A unique case of extrapulmonary sarcoidosis on F18 FDG PET/CT: “Tiger man”
Keywords:
18F-FDG PET-CT, : Sarcoidosis, extra-pulmonaryAbstract
Sarcoidosis is a systemic granulomatous disease in which muscle involvement is a rare extrapulmonary manifestation. We present the case of a 34-year-old man with shortness of breath lasting for three months. Computerized tomography showed intrathoracic lymph nodes and perihilar consolidations in both lungs. She received treatment for pneumonia, but because of insufficient regression, she was referred to our hospital's chest diseases department for further examination. Laboratory results showed an elevated calcium. We conducted an F-18 FDG PET CT scan because the clinicians suspected a cancer. PET/CT scan demonstrated hypermetabolism in bilateral lung parenchyma, multiple lymph nodes, spleen , muscles, and cutaneus/subcutaneus lesions. With the guidance of PET/CT with a suspicion of lymphoproliferative diseases, an axillary lymph node biopsy revealed granulomas; sarcoidosis was assumed, and corticosteroids were started. This case shows rarely seen muscle involvement of sarcoidosis by emphasizing the ability of PET/CT in detecting extrapulmonary involvements of the disease
References
1. Fayad F, Liote F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol. 2006;33:98–103.
2. Silverstein A, Siltzbach LE. Muscle involvement in sarcoidosis. Asymptomatic, myositis, and myopathy. Arch Neurol 1969;21:235‑41.
3. Prayson RA. Granulomatous myositis. Clinicopathologic study of 12 cases. Am J Clin Pathol 1999;112:63‑8.
4. Mathur A, Kremer JM. Immunopathology, rheumatic features, and therapy of sarcoidosis. Curr Opin Rheumatol 1992;4:76‑80.
5. Wolfe SM, Pinals RS, Aelion JA, Goodman RE. Myopathy in sarcoidosis: Clinical and pathologic study of four cases and review of the literature. Semin Arthritis Rheum 1987;16:300‑6.
6. Teirstein AS,Machac J, Almeida O, Lu P, Padilla ML, Iannuzzi MC. Results of 188 whole-body fluorodeoxyglucose positron emissiontomography scans in 137 patients with sarcoidosis. Chest. 2007;132:1949–53.
7. Piekarski E, Benali K, Rouzet F. Nuclear imaging in sarcoidosis. Semin Nucl Med. 2018;48:246–60.
8. Wieërs G, Lhommel R, Lecouvet F, Van den Bergh P, Lambert M. A tiger man. Lancet 2012;380:1859.
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