Ces radiol. 2015, 69(4):266-269 | DOI: 10.55095/CesRadiol2015/038

18F-FDG PET/CT detection of the tracheobronchial sarcoidosis atypically without pulmonary or mediastinal impairment in a woman with fever of unknown origin - a case reportCase report

Jiří Doležal1, Martin Slanina2, Tomáš Kriegler3, Eva Krčálová1
1 Oddělení nukleární medicíny FN, Hradec Králové
2 Klinika onkologie a radioterapie 1. LF UK a FN, Hradec Králové
3 Infekční oddělení, Pardubická nemocnice, Nemocnice pardubického kraje

Aim: To present a rare case report of the unexpected finding of the isolated tracheobronchial sarcoidosis atypically without pulmonary, mediastinal or extrapulmonary impairment on 18F-FDG PET/CT imaging in a 55-year-old woman with the fever of unknown origin (FUO).

Methods: The patient was examined for a few weeks for fever of unknown origin. Conventional diagnostics and imaging modalities didn't reveal the cause of the FUO. The woman underwent 18F-FDG PET/CT imaging, which was obtained 60 minutes after intravenous injection of 18F-FDG (406 MBq - 5.2 MBq/kg). The PET scan acquisition time was 2.5 minutes per bed position and seven bed positions were necessary. Contrast-enhanced CT (venous phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenuation correction.

Results: The examination revealed the unexpected intense 18F-FDG uptake in the wall of the tracheobronchial tree without the pulmonary, mediastinal lymph nodes or extrapulmonary 18F-FDG uptake. The PET finding was evaluated as a suspicion on the sarcoidosis which was subsequently proven by biopsy.

Conclusion: 18F-FDG PET/CT imaging is an effective diagnostics method in a patient with FUO. In our case report PET-CT detected an isolated tracheobronchial sarcoidosis atypically without pulmonary, mediastinal or extrapulmonary impairment, which resulted in a subsequent successful anti-inflammatory treatment and improved patient's management.

Keywords: tracheobronchial sarcoidosis, positron emission tomography, fluorodeoxyglucose
Grants and funding:

Práce byla podpořena MZ ČR - RVO (FNHK, 00179906).

Accepted: November 20, 2015; Published: December 1, 2015  Show citation

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Doležal J, Slanina M, Kriegler T, Krčálová E. 18F-FDG PET/CT detection of the tracheobronchial sarcoidosis atypically without pulmonary or mediastinal impairment in a woman with fever of unknown origin - a case report. Ces radiol. 2015;69(4):266-269. doi: 10.55095/CesRadiol2015/038.
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