Pulmonary brucellosis on FDG PET/CT

Area of Science:

• Nuclear Medicine
• Infectious Diseases
• Pulmonology

Background:

• Pulmonary nodules require thorough evaluation to determine their etiology.
• Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) is a key imaging modality for assessing metabolic activity in lesions.
• Brucellosis is a zoonotic infection that can affect multiple organ systems, including the lungs.

Observation:

• A 67-year-old male presented with a known pulmonary nodule.
• FDG PET/CT imaging revealed increased FDG uptake in the pulmonary lesions.
• Metastatic involvement was suspected due to increased activity in mediastinal and hilar lymph nodes, but no extrathoracic abnormalities were detected.

Findings:

• The imaging findings, in conjunction with clinical presentation, led to the diagnosis of pulmonary brucellosis.
• The characteristic pattern of FDG uptake in pulmonary lesions and regional lymph nodes aided in the diagnosis.
• Absence of extrathoracic disease was noted on the scan.

Implications:

• FDG PET/CT can be a valuable tool in diagnosing pulmonary brucellosis, especially when presenting as a nodular lesion.
• Early diagnosis and prompt initiation of anti-Brucella therapy are crucial for favorable patient outcomes.
• This case highlights the importance of considering infectious etiologies, such as brucellosis, in the differential diagnosis of pulmonary nodules with lymphadenopathy.