腹腔结核模仿恶性瘤在FDG PET/CT在一个患有结性脊髓炎的患者在阿达利马布:一个诊断挑战
Harish Goyal1, Srinivas Ananth Kumar1, Anirudh Abu Srinivasan1
1Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education Research, Puducherry, India.
Asia Oceania journal of nuclear medicine & biology
|February 2, 2026
概括
像阿达利木马布这样的TNF-α抑制剂可以重新激活结核病 (TB). 这一案例凸显了18F-FDG PET/CT如何帮助在免疫抑制患者中诊断腹腔结核病,有效指导治疗.
科学领域:
- 免疫学 免疫学 免疫学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 瘤坏死因子-α (TNF-α) 抑制剂对于治疗结性脊髓炎 (AS) 至关重要.
- 这些免疫抑制剂增加了结核病 (TB) 再激活的风险,特别是肺外结核病 (EPTB).
- EPTB可以潜伏地呈现,模仿恶性瘤并带来诊断挑战.
研究的目的:
- 在接受阿达利穆马布治疗的免疫抑制患者中报告腹膜结核病例.
- 为了说明18F-FDG PET/CT在诊断和监测EPTB中的实用性.
- 强调成像在缺乏微生物学证据时指导实证治疗中的作用.
主要方法:
- 一个40岁的男性患有AS,长期服用阿达利穆姆巴的病例报告.
- 诊断工作包括18F-FDG PET/CT,显示腹膜和淋巴结的参与.
- 基于临床和成像发现,开始实证抗结核疗法 (ATT).
主要成果:
- 患者出现了发烧和体重减轻,最初怀疑是恶性瘤.
- 18F-FDG PET/CT 显示了腹膜,腹膜,间膜和淋巴结的特征性吸收.
- 在经验性ATT之后,患者在随访PET/CT时表现出显著的临床改善和完全的代谢解决.
结论:
- 周周结核在免疫抑制患者,特别是那些服用TNF-α抑制剂的患者中具有诊断挑战.
- 18F-FDG PET/CT是检测EPTB和评估治疗反应的宝贵工具.
- 经验性ATT可以有效,并指导在缺乏微生物学证据的疑似病例的管理.
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