An atypical sarcoidosis involvement in FDG PET/CT: A case report.

An atypical sarcoidosis involvement in FDG PET/CT: A case report.

Medicine (Baltimore). 2016 Dec;95(52):e5700

Authors: Robin P, Benigni P, Feger B, Salaun PY, Abgral R

Abstract
RATIONALE: Sarcoidosis is an idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis which involve various organs. Laryngeal involvement is extremely rare, with a prevalence of about 0.5 to 1%.
DIAGNOSES: Here we present a case of laryngeal involvement of sarcoidosis demonstrated on F-Fluorodesoxyglucose Positron-Emission Tomography/Computed Tomography (FDG PET/CT).
PATIENT CONCERNS: A 63 year-old man suffering from dysphonia was referred to our department for characterization of laryngeal lesion suspicious for cancer with non-informative biopsy, the sample was not sufficient for diagnosis.
INTERVENTIONS: FDG PET/CT showed a pathological uptake on the right vocal cord, but also highlighted a bilateral uptake in intrathoracic hilar lymphadenopathy areas, typically found in several inflammatory diseases.
OUTCOMES: New laryngeal targeted biopsies revealed non-caseating epithelioid granulomas suggesting sarcoidosis involvement. After 6 months of systemic steroid treatment, FDG PET/CT showed a significant decrease of the laryngeal uptake.
LESSONS: This case shows the usefulness of FDG PET/CT to accurately assess inflammatory activity in rare extra-pulmonary sarcoidosis involvement. Moreover, this case emphasizes that FDG PET/CT is an interesting tool for assessing therapeutic efficacy of inflammatory diseases such as sarcoidosis.

PMID: 28033265 [PubMed - in process]

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