¹⁸F-FDG PET/CT diagnosis of sarcoidosis

Objective: To analyze the detection of sarcoidosis on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). Methods: Clinical and pathological data as well as PET/CT of 35 patients (21 women and 14 men, age range: 34-78 years, mean 45 ± 10 years) with histologically confirmed sarcoidosis from 2015 to 2019 in our hospital were analyzed retrospectively. Results: The clinical manifestations included cough (29), chest tightness and shortness of breath (22), chest pain (4), fever (3), superficial lymph node enlargement (3), and joint pain (1). PET/CT showed bilateral hilar, (34/35, 97.14%), mediastinal (33/35, 94.28%), right hilar (1/35, 2.86%), cervical (2/35, 5.71%), or abdominal (2/35, 5.71%) lymphadenopathy with increased FDG uptake, bilateral multiple or diffuse lung nodules (19/35, 54.29%), lung consolidation (3/35, 8.57%), pulmonary ground glass opacities (2/35, 5.71%), interstitial lung fibrosis (2/35, 5.71%), enlargement of tracheal blood vessels (16/35, 45.71%), pleural effusion (3/35, 8.57%), pericardial effusion (1/35, 2.86%), increased uptake in the diaphragm crura (1/35, 2.86%)and hepatic caudate lobe (1/35, 2.86%). Histology showed typical non-caseous necrotizing granulomatous lesions with negative specific staining in all patients by transbronchial lung biopsy (16), endobronchoscopic ultrasound-guided transbronchial needle aspiration (11), percutaneous lung biopsy (3), superficial lymph node biopsy (3), or thoracoscopic surgery (2). Conclusion: The clinical manifestations of sarcoidosis are diverse and nonspecific. PET/CT can aid diagnosis and depict active lesions. (authors)