title: 18F-FDG PET/CT in a case of multifocal skeletal tuberculosis without pulmonary disease and potential role for monitoring treatment response.
abstract: A 39-year-old man presented with left shoulder and interscapular pain. 99mTc-MDP bone scan demonstrated multiple active bone lesions including scapula, spines, ribs, and pelvis. Chest X-ray showed no active lung lesion, and MRI demonstrated infiltrative enhancing lesions in the T-spines and ribs, indicating skeletal metastasis. 18F-FDG PET/CT performed to search for hidden malignancy revealed multiple osteolytic lesions with intense FDG uptake, supporting metastasis. Tissue obtained from the T1 lesion showed no malignant cells but was positive for Mycobacterium tuberculosis. After 18 months of antituberculosis medication, follow-up 18F-FDG PET/CT showed complete normalization of FDG uptake in the skeletal lesions.
authors.affiliation: From the *Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and †Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Cho
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
authors.forename: Kyung-Han
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed; D014394:Tuberculosis, Osteoarticular / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate