PURPOSE: To describe findings of pulmonary tuberculoma at 2-[fluorine 18]fl
uoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET).
MATERIALS AND METHODS: Ten consecutive patients who underwent PET and subse
quently were proved to have pulmonary tuberculoma were analyzed. Tuberculos
is was proved histopathologically in eight by means of wedge resection or l
obectomy (n = 7) or needle biopsy (n = 1) and in two by means of clinical f
ollow-up for more than 2 years. PET scans were evaluated by using peak stan
dardized uptake values. Computed tomographic (CT) and histopathologic findi
ngs also were reviewed.
RESULTS: Nine of 10 tuberculomas showed FDC uptake at PET, and the mean pea
k standardized uptake value was 4.2 +/- 2.2 (SD). FDC uptake (range, 1.9-3.
7) in lesions adjacent to main abnormalities was demonstrated in four patie
nts. On CT scans, the mean of the longest nodule diameters was 21 mm +/- 8,
and there were some areas of branching linear opacities or satellite nodul
es that suggested pulmonary tuberculosis in seven patients. Histopathologic
findings were chronic granulomatous inflammation with caseation necrosis (
n = 7) and healed tuberculosis with aspergilloma (n = 1).
CONCLUSION: Pulmonary tuberculoma commonly causes an increase in FDC uptake
. These results suggest that in geographic regions with a high prevalence o
f granulomatous lesions, positive FDC PET results should be interpreted wit
h caution in differentiating benign from malignant pulmonary abnormalities.