From: FDG-PET/CT activity leads to the diagnosis of unsuspected TB: a retrospective study
Patient information | TB infection diagnosis | Comorbidities | Scan date | Thoracic CT scan | Thoracic FDG-PET scan | Microbiology and histopathology | Diagnosis and management |
---|---|---|---|---|---|---|---|
1. 69-year-old male from Morocco (immigrated to the US in 2004). Asymptomatic. Evaluated for potential lung metastases of prostate cancer | TST = 20 mm | DM, recently diagnosed prostate cancer (not on treatment) | 2011 | 2 cm spiculated nodule in RUL, 5 mm nodule in LUL | RUL nodule uptake (SUVmax 2.72) | Negative sputum microscopy and culture. Wedge resection showed necrotizing granulomas | Class 4 TB. RIF and INH for 4 months |
2. 58-year-old male from the Philippines (immigrated to the US in 2010). Asymptomatic. Evaluated for TB per immigration requirements | TST = 20 mm | DM | 2011 | 2.1 cm spiculated nodule in LUL | LUL nodule uptake (SUVmax 3.9) | Negative sputum microscopy and culture. Wedge resection showed necrotizing granulomas | Class 4 TB. RIF and INH for 4 months |
3. 34-year-old male from Haiti (immigrated to the US in 1998). Cough and night sweats for 1 month | Negative TST (self-reported) | HIV infection (CD4 cell count of 26 cells/mm, not on ART), smoking | 2009 | Centrilobular tree-in-bud opacities, 1 and 1.5 cm cavitary nodules in the LUL | LUL nodule uptake (SUVmax 3.1) | Positive MTB culture from sputum (at 3 weeks) and from bronchoalveolar lavage (at 3 days) | Class 3 TB. RIPE |
4. 77-year-old male from the Dominican Republic (immigrated to the US in 2010). Unintentional weight loss. Known to have an abnormal chest X-ray | TST = 15 mm (negative 8 weeks prior) | COPD | 2013 | Scarring of LUL, multiple nodules and tree-in-bud lesions in RUL, right hilar calcifications | RUL nodule uptake (SUVmax 1.5). Left hilar uptake (SUVmax 2.3). Colon uptake (SUVmax 7.9) | Positive MTB PCR from sputum. Positive MTB culture from colon ulceration (found on colonoscopy) | Class 3 TB. RIPE |
5. 54-year-old male from Vietnam (immigrated to the US in 1988). Cough for 2 weeks, which resolved spontaneously | Positive TST (self-reported) TB disease treated in 1979; LTBI treatment in 1989 upon arrival to the US | COPD | 2011 | 1.6 and 1.4 cm nodules in the RUL | RUL nodules uptake (SUVmax 2.6) | Positive MTB culture from bronchoalveolar lavage (at 5 weeks) | Class 3 TB. RIPE |