|PET/CT in breast carcinoma, combined withsarcoidosis, imitating mediаstinal lymph nodemetastases|
- Garcheva, P. Bochev, V. Hadhyiska
PET/CT is a high sensitive, but low-specific method visualizing all the metabolic active processes. Fluorodeoxyglucose (18F-FDG) uptake is high in tumors, as well as in infections, inflammations, granulomatous processes, postradiotherapy alterations and in activated organs and tissues like brown fat, adrenals, thyroid, thymus, or bone marrow. This uptake can represent differential diagnostic problem. The clinical case is a young patient with invasive ductal and lobular breast carcinoma, after sectoral resection, without lymph node dissection. The chemotherapy was stopped after 3 courses due to thrombosis of vena cephalica. The local clinical status raises suspicion of reccurence, as the ultrasound. PET/CT was not conclusive about mediastinal lymph node involvement. The histology proves sarcoidosis, which frequently demonstrates symmetric 18F-FDG avid mediastinal and hilar lymph nodes. However the biopsy is mandatory, because of the low specificity of PET/CT for discrimination of this systemic disorder from tumor involvement.
|Key words: PET/CT. DIFFERENTIAL DIAGNOSTIC PROBLEMS|