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F-18-FDG uptake in tuberculosis

S M Bakheet¹, J Powe, A Ezzat

¹Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. Siema@kfsh.edu.sa

Clinical Nuclear Medicine

|November 14, 1998

Summary

Abnormal fluorine-18 fluorodeoxyglucose (F-18 FDG) uptake on PET scans can indicate benign conditions like tuberculosis, not just cancer. Clinicians should consider infectious causes when interpreting scans in cancer patients, especially in high-risk populations.

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Area of Science:

Nuclear Medicine
Oncology
Infectious Diseases

Background:

Positron Emission Tomography (PET) with fluorine-18 fluorodeoxyglucose (F-18 FDG) is crucial for cancer staging.
Abnormal F-18 FDG uptake typically raises suspicion for malignancy.

Observation:

Two cases presented with intense F-18 FDG uptake in lymph nodes and lungs.
Uptake was initially concerning for metastatic disease but was attributed to benign conditions: tuberculous lymphadenitis and pneumonitis.

Findings:

Pathological confirmation revealed active tuberculosis in one patient and acid-fast bacilli in the second patient's bronchial lavage.
Widespread lymphadenopathy and lung uptake on F-18 FDG PET scans can be caused by infectious diseases.

Implications:

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It is essential to consider infectious etiologies, such as tuberculosis, when interpreting F-18 FDG PET scans in cancer patients.
This is particularly important in populations with a high prevalence of infectious diseases.
Misinterpretation could lead to delayed diagnosis and inappropriate treatment for both cancer and infections.