Nucl Med Mol Imaging.
2012 Jun;46(2):138-143.
A Patient with Psoriatic Arthritis Imaged with FDG-PET/CT Demonstrated an Unusual Imaging Pattern with Muscle and Fascia Involvement: A Case Report
- Affiliations
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- 1Department of Radiology and Center for Molecular and Functional Imaging (CMFI) at China Basin, University of California, San Francisco, 185 Berry Street Lobby 6 Suite 350, San Francisco, CA 94107-0946, USA. sukhkarn.bains@ucsf.edu
- 2Department of Radiology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Fancisco, CA 94121, USA.
- 3Department of Rheumatology, Nuclear Medicine Division, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
Abstract
- We describe the case of a patient with known history of psoriasis that presented with 1 year of unexplained fever, muscle weakness and marked weight loss, suspicious for B symptoms of a malignant origin. [18F]-Fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scans demonstrated an unusual serpiginous pattern of uptake in the fascia and muscles as well as lymph node activity. Multiple histological samples, including a final PET-probe guided lymph node surgical resection, excluded malignancy and confirmed the diagnosis of reactive inflammatory changes, with a plausible diagnosis of autoimmune lymphoproliferative syndrome with associated lymphadenitis, fasciitis and myositis, possibly mediated by tumor necrosis factor (TNF) inhibitor. To our knowledge, there is no evidence of a previously reported FDG uptake pattern of fascia and muscle involvement in psoriatic arthritis.
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