Two patients showing abnormal fluorine-18-fluorodeoxyglucose (FDG) uptake due to Mycobacterium avium complex (MAC) infection are presented. Intense focal FDG uptake in the lung field could have been caused by an infectious disease such as MAC. This should be considered as a possibility when FDG whole-body scans of patients with pulmonary nodules are interpreted. To our knowledge, this is the first description of an FDG-positron emission tomography (FDG-PET) image of MAC infection of the lung.
"In our case of disseminated disease, CT finding of spleen was unremarkable, although FDG PET revealed a focal hypermetabolic lesion. FDG uptake increases when metabolic activity is increased by the presence of inflammatory cells, and there are several reports related to FDG accumulation in MAC infection13,14. Moreover, FDG PET can well demonstrate the activity of disseminated MAC, assess the treatment response after anti-MAC therapy, and provide suitable biopsy sites15. "
[Show abstract][Hide abstract] ABSTRACT: Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.
[Show abstract][Hide abstract] ABSTRACT: F-18 FDG is the most commonly used radiotracer for PET. PET has become a very powerful tool for evaluating malignancy. However, localization of FDG is not specific for malignancy, and a number of benign conditions may accumulate FDG. The authors recently encountered a case of pulmonary nocardiosis exhibiting increased uptake of FDG on a PET scan performed to exclude pulmonary malignancy. Markedly increased FDG uptake led to a biopsy that demonstrated Nocardia infection. Localization of FDG in nocardiosis may be regarded as a false-positive case when imaging for malignancy, but can uncover a lethal condition that may otherwise go unnoticed.
Clinical Nuclear Medicine 01/2005; 29(12):834-5. DOI:10.1097/00003072-200412000-00021 · 3.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: FDG-PET has great potential in the evaluation of a variety of inflammatory and infectious disorders and possibly other benign disorders. FDG-PET is very helpful in the evaluation of chronic osteomyelitis, sarcoidosis, FUO, and differentiating toxoplasmosis from lymphoma in the central nervous system in HIV-positive patients. The assessment of efficacy of FDG-PET in the evaluation of arthroplasty-associated infection, large-vessel vasculitis, and other inflammatory and infectious disorders is ongoing but seems quite promising at this time.
Radiologic Clinics of North America 02/2005; 43(1):121-34. DOI:10.1016/j.rcl.2004.07.005 · 1.98 Impact Factor
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