PMC4541162_01
55-year-old woman presented with fatigue, swelling in the armpits, back pain, weight loss, and dry cough, later diagnosed with Stage 2 sacroidosis. (a) Positron emission tomography (PET) image shows involvement of lymph nodes (red arrows) and bones (red arrowheads). (b) Axial PET/CT and (c) contrast-enhanced CT images demonstrate right-sided hypermetabolic pleural thickening compatible with pleural sarcoidosis. Note that pleural involvement is indistinct on CT image (black arrows); however, the lesion is apparent on PET/CT (white arrows). Axial PET/CT image from (d) the level of porta hepatis shows discrete lymph nodes (arrowheads) and (e) the para-aortic region shows confluent lymph nodes (asterisk).
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F1
FDG-PET/CT scan was performed to evaluate disease activity [Figure 1]. FDG-PET/CT examination showed hypermetabolic lymph nodes in all lymphatic regions (cervical, axillar, supraclavicular, bilateral hilar, mediastinal, retroperitoneal, iliac, and inguinal), disseminated bone, right pleural and right gluteal soft tissue involvement with standardized uptake values (SUVs) ranging from 5 to 13.
55-year-old woman presented with fatigue, swelling in the armpits, back pain, weight loss, and dry cough, later diagnosed with Stage 2 sacroidosis. (a and b) Axial thoracic CT images show right-sided lung nodules compatible with lung parenchyma involvement of sarcoidosis (arrows).
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F2
There were also lung nodules in the upper zones, which were consistent with Stage 2 sarcoidosis [Figure 2].
55-year-old woman presented with fatigue, swelling in the armpits, back pain, weight loss, and dry cough, later diagnosed with Stage 2 sacroidosis. (a) PET image obtained after corticosteroid treatment reveals total regression of hypermetabolic lesions. (b and c) Axial thoracic CT images from the same lung levels show regression in the parenchymal nodules. Note that right-sided nodules almost completely disappear and one prominent nodule of right apex significantly shrinks (arrow) after medical treatment.
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F3
FDG-PET/CT scan obtained in the 4th month of treatment showed normal physiological levels and the lung nodules regressed [Figure 3].