IMAGE OF THE MONTH 18F-FDG PET/CT detects systemic involvement in sarcoidosis

A 37-year-old man was admitted for sudden onset of palpitation and chest X-ray detected a parahilar lung mass. Thoracic CT was suggestive of sarcoidosis (multiple lung nodules and mediastinal nodes) while abdominal ultrasound showed enlarged liver and spleen. Liver and lung biopsies showed sarcoid granulomas. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT was performed for staging and detected the presence of hypermetabolic lung nodules [maximum standardized uptake value (SUVmax) 3.7], lymph nodes (cervical, mediastinal, abdominal, inguinal), liver (SUVmax 3) and spleen (SUVmax 9.7). Moreover, PET/ CT documented multiple hypermetabolic cystic lesions at bone level (SUVmax 12), involving almost all skeletal segments included in the field of view. Sarcoidosis is a granulomatous disorder of unknow