Predictive value of brain : A case report18: A case reportF-FDG PET/CT in macrophagic myofasciitis?: A case report

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Abstract

Rationale:

Although several functional studies have demonstrated that positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT) appears to be efficient to identify a cerebral substrate in patients with known macrophagic myofasciitis (MMF), the predictive value of this imaging technique for MMF remains unclear.

Patient concerns:

We presented data and images of a 46-year-old woman.

Diagnoses:

The patient was referred to our center for suspected MMF due to diffuse arthromyalgias and cognitive disorder (involving an impairment of visual selective attention and a weakness in executive functions revealed by neuropsychological assessment) which occurred few years after last vaccine injections.

Interventions:

After a first negative deltoid muscle biopsy, a brain 18F-FDG PET/CT was performed and revealed the known spatial pattern of a cerebral glucose hypometabolism involving occipital cortex, medial temporal areas, and cerebellum.

Outcomes:

Given the clinical suspicion of MMF and brain 18F-FDG PET/CT findings, a 2nd deltoid muscle biopsy was performed and confirmed the diagnosis of MMF with typical histopathological features.

Lessons:

This case highlights the predictive value of brain 18F-FDG PET/CT as a noninvasive imaging tool for MMF diagnosis, even when muscle biopsy result comes back negative.

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