Neurosarcoidosis Mimics High-Grade Glioma in Dynamic 18F-FET PET Due to LAT Expression

Clin Nucl Med. 2018 Nov;43(11):840-841. doi: 10.1097/RLU.0000000000002266.

Abstract

We present a 45-year-old man with newly generalized tonic-clonic seizures due to a contrast-enhancing frontal lesion with perifocal edema suggestive for high-grade glioma (HGG). For further evaluation, a dynamic F-FET PET scan was performed, which showed high F-FET-uptake with early peak and constantly decreasing time-activity curves, a characteristic feature of HGG. Stereotactic biopsy and histological evaluation excluded a neoplastic lesion but confirmed a manifestation of neurosarcoidosis with strong expression of the L-amino-acid-transporter considered responsible for F-FET-uptake. Therefore, unknown manifestations of neurosarcoidosis represent a clinical pitfall in F-FET PET and can mimic HGG.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / diagnostic imaging*
  • Central Nervous System Diseases / diagnostic imaging*
  • Diagnosis, Differential
  • Glioma / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals
  • Sarcoidosis / diagnostic imaging*
  • Tyrosine / analogs & derivatives

Substances

  • Radiopharmaceuticals
  • (18F)fluoroethyltyrosine
  • Tyrosine

Supplementary concepts

  • Neurosarcoidosis