Abstract
During 2012–13, we diagnosed 4 patients with extensive skeletal tuberculosis (TB) who were referred to us as cases of bony metastasis with unknown primary. Radiological investigations done outside favoured a diagnosis of disseminated malignancy. Positron emission tomography/computed tomography (PET/CT) scan performed in our institute for localization of primary lesion also suggested metastatic disease. There was no evidence of malignancy on histo-pathological examination (HPE) of the involved sites. The diagnosis of TB was established on characteristics HPE. This article highlights the diagnostic dilemma of PET/CT in cases of TB versus malignancy and the importance of HPE for reaching an accurate diagnosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mehta JB, Dutt A, Harvill L, Mathews KM (1991) Epidemiology of extrapulmonary tuberculosis: a comparative analysis with pre-AIDS era. Chest 99:1134–8
Hong L, Wu JG, Ding JG, Wang XY, Zheng MH, Fu RQ et al (2010) Multifocal skeletal tuberculosis: experience in diagnosis and treatment. Med Mal Infect 40:6–11
Fancourt GJ, Ebden P, Garner P (1986) Bone tuberculosis: results and experience in Leicestershire. Br J Dis Chest 80:265–72
Moore SL, Rafii M (2001) Imaging of musculoskeletal and spinal tuberculosis. Radiol Clin North Am 39:329–42
Kwee TC, Kwee RM (2009) Combined FDG-PET/CT for the detection of unknown primary tumours; systemic review and metaanalysis. Eur Radiol 19:731–44
Fizazi K, Greco FA, Pavlidis N, Pentheroudakis G (2011) Cancers of unknown primary site: ESMO cinical practice guidelines for diagnosis, treatment and follow up. Ann Oncol 22:vi64–8
Kostakoglu L, Agress H, Goldsmith SJ (2003) Clinical role of FDG PET in evaluation of cancer patients. RadioGraphics 23:315–40
Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY et al (2000) Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 216:117–21
Griffeth LK (2005) Use of PET/CT scanning in cancer patients: technical and practical considerations. Proc (Bayl Univ Cent) 18:321–30
Zhu A, Lee D, Shim H (2011) Metabolic PET imaging in cancer detection and therapy response. Semin Oncol 38:55–69
Alavi A, Gupta N, Alberini JL, Hickeson M, Adam LE, Bhargava P et al (2002) Positron emission tomography imaging in non-malignant thoracic disorders. Semin Nucl Med 32:293–321
Tian G, Xiao Y, Chen B, Guan H, Den QY (2010) Multi-site abdominal tuberculosis mimics malignancy on 18F-FDG PET/CT; report of three cases. World J Gastroenterol 16:4237–42
Go SW, Lee HY, Lim CH, Jee W-H, Wang Y-P, Yoo IR et al (2012) Atypical disseminated skeletal tuberculosis mimicking metastasis on PET-CT and MRI. Intern Med 51:2961–5
Hl L, Pannu HK, Elting LS, Cooksley CD (1997) Tuberculosis in cancer patients: an update. J Thorac Imaging 12:41–6
Davidson PT, Horowity I (1970) Skeletal tuberculosis; a review with patient’s presentations and discussions. Am J Med 48:77–84
Handa U, Garg S, Mohan H, Gag SK (2010) Role of fine-needle aspiration cytology in tuberculosis of bone. Diagn Cytopathol 38:1–4
Francis IM, Das DK, Luthra UK, Sheikh M, Bashir M (1999) Value of radiologically guided aspiration cytology (FNAC) in the diagnosis of 29 cases. Cytopathology 10:390–401
Agashe V, Shenai S, Mohrir G, Deshmukh A, Bhaduri A, Deshpande R et al (2009) Osteoarticular tuberculosis—diagnostic solutions in a disease endemic region. J Infect Dev Ctries 3:511–6
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sundriyal, D., Shirsi, N., Gera, A. et al. Multiple Bony Metastatic Lesions and Evaluation of Primary: Case Records of a Cancer Research Centre. Indian J Surg Oncol 6, 213–217 (2015). https://doi.org/10.1007/s13193-015-0394-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-015-0394-z