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Granulomatous Myositis Showing Fluctuating “Leopard-Man” Sign

A Case Report on FDG PET/CT Imaging

Koyama, Masamichi MD*; Terauchi, Takashi MD*; Koizumi, Mitsuru MD*; Sugiura, Yoshiya MD

Clinical Nuclear Medicine: December 2019 - Volume 44 - Issue 12 - p 961–963
doi: 10.1097/RLU.0000000000002819
Interesting Images

A 57-year-old woman with a history of uterine endometrial carcinoma underwent PET/CT examinations for initial staging and posttreatment survey. Multiple patchy accumulations were noted in the muscles, particularly in both thighs. These accumulations resolved spontaneously 6 months after the follow-up examination. However, 3.5 years after the surgery, the multiple patchy accumulations reappeared in the muscle of the upper and lower extremities showing an increase in signal intensity from previous examination. A biopsy of the right thigh revealed epithelioid cell granuloma without necrosis. We therefore consider that this case might be “idiopathic” granulomatous myositis.

From the Department of *Nuclear Medicine

Division of Pathology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.

Received for publication March 29, 2019; revision accepted July 28, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Masamichi Koyama, MD, Department of Nuclear Medicine, The Cancer Institute Hospital of JFCR, 3-8-31, Ariake, Koto-ku, Tokyo 135-8550, Japan. E-mail:

Online date: October 31, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.





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      FDG PET/CT; muscle; epithelioid cell granuloma; leopard-man sign

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