ABSTRACT
Kikuchi disease is a rare entity characterized by lymphadenopathy and fever. Pathology study of lymph node biopsies provides the diagnosis. The disease course is favorable. The disease can occur isolated, or associated with other pathologies including lupus or mixed connective tissue disease. We report a case of Kikuchi disease in a 35-year-old woman, occurring 12 years after the diagnosis of overlap syndrome with antiphospholipid antibodies. The patient was given prednisone 25mg per day and long-term hydroxychloroquine. FDG PET/CT showed FDG-avidity nodular masses. After bolus corticosteroid therapy, outcome was favorable with disappearance of metabolic hyperactivity on the FDG PET/CT. The bolus prednisone treatment could then be discontinued. In the 61 cases of Kikuchi disease and lupus associations previously published, Kikuchi disease was diagnosed after lupus in only 13 % of the observations. In these cases, use of FDG PET/ CT was not reported. For us, FDG PET/CT was useful for diagnosis, for choosing the biopsy site and for follow-up.
Subject(s)
Fluorodeoxyglucose F18 , Histiocytic Necrotizing Lymphadenitis/diagnosis , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Adult , Female , Histiocytic Necrotizing Lymphadenitis/complications , Humans , Lupus Erythematosus, SystemicABSTRACT
Since its introduction in clinical practice in the 1990's, positron emission tomography (PET), usually with (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG), has become an important imaging modality in patients with cancer. For cervix carcinoma, FDG-PET is significantly more accurate than computed tomography (CT) and is recommended for loco-regional lymph node and extrapelvic staging. The metabolic dimension of the technique provides additional prognostic information. Ongoing studies now concentrate on more advanced clinical applications, such as the planning of radiotherapy, the response evaluation after the induction of therapy, the early detection of recurrence. Technical innovations, such as PET cameras with better spatial resolution and hybrid positron emission tomography/computed tomography (PET-CT), available now on the whole territory, provide both anatomic and metabolic information in the same procedure. From the point of view of biological metabolism, new radiopharmaceutical probes are being developed. Those hold promise for future refinements in this field. This article reviews the current applications of FDG-PET in patients with cervix cancer.
Subject(s)
Positron-Emission Tomography/methods , Uterine Cervical Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/radiotherapy , Adenocarcinoma/diagnostic imaging , Adult , Carcinoma, Squamous Cell/diagnostic imaging , Female , Fluorodeoxyglucose F18 , Humans , Neoplasm Staging , Prognosis , Radiopharmaceuticals , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/therapy , Uterine Neoplasms/diagnostic imagingABSTRACT
INTRODUCTION: In patients with a previous history of malignancy, the occurrence of a mediastinal mass with significant uptake of 18 Fluorodeoxyglucose on a PET-scan may lead to biopsy or resection. CASE REPORT: We report the case of a posterior mediastinal mass, with significant uptake of 18 Fluorodeoxyglucose on PET- scan, in a patient with a previous history of testicular seminoma. The lesion was actually a benign schwannoma. CONCLUSIONS: In the case of a mediastinal mass with conventional imaging being in favour of a neurogenic tumour a PET scan cannot confirm benignity or malignancy.