title: Unsuspected skeletal sarcoidosis mimicking metastatic disease on FDG positron emission tomography and bone scintigraphy.
abstract: Sarcoidosis is a disease process of unknown cause that exhibits heterogeneous clinical manifestations. Although the mediastinum and lungs are most commonly involved, the granulomatous process may also affect the skeleton, skin, eyes, kidneys, spleen, and liver. A 51-year-old woman with low back pain and no history of cancer was found to have a suspicious lesion at L4 on magnetic resonance imaging. Findings of bone scintigraphy were consistent with multiple metastases, and computed tomography of the chest identified two small indeterminate pulmonary nodules. Similarly, findings of fluorodeoxyglucose positron emission tomography were consistent with widespread skeletal metastases, but a primary tumor was not identified. Biopsy of a left femur lesion was diagnostic of active sarcoidosis with no evidence of cancer.
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA.
authors.forename: Vinicius
authors.initials: V
authors.lastname: Ludwig
authors.forename: Sarina
authors.initials: S
authors.lastname: Fordice
authors.forename: Ruth
authors.initials: R
authors.lastname: Lamar
authors.forename: William H
authors.initials: WH
authors.lastname: Martin
authors.forename: Dominique
authors.initials: D
authors.lastname: Delbeke
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed / Q000379:methods; D014915:Whole-Body Counting
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18