FDG PET/CT in a Case of Bilateral Tuberculous Epididymo-orchitis
We present a case of bilateral tuberculous epididymo-orchitis showing high FDG uptake on FDG PET/CT. In addition, the patient had a prostatic FDG-avid lesion, consistent with tuberculous prostatitis. This case indicates tuberculous epididymo-orchitis, especially in tuberculosis-endemic regions, should be considered as a differential diagnosis in patients with hypermetabolic epididymal or testicular lesions, including benign and malignant tumors, bacterial epididymo-orchitis, abscess, idiopathic granulomatous orchitis, and sarcoidosis.
CONCLUSIONS: The diagnosis and correct therapeutic strategy of entities that fall in between tuberculosis and sarcoidosis still remains challenging, especially in patients coming from endemic areas. PMID: 29993306 [PubMed - as supplied by publisher]
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
CONCLUSIONS: In high TB endemic countries, procedures like EBUS-TBNA are useful in obtaining tissue diagnosis of TB when ocular diagnosis may be inconclusive due to paucity of ocular tissue. PMID: 29543549 [PubMed - as supplied by publisher]
Ashu S Bhalla, A Das, P Naranje, A Goyal, R Guleria, Gopi C KhilnaniIndian Journal of Radiology and Imaging 2017 27(4):369-379 Sarcoidosis is a multi-systemic disorder of unknown etiology, although commonly believed to be immune-mediated. Histologically, it is characterized by noncaseating granuloma which contrasts against the caseating granuloma seen in tuberculosis (TB), an infectious disease that closely mimics sarcoidosis, both clinically as well as radiologically. In TB-endemic regions, the overlapping clinico-radiological manifestations create significant diagnostic dilemma, especially since the management options a...
Ashu S Bhalla, A Das, P Naranje, A Goyal, R Guleria, Gopi C KhilnaniIndian Journal of Radiology and Imaging 2017 27(4):380-388 The second part of the review discusses the role of different existing imaging modalities in the evaluation of thoracic sarcoidosis, including chest radiograph, computed tomography, magnetic resonance imaging, endobronchial ultrasound, and positron emission tomography. While summarizing the advantages and pitfalls of each imaging modality, the authors propose imaging recommendations and an algorithm to be followed in the evaluation of clinically suspected case of sarcoidosis in tuberculosis-endemic regions.
Conclusions: AFB stain, M.TB culture &TB-PCR have low diagnostic yield in EBUS-TBNA samples. AFB stain &M.TB culture are more likely to be positive in necrotising as compared to non-necrotising granulomatous samples of TB patients.
Conclusion: ILD are the disorders that are frequently unrecognized. More commonly the confusion is with TB which is over-diagnosed due to much reliance on chest x-ray findings and clinical diagnosis. Thorough knowledge about ILD should be provided to the primary care physicians, especially in countries with high TB burden, so that to limit unnecessary treatment with anti-tuberculous drugs and early referral to ILD clinic.
We report a case of a 52-year-old female with irritable cough. CT showed a lung mass with multiple bilateral lung nodules, and sarcoidosis was suspected. F-18 FDG PET/CT was undertaken for the diagnosis and showed intense uptake of FDG in the mass in the lower lobe of the right lung, multiple lymph nodes, liver, and spleen. The maximum standardized uptake value of F-18 FDG was 43.58. This pattern of involvement most likely represents lymphomatous involvement. Diagnoses: Histopathology suggested tubercular involvement. Intervention and outcomes: The patient received anti-TB treatment and recovered. Lessons: Abovementione...
ConclusionsThe index case of optic disc granuloma along with epididymitis had features of both tuberculosis and sarcoidosis and falls in the gray zone of tuberculous sarcoidosis and showed a response to both ATT and corticosteroids. We report this case report for its unique presentation.
Conclusions Incidental detection of granulomatous inflammation in patients undergoing lung resection for cancer, even in a TB-endemic country, may not require any intervention. Such findings may be due to either mycobacterial infection in the past or ‘sarcoid reaction’ to cancer. Although all patients should have their resected specimen sent for acid-fast bacilli culture and followed up until the culture results are reported, the initiation of the management of such patients as per existing lung cancer management guidelines does not affect their outcome adversely.