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KMID : 1148920180520050394
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Nuclear Medicine and Molecular Imaging
2018 Volume.52 No. 5 p.394 ~ p.397
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Langerhans’ Cell Histiocytosis Masquerading as Metastatic Papillary Thyroid Cancer on F-18 FDG PET/CT: Diagnostic Dilemma Solved by PET/CT-Guided Biopsy
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Malik Dharmender
Kumar Rajender
Mittal Bhagwant Rai
Parkash Gaurav
Bal Amanjit
Bhattacharya Anish
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Abstract
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We present a case of papillary thyroid cancer (post-thyroidectomy status) on regular treatment with suppressive Levothyroxine therapy. On follow-up at 6 months after radioactive iodine ablation for remnant thyroid tissue, her thyroglobulin, and anti-thyroglobulin levels were 0.06 ng/ml and 670 IU/ml, respectively. Low-dose whole-body I-131 scan was negative. To look for the cause of isolated increased anti-thyroglobulin level, a whole-body 18F-FDG PET/CT was done which revealed multiple FDG-avid lytic skeletal lesions suggestive of metastases. For confirmation of diagnosis, 18F-FDG PET/CT-guided metabolic biopsy was done, which revealed Langerhans’ cell histiocytosis on histopathological examination.
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KEYWORD
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Papillary thyroid cancer, Langerhans’ cell histiocytosis, Anti-thyroglobulin level, 18F-FDG PET/CT, PET/CT-guided biopsy
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