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Figure 1: A 52-year-old male, who presented with cervical lymphadenopathy and initially diagnosed to have tuberculosis and was treated with anti-tubercular drugs for 1 year without benefit, was referred for further evaluation. He was considered for re-biopsy for a definitive diagnosis. At the same time, he was referred for FDG-PET study to evaluate the overall disease status. FDG-PET (Fig 1: upper panel) showed multiple abnormal foci of FDG uptake in the both sided neck nodes, mediastinal and axillary nodes, liver, spleen, thyroid and multiple abdominal (paraaortic and inguinal nodes). The biopsy of the inguinal nodes was confirmatory of sarcoidosis. He had history of hypothyroidism, which is frequently associated in this disorder and is predicted to be due to association of autoimmunity that is very important in the pathogenesis of thyroid disease in this population. The patient was prescribed oral corticosteroid and was referred for reassessment of disease status following 6 weeks of initiation of therapy. The FDG-PET this time (Fig 1: lower panel) showed remarkable improvement of the disease status with near total resolution FDG hypermetabolism at the involved sites. (Reproduced from Basu et al.[1] with permission from Lippincott Williams and Wilkins)

Figure 1: A 52-year-old male, who presented with cervical lymphadenopathy and initially diagnosed to have tuberculosis and was treated with anti-tubercular drugs for 1 year without benefit, was referred for further evaluation. He was considered for re-biopsy for a definitive diagnosis. At the same time, he was referred for FDG-PET study to evaluate the overall disease status. FDG-PET (Fig 1: upper panel) showed multiple abnormal foci of FDG uptake in the both sided neck nodes, mediastinal and axillary nodes, liver, spleen, thyroid and multiple abdominal (paraaortic and inguinal nodes). The biopsy of the inguinal nodes was confirmatory of sarcoidosis. He had history of hypothyroidism, which is frequently associated in this disorder and is predicted to be due to association of autoimmunity that is very important in the pathogenesis of thyroid disease in this population. The patient was prescribed oral corticosteroid and was referred for reassessment of disease status following 6 weeks of initiation of therapy. The FDG-PET this time (Fig 1: lower panel) showed remarkable improvement of the disease status with near total resolution FDG hypermetabolism at the involved sites. (Reproduced from Basu et al.[1] with permission from Lippincott Williams and Wilkins)