Predictive value of brain 18F-FDG PET/CT in macrophagic myofasciitis?: A case report

Although several functional studies have demonstrated that positron emission tomography/computed tomography with F-fluorodeoxyglucose (F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging te...

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Published inMedicine (Baltimore) Vol. 96; no. 39; p. e8134
Main Authors Van Der Gucht, Axel, Abulizi, Mukedaisi, Blanc-Durand, Paul, Aoun-Sebaiti, Mehdi, Emsen, Berivan, Gherardi, Romain K, Verger, Antoine, Authier, François-Jérôme, Itti, Emmanuel
Format Journal Article
LanguageEnglish
Published United States Wolters Kluwer Health 01.09.2017
Subjects
Brain Diseases - diagnostic imaging
Clinical Case Report
Fasciitis - diagnostic imaging
Female
Fluorodeoxyglucose F18
Humans
Middle Aged
Myositis - diagnostic imaging
Positron Emission Tomography Computed Tomography - methods
Predictive Value of Tests
Radiopharmaceuticals
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Summary:Although several functional studies have demonstrated that positron emission tomography/computed tomography with F-fluorodeoxyglucose (F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging technique for MMF remains unclear. We presented data and images of a 46-year-old woman. The patient was referred to our center for suspected MMF due to diffuse arthromyalgias and cognitive disorder (involving an impairment of visual selective attention and a weakness in executive functions revealed by neuropsychological assessment) which occurred few years after last vaccine injections. After a first negative deltoid muscle biopsy, a brain F-FDG PET/CT was performed and revealed the known spatial pattern of a cerebral glucose hypometabolism involving occipital cortex, medial temporal areas, and cerebellum. Given the clinical suspicion of MMF and brain F-FDG PET/CT findings, a 2nd deltoid muscle biopsy was performed and confirmed the diagnosis of MMF with typical histopathological features. This case highlights the predictive value of brain F-FDG PET/CT as a noninvasive imaging tool for MMF diagnosis, even when muscle biopsy result comes back negative.
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ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000008134