Peritoneal tuberculosis with elevated serum CA125 mimicking peritoneal carcinomatosis on F-18 FDG-PET/CT

Ann Nucl Med. 2008 Jul;22(6):525-7. doi: 10.1007/s12149-008-0139-y. Epub 2008 Aug 1.

Abstract

18F-fluorodeoxyglucose positron emission tomography (F-18 FDG-PET) plays an important role in differentiating benign from malignant tumors. However, some false-positive findings, such as tuberculosis, may occur. We report a case referred for F-18 FDG whole-body PET computed tomography (PET/CT) scan owing to an elevated serum cancer antigen 125 (CA125). An FDG-PET/CT scan showed multiple hypermetabolic foci in the mesentery and peritoneum with further increase of FDG uptake on the delayed scan, mimicking peritoneal carcinomatosis. Subsequent laparoscopic biopsy showed granulomatous inflammation, and tuberculosis polymerase chain reaction showed a positive result. Serum CA125 returned to normal following treatment with anti-tuberculosis drugs. Peritoneal tuberculosis should be considered as a differential diagnosis in a tuberculosis endemic region.

Publication types

  • Case Reports

MeSH terms

  • Carbonic Anhydrases / blood*
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Middle Aged
  • Peritoneal Neoplasms / diagnosis*
  • Peritoneum / diagnostic imaging*
  • Positron-Emission Tomography / methods
  • Prognosis
  • Radiopharmaceuticals
  • Subtraction Technique
  • Tomography, X-Ray Computed / methods
  • Tuberculosis / blood*
  • Tuberculosis / diagnosis*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • CA13 protein, human
  • Carbonic Anhydrases