Unusual Delayed FDG-PET/CT Hypermetabolism Due to Charcoal-Induced Granuloma
(2018) Journal of the Belgian Society of Radiology — Vol. 102, n° 1 (2018) (2018)
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- Authors
Deprez, Fabrice 
- Abstract
- (en) A 63-year-old patient initially presented with right leg pain. First imaging studies (not shown) revealed a tumoral infiltration of the distal half of the femur. As sarcoma was initially suspected, a percutaneous biopsy was performed with charcoal (black carbon) deposit along needle tract. It revealed a high-grade follicular lymphoma and the patient was treated with 8 cycles of R-CHOP. Four months after treatment initiation, first follow-up 18F fluorodeoxyglucose (FDG) Positron Emission Tomography coupled with Computed Tomography (PET/CT) showed a persistent strong FDG uptake in the femur along with the biopsy track (Figure 1, arrow). Six months later, a follow-up FDG-PET/CT after completion of treatment showed a complete femoral metabolic response, but appearance of a hypermetabolic lesion (SUVmax = 17.3) in the muscle tissues next to the previous lymphoma localization (Figure 2: PET/CT – arrow: biopsy track). US-guided biopsy was performed and showed dark-pigmented fragments. Microscopically, striated muscle tissues and subcutaneous tissues with granulomatous inflammation that comprised multinucleated giant cells, fibrosis and charcoal deposits were observed (Figure 3: H-E coloration, ×10).
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Citations
Rahier, Q., & Deprez, F. (2018). Unusual Delayed FDG-PET/CT Hypermetabolism Due to Charcoal-Induced Granuloma. Journal of the Belgian Society of Radiology, 102(1 (2018)). https://doi.org/10.5334/jbsr.1549 (Original work published 2018)