Yonsei Med J.  2013 Nov;54(6):1554-1556. 10.3349/ymj.2013.54.6.1554.

Extensive Tuberculous Lymphadenitis Mimicking Distant Lymph Node Metastasis on F-18FDG PET/CT in a Patient with a History of Malignant Melanoma

• Park WJ
• Kim EK
• Park JH

• KMID: 1798159
• DOI: http://doi.org/10.3349/ymj.2013.54.6.1554

Abstract

18-Fluoredeoxyglucose position emission tomography and computed tomography (F-18FDG PET/CT) scanning has been useful in the evaluation of malignant disorders and has been extensively used in cancer screening.1 However, F-18FDG uptake was not found to be specific for cancer diagnosis. Here, we describe increased F-18FDG uptake on PET/CT caused by extensive tuberculous lymphadenitis in a 62-year-old woman with malignant melanoma.

Keyword

Tuberculous lymphadenitis; PET/CT; FDG; malignant melanoma

MeSH Terms

Female
Fluorodeoxyglucose F18/*diagnostic use
Humans
Lymphatic Metastasis/*diagnosis
Melanoma/*complications/*pathology/radiography
Middle Aged
Positron-Emission Tomography/*methods
Tomography, X-Ray Computed/*methods
Fluorodeoxyglucose F18

Figure

• 

  Fig. 1 A 62-year-old woman was diagnosed with malignant melanoma on the left sole of the foot. Four years after operation, she visited the hospital with complaints of a palpable lesion in her right neck. (A) The maximal intensity projection image showed multiple increased FDG uptakes (SUV max: 12.4) in both sides of the neck, both supraclavicular fossa and mediastinum, both hila, left parasternal, perigastric, and peripancreatic lymph node regions. (B) US showed that enlarged lymph nodeswerevery hypoechogenicity with loss of normal echogenic hilumin the right supraclavicular fossa (arrows), which was considered to be suspicious for metastasis. US-guided fine needle aspiration was done and the cytological result was negative for malignancy. As the cytological result was discordant with the previous image findings, excisional biopsy for the neck node was performed. (C) A histopathologic examination of the excisional biopsy revealed chronic granulomatous lymphadenitis with caseous necrosis which was consistent with tuberculous lymphadenitis (H&E, 200×). The tuberculosis polymerase chain reaction was positive as well. US, ultrasonography.

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