title: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in response monitoring of extra-pulmonary tuberculosis.
abstract: Positron emission tomography/computed tomography (PET/CT) using 2-deoxy-2-(fluorine-18) fluoro-D-glucose ((18)F-FDG) has become a standard diagnostic modality in oncological practice. F18-FDG PET/CT is sensitive in detecting malignancy; however, specificity is low in differentiating infections or inflammatory diseases from tumor. In the present case study, we report a patient with postoperative carcinoma of tongue presenting with cervical lymphadenopathy and fever. The PET/CT scan showed metabolically active generalized lymphadenopathy, and a possibility of lymphoma was suggested. Fine needle aspiration cytology showed the Ziehl-Neelsen staining to be strongly positive for acid-fast bacilli and first line of antitubercular drug was administrated. Six months later after the initiation of therapy, a follow-up PET/CT showed remarkable improvement of the disease status. This case study illustrates that tubercular infection can be a pitfall in F18-FDG PET/CT imaging. PET positive lesions do not always indicate malignancy, and histological confirmation of lesions with biopsy should always be performed. Once diagnosed to be tubercular, FDG PET/CT is a powerful imaging tool in monitoring the therapy.
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Arpana
authors.initials: A
authors.lastname: Arbind
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Maria
authors.initials: M
authors.lastname: D'souza
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Jaimini
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Saw
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Yachna
authors.initials: Y
authors.lastname: Solanki
authors.affiliation: Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.
authors.forename: Rajnish
authors.initials: R
authors.lastname: Sharma
keywords: 18Fluorine-fluoro-D-glucose; lymphoma; tuberculosis