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Clin Nucl Med ; 48(8): e374-e376, 2023 Aug 01.
Article in English | MEDLINE | ID: mdl-37220237

ABSTRACT

ABSTRACT: Malignancy-associated cerebellar hypermetabolism on [ 18 F]FDG PET/CT has 2 major causes: paraneoplastic autoimmune encephalitis and neoplasias (leptomeningeal/cerebellar metastases and primary cerebellar tumors). We present the case of a 33-year-old man with a newly diagnosed Hodgkin lymphoma and mere episodical headache, unexpectedly displaying intense cerebellar hypermetabolism on his staging [ 18 F]FDG PET/CT. Both neurolymphomatosis and paraneoplastic subacute cerebellar degeneration were ruled out by clinical presentation, MR, and repeated lumbar punctures. Instead, cerebrospinal fluid analysis unveiled a Cryptococcus neoformans meningitis, highlighting the possibility of paucisymptomatic central nervous system infections as differential diagnosis in malignancy-related cerebellar hypermetabolism in addition to (para)neoplastic causes.


Subject(s)
Cryptococcus neoformans , Hodgkin Disease , Meningitis , Paraneoplastic Cerebellar Degeneration , Male , Humans , Adult , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose F18 , Hodgkin Disease/complications , Hodgkin Disease/diagnostic imaging , Paraneoplastic Cerebellar Degeneration/pathology
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