Mediastinal histoplasmosis: F-18 FDG PET and CT findings simulating malignant disease.
We describe the computed tomography and F-18 FDG PET findings of a patient with extensive mediastinal nodal enlargement resulting from histoplasmosis. This patient with known metastatic melanoma presenting for restaging was initially considered to have widespread mediastinal and cervical metastases on the basis of the imaging findings. Bronchoalveolar lavage fluid and transbronchial lymph node biopsy were consistent with histoplasmosis. The imaging findings improved after treatment with antifungal medication. A relatively small area of pulmonary involvement proved to be the clue in the imaging studies that the disease was inflammatory rather than neoplastic.
Mackie
Gavin C
GC
Department of Radiology, Division of Nuclear Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA. gavinmackie@telstra.com
Pohlen
Judith M
JM
D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006660:Histoplasmosis / Q000175:diagnosis*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary*; D008482:Mediastinum / Q000000981:diagnostic imaging*; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D008875:Middle Aged; D010000:Osteitis / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18