PMC4706726_01
Abdominal dynamic CT images in a 54-years old female with sarcoidosis-lymphoma syndrome. a-d Plain CT image shows two well-circumscribed, peripherally-enhancing, low-density masses in the anterior segment (S5; 80 x 78 x 88 mm) and inferior segment (S7; 62 x 88 x 82 mm) of the right lobe of the liver. In the arterial phase, a hepatic artery is seen penetrating inside the tumor. CT computed tomography. Chest CT images in a 54-years old female with sarcoidosis-lymphoma syndrome. e Contrast enhancement shows mediastinal and hilar lymphadenopathies. f On lung window, there is irregular thickening of the bronchovascular bundles and central peribronchial fibro-infiltration lesions in the right middle and lower lobes
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Fig1
On abdominal dynamic CT (Fig. 1), two well-circumscribed, peripherally-enhancing, low-density masses were seen in the anterior segment (S5; 80 x 78 x 88 mm) and inferior segment (S7; 62 x 88 x 82 mm) of the right lobe of the liver.
Pre-therapy FDG PET/CT images in a 54-year-old female with sarcoidosis-lymphoma syndrome. Whole-body scan of FDG PET/CT was performed at 60 min after 290.7 MBq of FDG injection. (a MIP; b. coronal fusion; c-d. axial fusion) In the liver, there were intensive ring-form uptakes in the tumors, with maximum standard uptake values (SUVmax) of 18.3 in S5 and 19.5 in S7. The faint right middle and lower lobe consolidations had moderate FDG uptake (SUVmax, 4.6), whereas the multiple bilateral hilar and mediastinal lymphadenopathies showed mild FDG uptake (SUVmax, 2.7). FDG 18-fluorodeoxyglucose, PET positive emission tomography, CT computed tomography, MIP maximum intensity projection
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Fig2
FDG PET/CT images (Fig. 2) showed intensive ring-form FDG uptakes of the two liver tumors, with maximum standard uptake values (SUVmax) of 18.3 in S5 and 19.5 in S7. The two highly FDG-avid tumors in the right lobe of the liver disappeared (Fig. 2a-b). On FAMT PET/CT (Fig. 2c-d), there was no significant uptake of FAMT in the liver, as well as in the lungs and mediastinum.
PET/CT images in a 54-year-old female with sarcoidosis-lymphoma syndrome after chemotherapy. Whole-body scan of FAMT PET/CT was performed at 60 min after 281.7 MBq of FAMT injection. (a-b FDG PET/CT; c-d. FAMT PET/CT). High FDG uptake in the mediastinal lymphadenopathies (red arrow) was still seen. The FDG-avid liver tumor lesions disappeared. No FAMT uptake that was compatible with sarcoidosis lesions was seen in the mediastinal lymphadenopathies (green arrow). FDG
18F-fluorodeoxyglucose, PET positive emission tomography, CT computed tomography, FAMT L-[3-18F] alpha-methyltyrosine
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Fig3
These discrepant findings between FDG and FAMT were compatible with sarcoidosis as the etiology of the thoracic lesions (Fig. 3).