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Disseminated Multi-system Sarcoidosis Mimicking Metastases on 18F-FDG PET/CT


  • William Makis
  • Mark Palayew
  • Christopher Rush
  • Stephan Probst

Received Date: 02.10.2017 Accepted Date: 26.11.2017 Mol Imaging Radionucl Ther 2018;27(2):91-95 PMID: 29889033

A 60-year-old female with no significant medical history presented with hematuria. A computed tomography (CT) scan revealed extensive lymphadenopathy with hypodensities in the liver and spleen, and she was referred for an 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT (PET/CT) study to assess for malignancy of unknown primary. PET/CT revealed extensive 18F-FDG avid lymphadenopathy as well as innumerable intensely 18F-FDG avid lung, liver and splenic nodules, highly concerning for malignancy. A PET-guided bone marrow biopsy of the posterior superior iliac spine revealed several non-necrotizing, well-formed granulomas, consistent with sarcoidosis. The patient was managed conservatively and remained clinically well over the subsequent 9 years of follow-up.

Keywords: Sarcoidosis, artifact, mimic, lymphadenopathy, metastases, 18F-fluorodeoxyglucose, positron emission tomography


Informed Consent: All subjects in the study gave written informed consent or the institutional review board waived the need to obtain informed consent.

Peer-review: Externally and internally peer-reviewed.

Authorship Contributions

Surgical and Medical Practices: W.M., M.P., C.R., S.P., Concept: W.M., M.P., C.R., S.P., Design: W.M., M.P., C.R., S.P., Data Collection or Processing: W.M., M.P., C.R., S.P., Analysis or Interpretation: W.M., M.P., C.R., S.P., Literature Search: W.M., M.P., C.R., S.P., Writing: W.M., M.P., C.R., S.P.

Conflict of Interest: William Makis, Mark Palayew, Christopher Rush and Stephan Probst declare that they have no conflicts of interest.

Financial Disclosure: The authors declare that this study has received no financial support.

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