False positive finding from malignancy-like lesions on FDG PET/CT: case report of tuberculosis patients

Abstract

Background: The F-18 fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) has become an established diagnostic imaging for malignancy. However, there are other diseases that can also be identified with FDG, some of them are infections such as tuberculosis. Case presentation: In this case report, two patients showed multiple hypermetabolic tuberculosis lesions on FDG PET/CT, with one of the patients having history of malignancy. The objective of the present case report is to emphasize the need to use other differential diagnosis techniques for tuberculosis especially in tuberculosisendemic countries when interpreting FDG PET/CT. Conclusion: By analyzing diagnostic imaging alone, there is a high chance of misinterpreting asymptomatic tuberculosis patient as having malignancy. Therefore, there is need for correlation with clinical data as well as other imaging modalities and PET/CT with more specific tracer in order to differentiate malignancy from benign disease such as tuberculosis.

Solitary Periaortic Tuberculous Granuloma Mimicking Neoplastic Disease on 18F-FDG PET/CT

“…Our interesting case demonstrates an extremely rare pattern of idiopathic tuberculous granuloma as a solitary 18 F-FDG–avid periaortic mass, which was misdiagnosed as a neoplasm. It is still a dilemma to make an accurate differential diagnosis between tuberculous granulomas and malignancies, because both entities can present as solid masses with elevated 18 F-FDG avidity just as our case 8–10 . Nevertheless, awareness of this rare but possible atypical presentation of tuberculosis is helpful for the differential diagnosis of periaortic mass.…”

“…It is still a dilemma to make an accurate differential diagnosis between tuberculous granulomas and malignancies, because both entities can present as solid masses with elevated 18 F-FDG avidity just as our case. [8][9][10] Nevertheless, awareness of this rare but possible atypical presentation of tuberculosis is helpful for the differential diagnosis of periaortic mass.…”

Can High b Value Diffusion Be a Surrogate Marker for PET—A MR/PET Study in Neurooncology Set Up

“…MRI parameters on the other hand, such as PWI, MRS, contrast enhancement patterns have specificity and sensitivity and since these are ROI-based measurements, inherent flaws exist (12,13). MRS and PWI can help grade tumors but since they use large voxel sizes, they have low specificity (14). Contrast enhancement pattern, which represents blood-brain barrier imaging, helps to correlate, but pseudoprogression and pseudo regression are known entities (15).…”

Tracheobronchial Tuberculosis Mimicking Malignancy on Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

“…The FDG uptake and bronchial wall thickening from the trachea to the LMB resolved within two months ( Picture 2 ). A diagnosis of active pulmonary tuberculosis is often difficult to distinguish from malignancy on FDG-PET/CT ( 1 ). In this case, tracheobronchial tuberculosis mimicked metastatic malignant lymphoma.…”