Nodal tuberculosis on positron emission tomography/computed tomography with 18F-Fluordexosiglucose, a case report

Tuberculosis is an infectious disease, caused by the Mycobacterium tuberculosis bacillus. Extrapulmonary disease can cause nonspecific symptoms and signs, which makes diagnostic suspicion difficult. We present the case of a man with a history of cancer in complete remission, diagnosed with lymph node tuberculosis, after being admitted to our hospital due to fever, dyspnea, and central chest pain. A Positron Emission Tomography / Computed Axial Tomography with 18F-fluordexosiglucose is requested; which showed multiple mediastinal adenopathic conglomerates with intense radiotracer uptake, suggesting ruling out malignancy. Active lymph node tuberculosis will show increased metabolic activity with Positron Emission Tomography / Computed Tomography with 18F-fluordexosiglucose, which could make the differential diagnosis with malignant tumors or other granulomatous diseases difficult, as in the case of our patient. Therefore, it is important to consider lymph node tuberculosis as a differential diagnosis in patients with adenopathies suspected of malignancy.