title: A Patient with Psoriatic Arthritis Imaged with FDG-PET/CT Demonstrated an Unusual Imaging Pattern with Muscle and Fascia Involvement: A Case Report.
abstract: We describe the case of a patient with known history of psoriasis that presented with 1 year of unexplained fever, muscle weakness and marked weight loss, suspicious for B symptoms of a malignant origin. [(18)F]-Fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scans demonstrated an unusual serpiginous pattern of uptake in the fascia and muscles as well as lymph node activity. Multiple histological samples, including a final PET-probe guided lymph node surgical resection, excluded malignancy and confirmed the diagnosis of reactive inflammatory changes, with a plausible diagnosis of autoimmune lymphoproliferative syndrome with associated lymphadenitis, fasciitis and myositis, possibly mediated by tumor necrosis factor (TNF) inhibitor. To our knowledge, there is no evidence of a previously reported FDG uptake pattern of fascia and muscle involvement in psoriatic arthritis.
authors.affiliation: Department of Radiology and Center for Molecular and Functional Imaging (CMFI) at China Basin, University of California, San Francisco, 185 Berry Street Lobby 6 Suite 350, San Francisco, CA 94107-0946 USA.
authors.forename: Sukhkarn
authors.initials: S
authors.lastname: Bains
authors.affiliation: Department of Rheumatology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121 USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Reimert
authors.affiliation: Department of Radiology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Fancisco, CA 94121 USA.
authors.forename: Aung Zaw
authors.initials: AZ
authors.lastname: Win
authors.affiliation: Department of Radiology and Center for Molecular and Functional Imaging (CMFI) at China Basin, University of California, San Francisco, 185 Berry Street Lobby 6 Suite 350, San Francisco, CA 94107-0946 USA.
authors.forename: Sana
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Radiology and Center for Molecular and Functional Imaging (CMFI) at China Basin, University of California, San Francisco, 185 Berry Street Lobby 6 Suite 350, San Francisco, CA 94107-0946 USA ; Department of Radiology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Fancisco, CA 94121 USA.
authors.forename: Carina Mari
authors.initials: CM
authors.lastname: Aparici
keywords: Autoimmune; Autoimmune lymphoproliferative syndrome; FDG-PET/CT; Psoriasis