18F-FDG PET and PET/CT in Diagnosis and Treatment Monitoring of Pyrexia of Unknown Origin Due to Tuberculosis with Prominent Hepatosplenic Involvement

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FIGURE 1.
Pretreatment CT scan of abdomen showing hypoattenuating lesions (arrows) in liver and spleen suggestive of granulomas.
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FIGURE 2.
Whole-body ¹⁸F-FDG PET images demonstrating abnormal ¹⁸F-FDG–avid foci (arrows) in liver and spleen along with solitary mediastinal node hypermetabolism.
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FIGURE 3.
(A) Hematoxylin- and eosin-stained section of liver biopsy sample showing liver parenchyma with epithelioid cell granuloma (×5). (B) Higher magnification of same section showing granuloma composed of epithelioid cells, Langhans giant cells, and lymphocytes (×40).
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FIGURE 4.
Posttreatment CT scan of abdomen showing resolution of liver lesions but persistence of splenic lesions (arrows).
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FIGURE 5.
Follow-up ¹⁸F-FDG PET/CT images showing no evidence of ¹⁸F-FDG–concentrating abnormal focus in whole-body survey. These results were suggestive of complete metabolic response, as was commensurate with patient’s clinical improvement.