Asymptomatic primary tuberculous pleurisy with intense 18-fluorodeoxyglucose uptake mimicking malignant mesothelioma

BMC Infectious Diseases

Fumitaka Ogushi¹  Keishi Naruse³  Norihiko Hamada²  Motohiko Kume⁴  Naoki Shiota⁵  Tsutomu Shinohara⁶ 

[1] Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan;Department of Radiology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan;Department of Pathology, Kochi National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan;Department of Surgery II, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan;Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan;Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi, 780-8077, Japan

关键词: Positron emission tomography;    Fluorodeoxyglucose;    Primary tuberculous pleurisy;   

Others  :  1158600
DOI  :  10.1186/1471-2334-13-12

 received in 2012-09-17, accepted in 2013-01-11,  发布年份 2013

【 摘 要 】

Background

The pathogenesis of primary tuberculous pleurisy is a delayed-type hypersensitivity immunogenic reaction to a few mycobacterial antigens entering the pleural space rather than direct tissue destruction by mycobacterial proliferation. Although it has been shown that pulmonary tuberculosis induces 18-fluorodeoxyglucose (FDG) uptake in active lesions, little is known about the application of FDG positron emission/computed tomography (FDG PET/CT) to the management of primary tuberculous pleurisy.

Case presentation

We report a case of asymptomatic primary tuberculous pleurisy presenting with diffuse nodular pleural thickening without distinct pleural effusion and parenchymal lung lesions mimicking malignant mesothelioma. An initial FDG PET/CT scan demonstrated multiple lesions of intense FDG uptake in the right pleura and thoracoscopic biopsy of pleural tissue revealed caseous granulomatous inflammation. The patient received antituberculous therapy for 6 months, with clearly decreased positive signals on a repeated FDG PET/CT scan.

Conclusion

FDG PET/CT imaging may be useful for evaluating disease activity in tuberculous pleurisy patients with an unknown time of onset.

【 授权许可】

   
2013 Shinohara et al.; licensee BioMed Central Ltd.

【 图 表 】

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