Atypical disseminated skeletal tuberculosis mimicking metastasis on PET-CT and MRI.
Multifocal skeletal tuberculosis is a very rare manifestation of tuberculous infection. The multiple bone lesions of multifocal skeletal tuberculosis are difficult to differentiate from metastasis, even when performing 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (FDG PET/CT) or magnetic resonance imaging (MRI). A 25-year-old man presented with an abnormal chest X-ray. Radiologically, there were extensive osteolytic lesions on the skull, along the entire spine and on the ribs and both iliac bones, suggesting a diagnosis of bone metastasis. On FDG PET/CT, intensely increased F-18 FDG lesions were observed. A bone biopsy with a microbiologic study revealed a tuberculous infection. Follow-up PET/CT performed after treatment showed marked improvement in the extensive FDG uptake lesions.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Korea.
Seong Woo
SW
Go
Hea Yon
HY
Lee
Chae Hun
CH
Lim
Won-Hee
WH
Jee
Young-Pil
YP
Wang
Ie Ryung
IeR
Yoo
Ji Young
JY
Kang
D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis*