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Case Reports
. 2017 Sep 8:11:766.
doi: 10.3332/ecancer.2017.766. eCollection 2017.

Unusual case of splenic sarcoidosis without morphological lesions detected by PET-CT in a patient with breast cancer: functional imaging between pitfalls and therapeutic guide

Gaetano Paone  1 , Simona Di Lascio  2 , Andrea Azzola  3 , Luca Mazzucchelli  4 , Olivia Pagani  2
Affiliations
Case Reports

Unusual case of splenic sarcoidosis without morphological lesions detected by PET-CT in a patient with breast cancer: functional imaging between pitfalls and therapeutic guide

Gaetano Paone et al. Ecancermedicalscience. .

Abstract

A 60-year-old woman under treatment with letrozole for metastatic breast cancer underwent 18F-FDG PET-CT for restaging. A new widespread intense splenic FDG uptake without nodular lesions and multiple FDG-avid mediastinal and abdominal nodes were observed. Based on these findings, a nodal and transbronchial lung biopsy was performed. Histological results were compatible with sarcoidosis. The patient began steroid treatment and 6 weeks after a PET-CT showed normalisation of both splenic and nodal uptake. In our case, 18F-FDG PET-CT has been useful in detecting a rare case of splenic sarcoidosis without typical nodular lesions on CT images, impacting the patient's treatment and prognosis.

Keywords: 18F-FDG; breast cancer; positron emission tomography; spleen sarcoidosis.

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Figures

Figure 1.
Figure 1.. First F-FDG performed; intense and diffuse tracer uptake in the spleen and hilar lymph nodes.
Figure 2.
Figure 2.. Histological features showing non-caseating granuloma between the mucinous bronchial glands (A) and submucosal granuloma consisting of a nodular cluster of epithelioid and giant cells (B).
Figure 3.
Figure 3.. PET-CT after treatment that shows a rapid decrease of FDG uptake.
See this image and copyright information in PMC

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