PMC6875228_01
Whole body Flourine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). (a) Coronal PET/CT abdomen showing enlarged liver and spleen with multiple ill-defined FDG avid lesions. (b) Coronal PET/CT abdomen showing FDG avidity in few small pelvic lymph nodes. (c) Whole body sagittal PET/CT showing FDG avidity in the liver, spleen and pelvic lymph nodes.
CRIN2019-3736495.001.jpg
PMC6875228_01_CRIN2019-3736495.001.jpg
fig1
Since hypercalcemia and renal failure persisted even after treatment with intravenous fluids, diuretics, and calcitonin, a whole body flourine-18-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) was done which showed lesions with increased metabolic activity in the liver, spleen, and left internal iliac, left external iliac, right internal iliac lymph nodes as shown in Figure 1.
Histopathology findings. (a and b) Liver biopsy showing multifocal nodular granulomatous inflammation with central necrosis and giant cells.
CRIN2019-3736495.002.jpg
PMC6875228_01_CRIN2019-3736495.002.jpg
fig2
Hence, CT:guided percutaneous biopsy of the liver lesions was done which showed necrotizing granulomatous inflammation with no features suggestive of vasculitis as shown in Figure 2. 