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FDG PET/CT Findings in TAFRO Syndrome

Hotta, Masatoshi, MD*; Minamimoto, Ryogo, MD, PhD*; Yashima, Arisa, MD; Nakano, Masahiro, MD; Yamashita, Hiroyuki, MD, PhD

doi: 10.1097/RLU.0000000000002278
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A 67-year-old woman with prolonged fever, thrombocytopenia, and renal dysfunction underwent FDG PET/CT to evaluate underlying causes, including malignancy. PET/CT showed FDG uptake in ascites, subcutaneous edema, lymph nodes, spleen, and bone marrow. Subsequent bone marrow biopsy revealed myelofibrosis, and laboratory testing showed elevated concentrations of interleukin 6 in serum and ascites. These findings led to the diagnosis of TAFRO syndrome, a variant of multicentric Castleman disease, characterized by thrombocytopenia, anasarca, fever, reticulin myelofibrosis, and organomegaly. Because TAFRO syndrome is potentially fatal, accurate diagnosis is crucial. Characteristic FDG PET/CT findings facilitate the diagnosis of TAFRO syndrome, which is generally challenging.

From the *Department of Nuclear Medicine, and

Division of Rheumatic Diseases, National Center for Global Health and Medicine, Tokyo, Japan.

Received for publication May 31, 2018; revision accepted August 8, 2018.

Conflicts of interest and sources of funding: none declare.

Correspondence to: Masatoshi Hotta, MD, Department of Nuclear Medicine, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. E-mail: masatoshihotta@yahoo.co.jp.

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