Weekly Chest CasesArchive of Old Cases

Case No : 269 Date 2002-12-21

  • Courtesy of Jin Mo Goo, M.D., Jung-Gi Im, M.D. / Seoul National University Hospital, Seoul, Korea
  • Age/Sex 56 / M
  • Chief ComplaintChest radiograph abnormality.
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Tuberculous Lymphadenitis Showing High FDG Uptake on PET
Radiologic Findings
Contrast-enhanced CT scans show enlarged right hilar and interlobar lymph nodes. There are punctate calcifications in the right hilar lymph node. FDG-PET scan reveals hypermetabolic lesions in the right hilar and interlobar areas. The peak standardized uptake value of the lesion was 10. Exploratory thoracotomy was performed and the pathologic findings of the lymph node were consistent with tuberculous lymphadenopathy.
Brief Review
FDG PET can demonstrate the glucose metabolism of a lesion, which can be helpful in differentiating between benign and malignant pulmonary lesions. Malignant cells demonstrate higher glucose metabolic activity than benign lesions do. However, FDG is not a cancer-specific agent, and it has been reported that benign diseases related mainly to infection or inflammation also can show intense uptake. In geographic regions with a high prevalence of granulomatous lesions, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.
References
1. Goo JM, Im JG, Do KH, et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 2000; 216: 117-121.
Keywords
Mediastinum, Infection,

No. of Applicants : 21

▶ Semi-Correct Answer : 3/21,  14.3%
  • - CHU Nancy-Brabois, France Denis Regent
  • - Ewha Womans University Hospital, Korea Ji Young Hwang
  • - Ewha Womans' University Hospital, Korea Sung Shine Shim
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