosis medication, follow-up 18F-FDG PET/CT showed complete normalization of FDG uptake in the skeletal lesions.

• Authors: Young Seok Cho, Doo Ryeon Chung, Eun Jung Lee, Byung-Tae Kim, Kyung-Han Lee
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 39 Issue 11 Pg. 980-3 (Nov 2014) ISSN: 1536-0229 [Electronic] United States
• PMID: 24561689 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• Technetium Tc 99m Medronate

Topics

• Adult
• Bone Neoplasms (diagnostic imaging, pathology)
• Diagnosis, Differential
• Fluorodeoxyglucose F18
• Humans
• Magnetic Resonance Imaging
• Male
• Multimodal Imaging
• Positron-Emission Tomography
• Radiopharmaceuticals
• Technetium Tc 99m Medronate
• Tomography, X-Ray Computed
• Tuberculosis, Osteoarticular (diagnostic imaging, microbiology, pathology)