Table 1.
Characteristics of five patients who received a diagnosis of TB after FDG-PET/CT scan
| 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 |
CT computerized tomography, FDG-PET 18F-fluoro-2-deoxy-glucose-positron emission tomography, TST tuberculin skin test, DM diabetes mellitus, RUL right upper lobe, LUL left upper lobe, SUVmax maximum standard uptake value, TB tuberculosis, RIF rifampin, INH isoniazid, HIV human immunodeficiency virus, MTB Mycobacterium tuberculosis, RIPE rifampin, isoniazid, pyrazinamide and ethambutol, COPD chronic obstructive pulmonary disease, PCR polymerase chain reaction