A Patient with Psoriatic Arthritis Imaged with FDG-PET/CT Demonstrated an Unusual Imaging Pattern with Muscle and Fascia Involvement: A Case Report

• Published in: Nuclear medicine and molecular imaging Vol. 46; no. 2; pp. 138 - 143
• Main Authors: Bains, Sukhkarn, Reimert, Matthew, Win, Aung Zaw, Khan, Sana, Aparici, Carina Mari
• Format: Journal Article
• Language: Korean
• Published: 2012
• Subjects: FDG-PET/CT; Autoimmune lymphoproliferative syndrome; Psoriasis; Autoimmune
• ISSN: 1869-3474; 1869-3482

We describe the case of a patient with known history of psoriasis that presented with 1 year of unexplained fever, muscle weakness and marked weight loss, suspicious for B symptoms of a malignant origin. [$^{18}F$]-Fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scans demonstrated an unusual serpiginous pattern of uptake in the fascia and muscles as well as lymph node activity. Multiple histological samples, including a final PET-probe guided lymph node surgical resection, excluded malignancy and confirmed the diagnosis of reactive inflammatory changes, with a plausible diagnosis of autoimmune lymphoproliferative syndrome with associated lymphadenitis, fasciitis and myositis, possibly mediated by tumor necrosis factor (TNF) inhibitor. To our knowledge, there is no evidence of a previously reported FDG uptake pattern of fascia and muscle involvement in psoriatic arthritis.