悪性腫瘍を模倣する肺外結核
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
まとめ
肺外結核（TB）の診断と治療効果の判定は困難な場合がある。18F-フルオロデオキシグルコース陽電子放出断層撮影/コンピューター断層撮影（18F-FDG PET/CT）は、悪性腫瘍の評価とTB治療効果の判定に役立つ。
科学分野:
- 核医学
- 放射線学
- 感染症学
背景:
- 結核（TB）は、特に開発途上国において、世界的な健康問題となっている。
- 結核の診断は、しばしば癌のような他の病状を模倣する多様な病像のために困難な場合がある。
- 肺結核は一般的であるが、肺外結核はあらゆる臓器系に影響を与える可能性がある。
研究 の 目的:
- 悪性腫瘍の評価中に診断された肺外結核の症例を報告すること。
- 肺外結核の診断における18F-フルオロデオキシグルコース陽電子放出断層撮影/コンピューター断層撮影（18F-FDG PET/CT）の有用性を実証すること。
- TBの治療効果の評価における18F-FDG PET/CTの役割を説明すること。
主な方法:
- 62歳女性患者が悪性腫瘍スクリーニングのために18F-FDG PET/CTを受けた。
- 診断画像では、肺外結核と一致する所見が明らかになった。
- 抗TB治療に対する患者の反応は、連続的な18F-FDG PET/CTスキャンを用いて監視された。
主要な成果:
- 18F-FDG PET/CTは、悪性腫瘍の評価を受けていた患者において、肺外結核を特定することに成功した。
- 画像診断では、結核に典型的な炎症と病変の広がりを示す特徴的なパターンが示された。
- 18F-FDG PET/CTによる治療効果の評価では、代謝活性の低下が示され、治療効果が示唆された。
結論:
- 18F-FDG PET/CTは、特に非定型的に現れる場合に、肺外結核の診断に有用なツールである。
- この画像モダリティは、結核と悪性腫瘍を鑑別するのに役立つ。
- 18F-FDG PET/CTは、肺外結核患者の治療効果の有効な監視を可能にする。
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