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Extrapulmonary Tuberculosis Mimicking Malignancy.
Cansu Güneren1, Rabia Lebriz Uslu Beşli1, Haluk Burçak Sayman1
1İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Nuclear Medicine, İstanbul, Türkiye.
Molecular Imaging and Radionuclide Therapy
|December 19, 2025
Summary
Extrapulmonary tuberculosis (TB) diagnosis and treatment response can be challenging. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) aids in evaluating malignancy and assessing TB treatment effectiveness.
Area of Science:
- Nuclear medicine
- Radiology
- Infectious diseases
Background:
- Tuberculosis (TB) is a major global health issue, particularly in developing nations.
- Diagnosing TB can be difficult due to its varied presentation, often mimicking other conditions like cancer.
- While pulmonary TB is common, extrapulmonary TB can affect any organ system.
Purpose of the Study:
- To report a case of extrapulmonary tuberculosis diagnosed during malignancy evaluation.
- To demonstrate the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosing extrapulmonary TB.
- To illustrate the role of 18F-FDG PET/CT in assessing treatment response for TB.
Main Methods:
- A 62-year-old female patient underwent 18F-FDG PET/CT for cancer screening.
- Diagnostic imaging revealed findings consistent with extrapulmonary TB.
- The patient's response to anti-TB treatment was monitored using serial 18F-FDG PET/CT scans.
Main Results:
- 18F-FDG PET/CT successfully identified extrapulmonary TB in a patient initially evaluated for malignancy.
- Imaging demonstrated characteristic patterns of inflammation and disease spread typical of TB.
- Treatment response assessment via 18F-FDG PET/CT showed a decrease in metabolic activity, indicating treatment efficacy.
Conclusions:
- 18F-FDG PET/CT is a valuable tool for diagnosing extrapulmonary TB, especially when it presents atypically.
- This imaging modality assists in differentiating TB from malignancy.
- 18F-FDG PET/CT enables effective monitoring of treatment response in extrapulmonary TB patients.
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