PMC4901025_01
42-year-old male with sarcoidosis. Indium-111 pentetreotide scintigraphy using whole-body anterior and posterior projections at 4 hours and 24 hours demonstrates multiple foci of increased radiotracer uptake within the mediastinum, bilateral hilar regions, and left lower lung concerning for metastatic carcinoid (arrows). The right kidney is slightly displaced superiorly, which is consistent with patient's history of partial hepatectomy. Normal physiologic activity is present in the liver, kidneys, spleen, bowel, and bladder.
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Indium-111 pentetreotide scintigraphy demonstrated increased activity within the mediastinum, bilateral hilar regions, and left lower lobe suspicious for metastatic disease (Fig. 1).
42-year-old male with sarcoidosis. Select axial 18F-FDG PET/CT images of the chest demonstrate multiple large, hypermetabolic mediastinal and bilateral hilar lymph nodes (A and B).  There is also hypermetabolic activity within bilateral lower lobes (D) corresponding to airspace consolidation in the left lower lobe and irregular thickening of bronchovascular bundles. Nodularity along the fissures appears mainly in the right lower lobe (C).
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There was also hypermetabolic activity within the bilateral lower lobes corresponding to areas of interstitial thickening bilaterally and airspace consolidation in the left lower lobe (Fig. 2, A-D), which raised suspicion for sarcoidosis as a potential differential diagnosis.