[Case of pulmonary tuberculosis with both a solitary nodule and enlarged lymph nodes showing intense uptake on 18f-fluoro-deoxy glucose positron emission tomography (18FDG-PET) requiring differentiation from lung cancer].
A 63-year-old man was admitted to our hospital for the evaluation of an abnormal nodule in lung. Chest CT demonstrated a smooth nodular shadow in the left S6 and enlarged left hilar and mediastinal lymph nodes. Local uptake in these nodes was demonstrated on 18FDG-PET. Although bronchoscopic study was performed, definitive diagnosis had not yet been determined. After one year, the nodular shadow increased in its size. To confirm the diagnosis, VATS was performed. The histological findings showed a caseating epithelioid-cell granuloma and culture of the specimen was positive for Mycobacterium tuberculosis. This case suggested the difficulty in distinguishing lung cancer from solitary tuberculous nodules by using 18FDG.
Ishikawa
Shigenori
S
Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital, 5-8-31, Agenogi, Matsue-shi, Shimane 690-8556, Japan. ishi-kma@matsue.hosp.go.jp
Yano
Shuichi
S
Kobayashi
Kanako
K
Touge
Hirokazu
H
Tokuda
Yoshiyuki
Y
Ikeda
Toshikazu
T
Takeyama
Hiroyasu
H
D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D000995:Antitubercular Agents; D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18