A Case of Muscle Sarcoidosis Who Developed a Subcutaneous Nodule on His Right Cheek: The Diagnostic Application of Positron Emission Tomography (PET)

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  • Saito Yuki
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Hasegawa Minoru
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Murata Tomoko
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Chujo Sonoko
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Ishii Takayuki
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Matsushita Takashi
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Hujimoto Akihide
    Department of Dermatology, Kanazawa University, Graduate School of Medicine
  • Orito Hidemitsu
    Department of Dermatology, Himi Municipal Hospital
  • Takakura Hirotada
    Department of Otolaryngology, Himi Municipal Hospital
  • Takehara Kazuhiko
    Department of Dermatology, Kanazawa University, Graduate School of Medicine

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  • 右頬部に皮下結節を生じた筋サルコイドーシスの1例―Positron emission tomography（PET）が診断上有用であった症例―
  • ミギ ホオブ ニ ヒカ ケッセツ オ ショウジタ キン サルコイドーシス ノ 1レイ Positron emission tomography PET ガ シンダン ジョウ ユウヨウ デ アッタ ショウレイ

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Abstract

A 50-year-old man noticed an asymptomatic, small, subcutaneous nodule on his right cheek four months before his first visit. The findings of magnetic resonance imaging of his head were not able to role out a malignancy. However, a positron emission tomography (PET) image showed 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) accumulation in his cheek. Furthermore, multiple FDG accumulations were detected in the soft tissues of his extremities. The distribution of FDG uptake suggested the inflammatory changes of sarcoidosis. Histopathologically, his right cheek nodule consisted of non-caseating epithelioid cell granulomas. There was no indication of sarcoidosis in his other organs. We tried taking random skeletal muscle biopsies to confirm the diagnosis. We diagnosed him with muscle sarcoidosis, because epithelioid granuloma was detected in his right gastrocnemius muscle. PET imaging is a potent tool for detecting early guranulomatous inflammatory changes and may help in diagnosing sarcoidosis.

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