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FDG-PET/CT of sarcoidosis and sarcoid reactions following antineoplastic treatment.
MedLine Citation:
PMID:  23543853     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Sarcoidosis or sarcoid reactions, which appear as FDG-avid lesions in oncologic patients, need to be differentiated from disseminated malignancies. We aimed to promote awareness of development of sarcoidosis or sarcoid reactions after antineoplastic therapy to avoid diagnostic errors with FDG-PET/CT findings and assess the utility of FDG-PET/CT for follow-up. We retrospectively reviewed radiological reports of FDG-PET/CT scans performed between January 2009 and December 2011. Among oncologic patients with more than 2 FDG-PET/CT scans, those with nearly symmetrical increases in FDG uptake in the hilar or mediastinal lymph nodes were identified, and those with known sarcoidosis, concurrent diagnoses of sarcoidosis with malignancy, or histopathologically proven malignancies were excluded. Then, only those cases were selected for which sarcoidosis or sarcoid reactions were diagnosed. Four of 376 oncologic cases met the criteria. At 9 months to 6 years after antineoplastic therapy, abnormal FDG uptakes were observed in the hilar, mediastinal, abdominal, pelvic, and inguinal nodes, and/or spleen and lung parenchyma with SUVmax up to 17.7. On the basis of these findings, 1 patient received anticancer chemotherapy because of tumor recurrence suspicion. A gradual decrease in FDG uptake was observed on subsequent PET/CT scans. Sarcoidosis or sarcoid reactions should be considered in differential diagnosis of oncologic patients who have developed FDG-avid lesions any time after antineoplastic therapy. FDG-PET/CT can be used for follow-up in nondiagnostic situations to detect decreases in FDG uptake due to presence of sarcoidal granulomas.
Authors:
Kentaro Inoue; Ryoi Goto; Hideo Shimomura; Hiroshi Fukuda
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-15
Journal Detail:
Title:  SpringerPlus     Volume:  2     ISSN:  2193-1801     ISO Abbreviation:  Springerplus     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101597967     Medline TA:  Springerplus     Country:  -    
Other Details:
Languages:  ENG     Pagination:  113     Citation Subset:  -    
Affiliation:
Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ward, Sendai, 980-8575 Japan.
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