Lung and Nodal Involvement in Nontuberculous Mycobacterial Disease: PET/CT Role

Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded. 18F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored. This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases. @ERSpublications PET/CT is an imaging modality that could play a role in evaluation of inflammatory and infectious lung diseases

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“…Conversely, other authors [37] demonstrated average values of lung lesions were less in NTM than in tuberculosis.…”

Section: Acute Infectious Processesmentioning

confidence: 75%

PET/CT in nononcological lung diseases: current applications and future perspectives

et al. 2016

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“…In MAC infection, macrophages are activated and play an important role in the formation of granulomas which increases the FDG uptake, and consequently, PET-CT scans show enhanced FDG uptake in patients with MAC infection. The average SUV max for LNs in NTM infection is 3.59 ± 2.32 (range 1.14 - 9.01), while for TB infection, this value is 7.23 ± 3.03 (range 1.78- 15.72) [17]. Based on our patient's abdomen/pelvic CT and PET-CT finding, we suspected a lymphoma and conducted a LN biopsy that revealed LN involvement of MAC.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium avium Complex Infection-Related Immune Reconstitution Inflammatory Syndrome Mimicking Lymphoma in an Human Immunodeficiency Virus-Infected Patient

et al. 2018

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In acquired immunodeficiency syndrome (AIDS) patients, immune reconstitution inflammatory syndrome (IRIS) due to Mycobacterium avium complex (MAC) infection is one of the most difficult IRIS types to manage. We report an unusual case of MAC-associated IRIS. At first the patient was diagnosed human immunodeficiency virus (HIV) infection after he was admitted with pneumocystis pneumonia. After starting antiretroviral therapy he presented unmasked IRIS with MAC infection. Next, he was hospitalized with continuous loose stools and new-onset fever. Investigation included computed tomography (CT), which showed homogeneous enhancement and enlargement of the lymph nodes (LN), elevation of ferritin (>1,650 ng/mL) and lactate dehydrogenase (306 IU/L) levels, and F- fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan, which showed increased FDG uptake. These findings were highly indicative of lymphoma. We performed laparoscopic biopsy of the mesenteric LN, and the biopsy culture grew MAC. So we made a diagnosis of MAC-associated. Therefore, IRIS must be considered as a possible diagnosis when AIDS patients develop new symptoms or exhibit exacerbations of existing symptoms. Furthermore the biopsies should be conducted.

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“…Therefore, subspecies identification is becoming increasingly important for NTM therapy. 18 Giudice et al 19 reported that PET-CT has the potential to identify both pulmonary and lymph node NTM infection and showed an average SUV of 1.21 AE 0.29 (range: 0.90-1.70) in affected mediastinal lymph nodes. In the present case, PET-CT showed a maximum SUV of 10.2 in bilateral cervical lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Coinfection by Talaromyces marneffei and Mycobacterium abscessus in a human immunodeficiency virus-negative patient with anti-interferon-γ autoantibody: a case report

et al. 2021

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Patients with anti-interferon (IFN)-γ autoantibodies have weakened immune defenses against intracellular pathogens. Because of its low incidence and non-specific symptoms, diagnosis of anti-IFN-γ autoantibody syndrome is difficult to establish during the early stages of infection. Here, we report a patient with high titers of serum anti-IFN-γ autoantibodies suffering from opportunistic infections. The patient presented with intermittent fever for 2 weeks. During his first hospitalization, he was diagnosed with Talaromyces marneffei pulmonary infection and successfully treated with antifungal therapy. However, multiple cervical lymph nodes subsequently became progressively enlarged. Mycobacterium abscessus infection was confirmed by positive cervical lymph node tissue cultures. High-titer serum anti-IFN-γ antibodies were also detected. Following anti- M. abscessus therapy, both his symptoms and lymph node lymphadenitis gradually improved. Anti-IFN-γ autoantibody syndrome should be considered in adult patients with severe opportunistic coinfections in the absence of other known risk factors.

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Lung and Nodal Involvement in Nontuberculous Mycobacterial Disease: PET/CT Role

Cited by 19 publications

References 17 publications

PET/CT in nononcological lung diseases: current applications and future perspectives

PET/CT in nononcological lung diseases: current applications and future perspectives

Mycobacterium avium Complex Infection-Related Immune Reconstitution Inflammatory Syndrome Mimicking Lymphoma in an Human Immunodeficiency Virus-Infected Patient

Coinfection by Talaromyces marneffei and Mycobacterium abscessus in a human immunodeficiency virus-negative patient with anti-interferon-γ autoantibody: a case report

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