Prostate-Specific Membrane Antigen PET/CT in Splenic Sarcoidosis

Abstract

A 65-year-old man who had prostate cancer presented with slightly progressive prostate-specific antigen values. In this situation of biochemical relapse, prostate-specific membrane antigen (PSMA) PET/CT has proven to be superior to choline PET. The Ga-PSMA PET/CT of our patient revealed PSMA-positive tissue in the spleen. Although the localization was not typical for metastases, metastasis could not be excluded because of the intense focal tracer uptake. A supplementary MRI was performed but also failed to rule out a malignant origin. Finally, biopsy confirmed benign disease in the spleen in the form of granulomatous disease.

Elevated 68Ga Prostate-Specific Membrane Antigen Activity in Metastatic Non–Small Cell Lung Cancer

“…8 Prostate-specific membrane antigen expression has also been reported in nonmalignant conditions such as sarcoidosis and Paget disease of the bone. 11,12 …”

PSMA Ligands for PET Imaging of Prostate Cancer

“…Accordingly, there is increasing evidence that PSMA ligand uptake is not exclusively specific for PC. A large number of case series and reports describe increased PET signal in benign lesions (e.g., neurogenic tissue, Paget disease, thyroid adenoma, granulomatous disease, and adrenal adenoma) as well as in malignant diseases (e.g., renal cell carcinoma, lung cancer, glioblastoma, hepatocellular carcinoma, and thyroid cancer) (87)(88)(89)(90)(91)(92)(93)(94)(95). Supplemental Table 1 (supplemental materials are available at http://jnm.snmjournals.org) summarizes the current evidence in the literature.…”

Diagnostic sensitivity of Tc-99m HYNIC PSMA SPECT/CT in prostate carcinoma: A comparative analysis with Ga-68 PSMA PET/CT

“…Not all lesions which demonstrate tracer avidity were histologically confirmed to be due to prostate cancer or its metastases in this study. This exercise would be necessary considering that PSMA‐based radiotracers uptake has been reported in different non‐prostatic malignancies as well as benign conditions resulting from PSMA expression in neovasculature . This was, however, not the purpose of this study.…”