PMC5173514_01
(a) FDG-PET/CT showed multifocal uptake lesions of supraclavicular and mediastinal lymphadenopathies, right lobe of the liver, right lower lobe of the lung, third right rib, fourth lumbar vertebra and prostate (supraclavicular lymph node: maximum standardized uptake value (mSUV) 9.85, supramediastinal lymph node: mSUV 4.73, paraaortic lymph node: mSUV 6.31, subcarinal lymph node: mSUV 12.31, right lobe of liver: mSUV 6.23, right lower field of the lung: mSUV 4.54, third right rib: mSUV 2.04, the fourth lumbar vertebra: mSUV 2.64, and prostate: mSUV 7.2). (b) Conventional CT showed infiltrations on S7 and subcarinal lymph node swelling (arrow). (c) Follow-up FDG-PET/CT one year after antibiotic treatment showed an improvement in the multifocal intensity lesions, confirming the efficiency of antituberculosis therapy. (d) Follow-up CT showed an improvement in the lung fields and subcarinal lymphadenopathy (arrow).
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Two months after radiotherapy, FDG-PET/CT demonstrated multifocal intense FDG accumulations in supraclavicular and mediastinum lymphadenopathies, the liver, lung, rib and vertebral columns (Fig. 1a). Chest CT showed infiltrations on S1 and S7 and multiple lymphadenopathies of the right supraclavicular, para-aortic and mediastinum lymph nodes (Fig. 1b). Follow-up CT showed an improvement in the pulmonary infiltrations and lymphadenopathies and FDG-PET/CT showed a significantly decreased intensity of the multifocal lesions detected prior to treatment (Fig. 1c and d).
Hematoxylin and Eosin staining specimens. The supraclavicular lymph node biopsy showed granulomatous inflammation with caseous necrosis and multinucleated giant cells. Magnification: 100x.
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The biopsy specimen showed granulomatous inflammation with caseous necrosis and multinucleated giant cells, which was consistent with a mycobacterial infection and no evidence of malignancy (Fig. 2).