A case of sarcoidosis diagnosed by positron emission tomography/computed tomography

Abstract

Sarcoidosis is a multisystem granulomatous disorder of unknown cause which may affect any organ or system but primarily involve the lungs and the lymphatic system. Extrapulmonary sarcoidosis represents approximately 30-50% of patients. We report the case of a 51-year-old female who presented with increasing complaints of a cough, weakness, weight loss, and chest pain and who was found to have a suspicious lesion on thorax computed tomography(CT). Fluorodeoxyglucose (FDG) positron emission tomography/CT performed for diagnostic purposes demonstrated increased FDG accumulation at the bilateral enlarged parotid and lacrimal gland and in the reticulonodular infiltration area located in the left lung as well as multiple lymphadenopathies with increased FDG accumulation. There were also hepatosplenomegaly and splenic uptake. Skin biopsy showed noncaseating granulomas, and the patient was diagnosed as stage 2 sarcoidosis.

Keywords: FDG; Fluorodeoxyglucose positron emission tomography/computed tomography; sarcoidosis.

Figure 1

Axial positron emission tomography (a), computed tomography (b), and fusion (c) images of fluorodeoxyglucose positron emission tomography/computed tomography scintigraphy showed increased fluorodeoxyglucose accumulation at the bilateral enlarged lacrimal (upper row, arrow) and parotid gland (lower row, arrow)

Figure 2

Axial positron emission tomography (a), computed tomography (b), fusion (c), and coronal positron emission tomography/computed tomography fusion (d) images demonstrated hypermetabolism at the left parahilar region as well as bilateral hilar lymphadenopathies which cause concentric narrowing at the left lower lobe bronchus

Figure 3

Maximum intensity projection image revealed multiple lesions of the supraclavicular, axillary and hilar lymph nodes, lungs, abdominal-pelvic lymph nodes, liver, and spleen

Figure 4

There were maculopapular rashes at the bilateral dorsum of hand