Öz
Kedi tırmığı hastalığı, Bartonella Henselae isimli bakterinin neden olduğu ve inokülasyon sahasını direne eden lenf nodlarının etkilendiği bir enfeksiyondur. Kedi tırmığı hastalığında en sık olarak aksiller, servikal ve inguinal yerleşimli lenf nodları etkilenmektedir. Doğasındaki granulomatozis nedeni ile bu hastalık FDG-avid kabul edilebilir. Ultrasonografik incelemesinde multipl abdominal lenfadenopati saptanan 49 yaşındaki kadın olgunun FDG-PET/BT bulgularını sunmaktayız. Olgunun F18 FDG PET/BT tetkikinde, bilateral aksiller ve abdominopelvik yerleşimli hipermetabolik lenf nodları yanısıra (SUVmax:6.2-18.5), dalakta hipermetabolik hipodens bir lezyon saptandı (SUVmax:11.3). Uygulanan aksiller lenf nodu eksizyonu sonrası patolojik olarak süpüratif gralülomatöz lenfadenit saptanmasına, yakın zamanda kedi tırmalaması öyküsünün eşlik ediyor oluşu ile, olguya Kedi Tırmığı Hastalığı tanısı konuldu. Sonuç olarak onkolojik PET/BT tetkikinde yalancı pozitiflik sebepleri arasında Kedi tırmığı hastalığı da akılda tutulmalıdır. Ek olarak, Kedi tırmığı hastalığında PET/BT’nin uygun biyopsi alanını göstermede ve diğer hastalık alanlarının saptanmasında rol oynayabileceği düşünülmektedir
Anahtar Kelimeler
Kaynakça
- Bergman AM, Groothedde JW, Schellekens JFP, van Embden JD, Ossewaarde JM, Schouls LM. Etiology of catscratch disease: a comparison of polymerase chain reaction detection of Bartonella and Afipia felis DNA with serology and skin tests. J Infect Dis. 1995; 171 (4): 916-23.
- Mosbacher ME, Klotz S, Klotz J, Pinnas JL. Bartonella henselae and the potential for arthropod vector-borne transmission. Vector Borne Zoonotic Dis. May 2011; 11 (5): 471-7.
- Markaki S, Sotiropoulou M, Papaspirou P, Lazaris D. Cat-scratch disease presenting as a solitary tumour in the breast: report of three cases. Eur J Obstet Gynecol Reprod Biol. 2003; 106 (2): 175-8.
- Spach DH, Kaplan SL. Microbiology, epidemiology, clinical manifestations, and diagnosis of cat scratch disease. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on May 28, 2020).
- Vaidyanathan S, Patel CN, Scarsbrook AF, Chowdhury FU. FDG PET/CT in infection and inflammation--current and emerging clinical applications. Clin Radiol. 2015; 70 (7): 787-800.
- Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop 2012; 52 (1): 1–16.
- Sander A, Berner R, Ruess M. Serodiagnosis of cat scratch disease; response to Bartonella henselae in children and review of diagnostic methods. Eur J Clin Microbiol Infect Dis. 2001; 20 (6): 392-401.
- Lin E, Alavi A. PET and PET/CT A clinical guide, Second edition. Thieme Medical Publishers, Inc.2009. P:25.
- Nwawka OK, Nadgir R, Fujita A, Sakai O. Granulomatous disease in the head and neck: developing a differential diagnosis. Radiographics. 2014; 34 (5): 1240-56.
- Rappaport DC, Cumming WA, Ros PR. Disseminated hepatic and splenic lesions in cat-scratch disease: imaging features. AJR Am J Roentgenol. 1991; 156 (6): 1227-8.
- Jeong W, Seiter K, Strauchen J. et al. PET scan-positive cat scratch disease in a patient with T cell lymphoblastic lymphoma. Leuk Res. 2005; 29 (5): 591–4.
- Imperiale A, Blondet C, Ben-Sellem D. Et al. Unusual Abdominal Localization of Cat Scratch Disease Mimicking Malignancy on F-18 FDG PET/CT Examination. Clin Nucl Med 2008; 33 (9): 621–3.
Öz
Cat-scratch disease is a bacterial infection caused by Bartonella Henselae which affects lymph nodes that drain the sites of inoculation. Axillary, cervical and inguinal lymph nodes are the most common regions being involved. The disease can be considered as an FDG-avid disease, given the granulomatous nature of the infection. We herein report F18 FDG PET/CT findings of a 49-year-old woman, who has abdominal lymphadenopathy revealed on ultrasonography (USG). PET/CT scan demonstrated bilateral axillary and abdominopelvic hypermetabolic enlarged lymph nodes with SUVmax value of 6.2 to 18.5. Moreover, a hypermetabolic hypodense lesion in the spleen with SUVmax value of 11.3 was detected. Excisional biopsy of the axillary lymph node performed. Based on clinical-histopathological findings and the history of being scratched by a cat recently, the patient was diagnosed with cat-scratch disease. In conclusion, cat-scratch disease represents a cause of false-positive results in oncological PET/CT scans. Furthermore, PET/CT may have a role in revealing the applicable biopsy area and showing the additional involvement sites. Keywords: Cat-Scratch Disease, PET-CT, Lymphadenopathy.
Anahtar Kelimeler
Kaynakça
- Bergman AM, Groothedde JW, Schellekens JFP, van Embden JD, Ossewaarde JM, Schouls LM. Etiology of catscratch disease: a comparison of polymerase chain reaction detection of Bartonella and Afipia felis DNA with serology and skin tests. J Infect Dis. 1995; 171 (4): 916-23.
- Mosbacher ME, Klotz S, Klotz J, Pinnas JL. Bartonella henselae and the potential for arthropod vector-borne transmission. Vector Borne Zoonotic Dis. May 2011; 11 (5): 471-7.
- Markaki S, Sotiropoulou M, Papaspirou P, Lazaris D. Cat-scratch disease presenting as a solitary tumour in the breast: report of three cases. Eur J Obstet Gynecol Reprod Biol. 2003; 106 (2): 175-8.
- Spach DH, Kaplan SL. Microbiology, epidemiology, clinical manifestations, and diagnosis of cat scratch disease. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on May 28, 2020).
- Vaidyanathan S, Patel CN, Scarsbrook AF, Chowdhury FU. FDG PET/CT in infection and inflammation--current and emerging clinical applications. Clin Radiol. 2015; 70 (7): 787-800.
- Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop 2012; 52 (1): 1–16.
- Sander A, Berner R, Ruess M. Serodiagnosis of cat scratch disease; response to Bartonella henselae in children and review of diagnostic methods. Eur J Clin Microbiol Infect Dis. 2001; 20 (6): 392-401.
- Lin E, Alavi A. PET and PET/CT A clinical guide, Second edition. Thieme Medical Publishers, Inc.2009. P:25.
- Nwawka OK, Nadgir R, Fujita A, Sakai O. Granulomatous disease in the head and neck: developing a differential diagnosis. Radiographics. 2014; 34 (5): 1240-56.
- Rappaport DC, Cumming WA, Ros PR. Disseminated hepatic and splenic lesions in cat-scratch disease: imaging features. AJR Am J Roentgenol. 1991; 156 (6): 1227-8.
- Jeong W, Seiter K, Strauchen J. et al. PET scan-positive cat scratch disease in a patient with T cell lymphoblastic lymphoma. Leuk Res. 2005; 29 (5): 591–4.
- Imperiale A, Blondet C, Ben-Sellem D. Et al. Unusual Abdominal Localization of Cat Scratch Disease Mimicking Malignancy on F-18 FDG PET/CT Examination. Clin Nucl Med 2008; 33 (9): 621–3.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 13 Eylül 2021 |
| Gönderilme Tarihi | 29 Mayıs 2020 |
| Yayımlandığı Sayı | Yıl 2021 |