INTRAOSSEOUS SARCOIDOSIS MIMICKING AS BONE METASTASES ON 18F- FDG PET/CT

  • Saima Muzahir Tennessee Interventional and Imaging Associates, Chattanooga Tennessee
  • Scott Perlman Department of Radiology, Division of Nuclear Medicine, University of Wisconsin Madison
  • Thomas Warner Department of Pathology, University of Wisconsin Madison
  • Lance T Hall Department of Radiology, Division of Nuclear Medicine, University of Wisconsin Madison

Abstract

A 62-year-old male with known prostate cancer underwent 18F- uorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) scan for suspected osseous metastases after a magnetic resonance imaging of the pelvis, done for chronic low back pain and demonstrated a number of suspicious T1 hypointense/T2 hyperintense lesions in the sacrum, iliac bones and right proximal femur.18F-FDG PET/CT showed abnormal foci of increased tracer uptake in the sacrum, iliac bones and right proximal femur. Core biopsies from the sacrum were performed, showing intertrabecular non-caseating granulomata with surrounding small lymphocytes. Acid-fast bacilli and Gomori methenamine silver stains were negative, consistent with intraosseous sarcoidosis.

Key words: 18F- uorodeoxyglucose positron emission tomography/computed tomography, non-caseating granulomata, sarcoidosis 

References

Braun JJ, Kessler R, Constantinesco A, et al. 18F-FDG PET/CT in sarcoidosis management: Review and report of 20 cases. Eur J Nucl Med Mol Imaging 2008;35:1537-43.

Waanders F, van Hengel P, Krikke A, et al. Sarcoidosis mimicking metastatic disease: A case report and review of the literature. Neth J Med 2006;64:342-5.

Cohen PR, Kurzrock R. Sarcoidosis and malignancy. Clin Dermatol 2007;25:326-33.

Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 2001;164:1885-9.

Rizzato G, Palmieri G, Agrati AM, et al. The organ-speci c extrapulmonary presentation of sarcoidosis: A frequent occurrence but a challenge to an early diagnosis. A 3-year- long prospective observational study. Sarcoidosis Vasc Diffuse Lung Dis 2004;21:119-26.

Jelinek JS, Mark AS, Barth WF. Sclerotic lesions of the cervical spine in sarcoidosis. Skeletal Radiol 1998;27:702-4. 7. Talmi D, Smith S, Mulligan ME. Central skeletal sarcoidosis mimicking metastatic disease. Skeletal Radiol 2008;37:757-61.

Mangino D, Stover DE. Sarcoidosis presenting as metastatic bony disease. A case report and review of the literature on vertebral body sarcoidosis. Respiration 2004;71:292-4.

James DG, Neville E, Carstairs LS. Bone and joint sarcoidosis. Semin Arthritis Rheum 1976;6:53-81.

Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med 1997;336:1224-34.

Kennedy MP, Jimenez CA, Mhatre AD, et al. Clinical implications of granulomatous in ammation detected by endobronchial ultrasound transbronchial needle aspiration in patients with suspected cancer recurrence in the mediastinum. J Cardiothorac Surg 2008;3:8.

Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: Physiologic and benign variants. Radiographics 1999;19:61-77.

Teirstein AS, Machac J, Almeida O, et al. Results of 188 whole-body uorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. Chest 2007;132:1949-53.

Goswami T, Siddique S, Cohen P, et al. The sarcoid lymphoma syndrome. Clin Lymphoma Myeloma Leuk 2010;10:241-7.

KarapetisCS,StricklandAH,YipD,etal.PETandPLAP in suspected testicular cancer relapse: Beware sarcoidosis. Ann Oncol 2001;12:1485-8.

Brincker H. Sarcoid reactions in malignant tumours. Cancer Treat Rev 1986;13:147-56.

Karam M, Roberts-Klein S, Shet N, et al. Bilateral hilar foci on 18F-FDG PET scan in patients without lung cancer: Variables associated with benign and malignant etiology. J Nucl Med 2008;49:1429-36.

Published
2015-04-30
How to Cite
1.
Muzahir S, Perlman S, Warner T, Hall LT. INTRAOSSEOUS SARCOIDOSIS MIMICKING AS BONE METASTASES ON 18F- FDG PET/CT. J Cancer Allied Spec [Internet]. 2015Apr.30 [cited 2024Nov.25];1(1). Available from: https://jcas.journals.publicknowledgeproject.org/index.php/jcas/article/view/16