Uptake of Fluorine-18-Fluorodeoxyglucose in Pulmonary Mycobacterium avium Complex Infection

First Department of Internal Medicine, Kagawa Medical University, Kagawa.
Internal Medicine (Impact Factor: 0.9). 09/2003; 42(8):726-9. DOI: 10.2169/internalmedicine.42.726
Source: PubMed


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.

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    • "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. "
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    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.
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