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Nuclear Medicine |
1 From the Departments of Radiology and Institute of Radiation Medicine (J.M.G., J.G.I., K.H.D., J.B.S.) and Nuclear Medicine (J.S.Y., J.K.C.), Seoul National University Hospital, 28, Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea; and the Department of Diagnostic Radiology, Ewha Womans University Mokdong Hospital, Seoul, South Korea (H.Y.K.). Received August 27, 1999; revision requested October 7; revision received November 2; accepted November 10. Address correspondence to J.G.I. (e-mail: imjg@radcom.snu.ac.kr).
PURPOSE: To describe findings of pulmonary tuberculoma at 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET).
MATERIALS AND METHODS: Ten consecutive patients who underwent PET and subsequently were proved to have pulmonary tuberculoma were analyzed. Tuberculosis was proved histopathologically in eight by means of wedge resection or lobectomy (n = 7) or needle biopsy (n = 1) and in two by means of clinical follow-up for more than 2 years. PET scans were evaluated by using peak standardized uptake values. Computed tomographic (CT) and histopathologic findings also were reviewed.
RESULTS: Nine of 10 tuberculomas showed FDG uptake at PET, and the mean peak standardized uptake value was 4.2 ± 2.2 (SD). FDG uptake (range, 1.9–3.7) in lesions adjacent to main abnormalities was demonstrated in four patients. On CT scans, the mean of the longest nodule diameters was 21 mm ± 8, and there were some areas of branching linear opacities or satellite nodules that suggested pulmonary tuberculosis in seven patients. Histopathologic findings were chronic granulomatous inflammation with caseation necrosis (n = 7) and healed tuberculosis with aspergilloma (n = 1).
CONCLUSION: Pulmonary tuberculoma commonly causes an increase in FDG uptake. These results suggest that in geographic regions with a high prevalence of granulomatous lesions, positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities.
Index terms: Lung, CT, 60.12112, 60.12115 • Lung, diseases, 60.2056, 60.236 • Lung, granuloma, 60.20 • Lung, nodule, 60.3221 • Lung, PET, 60.12163 • Tuberculosis, pulmonary, 60.236
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