Singapore Med J 2014; 55(7): e101-e103; http://dx.doi.org/10.11622/smedj.2013237
Hepatic tuberculosis: a rare cause of fluorodeoxyglucose hepatic superscan with background suppression on positron emission tomography
Wong SM, Yuen HY, Ahuja AT
Correspondence: Dr Simon Wong, wsm652@ha.org.hk
ABSTRACT
Fluorodeoxyglucose (FDG) hepatic superscan refers to the diffuse intense uptake of 18F-FDG in the liver on positron emission tomography (PET), with reduced physiological activity in the brain and heart. The common causes include lymphoma and metastasis. In this case report, we describe the imaging features of tuberculosis as a rare cause of FDG hepatic superscan. PET imaging may be the only clue to a diagnosis of hepatic tuberculosis, as other imaging modalities may demonstrate only nonspecific hepatomegaly. It is important to consider this entity in the differential diagnosis of patients presenting with FDG hepatic superscan and proceed with liver biopsy for a definitive diagnosis.
Keywords: 18F-FDG, liver, lymphoma, positron-emission tomography, tuberculosis
Singapore Med J 2014; 55(7): e101-e103; http://dx.doi.org/10.11622/smedj.2013237
REFERENCES
1. Itti E, Juweid ME, Haioun C, et al. Improvement of early 18F-FDG PET interpretation in diffuse large B-cell lymphoma: importance of the reference background. J Nucl Med 2010; 51:1857-62.
http://dx.doi.org/10.2967/jnumed.110.080556 |
| |
2. Kaneko K, Nishie A, Arima F, et al. A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma. Ann Nucl Med 2011; 25:303-7.
http://dx.doi.org/10.1007/s12149-010-0460-0 |
| |
3. Basu S, Nair N. Unusually elevated liver radioactivity on F-18 FDG PET in Hodgkin's disease: hepatic 'superscan'. Clin Nucl Med 2004; 29:626-8.
http://dx.doi.org/10.1097/00003072-200410000-00005 |
| |
4. Tichelaar V, Gemmel F, de Rhoter W, Bronkhorst C, de Graaf H. FDG hepatic superscan caused by massive breast cancer invasion. Clin Nucl Med 2009; 34:716-8.
http://dx.doi.org/10.1097/RLU.0b013e3181b53f43 |
| |
5. Jeong YJ, Sohn MH, Lim ST, et al. 'Hot liver' on 18F-FDG PET/CT imaging in a patient with hepatosplenic tuberculosis. Eur J Nucl Med Mol Imaging 2010; 37:1618-9.
http://dx.doi.org/10.1007/s00259-010-1477-2 |
| |
6. Lustberg MB, Aras O, Meisenberg BR, et al. FDG PET/CT findings in acute adult mononucleosis mimicking malignant lymphoma. Eur J Haematol 2008; 81:154-6.
http://dx.doi.org/10.1111/j.1600-0609.2008.01088.x |
| |
7. Saluja SS, Ray S, Pal S, et al. Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg 2007; 7:10.
http://dx.doi.org/10.1186/1471-2482-7-10 |
| |
8. Hwang SW, Kim YJ, Cho EJ, et al. [Clinical features of hepatic tuberculosis in biopsy-proven cases]. Korean J Hepatol 2009; 15:159-67. Korean.
http://dx.doi.org/10.3350/kjhep.2009.15.2.159 |
| |
| 9. Dähnert W. Radiology Review Manual. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins, 2011. |
