Abstract
Sir—We read with interest the manuscript by Chowdhury et al. 1 Chowdhury F.U. Sheerin F. Bradley K.M. et al. Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern. Clin Radiol. 2009; 64: 675-681 Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar reporting the occurrence of sarcoid-like reactions in 1.1% of cancer patients at 2- [18F]-fluoro-2-deoxy-d-glucose (FDG)/computed tomography (CT) examination. We also observed FDG uptake in sarcoid-like reactions in cancer patients. In addition, we have observed two cancer patients with mediastinal and hilar biopsy-proven sarcoid-like reactions demonstrating a significant decrease in FDG uptake after anticancer treatment. Although false-positive FDG uptake in sarcoid-like reactions in cancer patients is a well-known and frequently described phenomenon in the evaluation of tumour stage 2 Gonzalez-Stawinski G.V. Lemaire A. Merchant F. et al. A comparative analysis of positron emission tomography and mediastinoscopy in staging non-small cell lung cancer. J Thorac Cardiovasc Surg. 2003; 126: 1900-1905 Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar , 3 Karam M. Roberts-Klein S. Shet N. et al. Bilateral hilar foci on 18F-FDG PET scan in patients without lung cancer: variables associated with benign and malignant etiology. J Nucl Med. 2008; 49: 1429-1436 Crossref PubMed Scopus (44) Google Scholar , 4 Nakagawa M. Hara M. Sakurai K. et al. Diagnostic accuracy of 18F-2-deoxy-fluoro-d-glucose positron emission tomography for pN1 lymph nodes in patients with lung cancer. Acta Radiol. 2009; 50: 638-644 Crossref PubMed Scopus (6) Google Scholar and during follow-up, 5 Hollister Jr., D. Lee M.S. Eisen R.N. et al. Variable problems in lymphomas: case 2. Sarcoidosis mimicking progressive lymphoma. J Clin Oncol. 2005; 23: 8113-8116 Crossref PubMed Scopus (13) Google Scholar , 6 Yao M. Funk G.F. Goldstein D.P. et al. Benign lesions in cancer patients: case 1. Sarcoidosis after chemoradiation for head and neck cancer. J Clin Oncol. 2005; 23: 640-641 Crossref PubMed Scopus (23) Google Scholar , 7 Zinzani P.L. Tani M. Trisolini R. et al. Histological verification of positive positron emission tomography findings in the follow-up of patients with mediastinal lymphoma. Haematologica. 2007; 92: 771-777 Crossref PubMed Scopus (73) Google Scholar this decrease in FDG accumulation in sarcoid-like lesions after anticancer treatment is not. As metabolic tumour response assessment with FDG-positron-emission tomography (PET) has been accepted as a surrogate endpoint for the evaluation of anticancer treatment in oncology, 8 Wahl R.L. Jacene H. Kasamon Y. et al. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50: 122S-150S Crossref PubMed Scopus (2593) Google Scholar and decrease in FDG uptake is considered to be a treatment-induced tumour response, we would like to bring these two cases to the attention of readers. Re: Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern—a replyClinical RadiologyVol. 65Issue 1PreviewSir—We are grateful to van der Veldt and colleagues for their interesting observations with reference to our recent study evaluating the prevalence of sarcoid-like reactions in oncology patients presenting for 2- [18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography and computed tomography (PET/CT) for staging and restaging of solid-organ malignancy.1 They describe two cases where there was a decrease in FDG avidity within histologically proven sarcoid-like reaction following chemotherapy. Full-Text PDF
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