Tuberculosis the great mimicker: 18F-fludeoxyglucose positron emission tomography/computed tomography in a case of atypical spinal tuberculosis.
Tuberculosis (TB) has aptly been called the great mimicker. A 14-year-old boy, who had been treated for Hodgkin's Lymphoma 2 years back and had been in remission, underwent a whole body 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan, owing to a recent onset of backache and difficulty in walking. The study showed an FDG avid destructive lesion of the posterior elements of the sixth, seventh and eighth dorsal vertebrae along with a hypermetabolic collection in the adjacent paraspinal muscles with extension into the spinal canal, causing encasement of the thecal sac as well. Based on this constellation of findings, a diagnosis of atypical spinal TB was made, which was subsequently proven on histopathology. The present case illustrates that spinal TB, including the atypical form can be diagnosed on PET/CT even in clinically unsuspected cases.
Division of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Majumdar Marg, New Delhi, India.
Maria Mathew
MM
D'souza
Division of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Majumdar Marg, New Delhi, India.
Anupam
A
Mondal
Division of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Majumdar Marg, New Delhi, India.
Rajnish
R
Sharma
Division of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Brig. SK Majumdar Marg, New Delhi, India.
Abhinav
A
Jaimini
Department of Dermatology and Venereology, ESIPGIMSR, New Delhi, India.
Urmi
U
Khanna
Atypical spinal tuberculosis; mimicker; positron emission tomography/computed tomography