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FDG PET/CT in Immunoglobulin G4-Related Spinal Hypertrophic Pachymeningitis
Qian Zhao1, Aisheng Dong, Yushu Bai
1From the *Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia; and Departments of †Nuclear Medicine, ‡Orthopaedic Surgery, and §Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Abstract:
A 49-year-old woman complained of right upper back pain for 1 month. Serum tests showed increased erythrocyte sedimentation rate. Thoracic spinal MRI showed an epidural lesion at the T1-T4 level with inhomogeneous signal intensity on T2-weighted images, slightly higher signal intensity than spinal cord on T1-weighted images, and remarkable enhancement on enhanced T1-weighted images. Epidural malignant tumor was suspected. FDG PET/CT was performed showing increased FDG uptake of the lesion extending to the right T1-T2 and T2-T3 neural foramina. A decompressive posterior thoracic laminectomy with the lesion resection was performed. Immunoglobulin G4-related spinal hypertrophic pachymeningitis was confirmed by pathology.
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