-Case Reports-

Bone Marrow Sarcoidosis with Pancytopenia and Renal Failure Presenting as Fever of Unknown Origin: The Pivotal Role of 18F-FDG PET/CT in Lesion Detection

Naoto Matsuda^1,2, Syun Iida³, Yukitomo Ogino⁴, Noboru Saito¹ and Masahiro Yasutake²

¹Department of General Medicine, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
²Department of General Medicine and Health Science, Nippon Medical School, Tokyo, Japan
³Department of Pathology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
⁴Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan

We describe a case of fever of unknown origin (FUO), renal failure, and pancytopenia. Initially, lymph proliferative disorder was suspected; therefore, bone marrow biopsy and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) were performed. Bronchoscopy and lung biopsy were performed because of abnormal FDG uptake in both lung fields. Imaging data and laboratory and histological results confirmed sarcoidosis with bone marrow invasion. The patient was discharged after favorable response to corticosteroid therapy. Sarcoidosis may present as FUO without typical specific presentations in the skin or lungs. Combined 18F-FDP PET/CT helped identify the biopsy site and confirmed the sarcoidosis diagnosis.

J Nippon Med Sch 2021; 88: 145-148

Keywords
sarcoidosis, fever of unknown origin, 18F-FDG PET/CT scan, lung biopsy, bone marrow sarcoidosis

Correspondence to
Naoto Matsuda, Department of General Medicine and Health Science, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
naoto-matsuda@nms.ac.jp

Received, May 8, 2020
Accepted, July 2, 2020