Muscle Involvement Caused by Chronic Active Epstein-Barr Virus Infection on 18F-FDG PET/CT in a Pediatric Patient

Abstract

A 7-year-old girl with chronic active EBV (CAEBV) infectionassociated hemophagocytic lymphohistiocytosis presented with fever. 18 F-FDG PET/CT revealed heterogeneous FDG uptake in multiple muscle groups without significant abnormal activity elsewhere. On repeat FDG PET/CT scan 1 year later after therapy, the abnormal activity in muscles disappeared. Skeletal muscle involvement by CAEBV infection should be included as differential diagnosis for increased muscle activity on FDG PET/CT study.

A differential diagnosis method for systemic CAEBV and the prospect of EBV-related immune cell markers via flow cytometry

“…However, in some CAEBV case reports, the determinant findings involved PET-CT scans facilitating targeted biopsy with conclusive histopathological analysis [ 90 , 91 ]. In addition to abnormal activity in the lymph nodes, liver, or spleen, heterogeneous 18 F-FDG uptake associated with mild swelling in multiple skeletal muscle groups may also indicate an active state [ 91 ]. In CAEBV enteritis, PET/CT revealed diffuse FDG uptake in the small intestine [ 92 ].…”

Simultaneous Detection of 2 Types of Malignancies in a Pediatric Patient on FDG PET/CT Led to Diagnosis of Li-Fraumeni Syndrome

“…18 F-FDG PET/CT, as a whole-body imaging technique of the simultaneous acquisition metabolic activity combined with anatomy information, can show all lesions after 1 scan, including malignancy [10][11][12] and benign disease. [13][14][15][16] The Pediatric Cancer Working Group of the American Association for Cancer Research proposed early tumor surveillance protocols for pediatric cancer in pediatric patients with known LFS. 17 Our case indicates that different malignant tumors identified on FDG PET/CT in pediatric patients without known LFS should prompt gene analysis of LFS and other syndromes that are predisposed to cancer.…”

“…It is important to screen the second tumor in the suspicious patient. 18 F-FDG PET/CT, as a whole-body imaging technique of the simultaneous acquisition metabolic activity combined with anatomy information, can show all lesions after 1 scan, including malignancy 10–12 and benign disease 13–16 . The Pediatric Cancer Working Group of the American Association for Cancer Research proposed early tumor surveillance protocols for pediatric cancer in pediatric patients with known LFS 17 .…”