"Cold" Spondylodiscitis on 18F-FDG PET/CT in a Patient With Myelofibrosis.

ABSTRACT

A 74-year-old man was evaluated by bone scan for possible rib fractures, which revealed a diffuse skeletal uptake secondary to myelofibrosis and focal midthoracic uptake. Chest CT and F-FDG PET/CT demonstrated pathological vertebral fractures of the midthoracic spine, which appeared as a cold defect on PET comparing to intense marrow uptake related to myelofibrosis and a lung nodule with a low uptake, later biopsy-proven as non-small cell lung carcinoma (NSCLC). MRI confirmed CT findings for the spine noting also an enhanced epidural collection. Biopsies did not reveal malignant cells. Final diagnosis was spondylodiscitis and a stage I NSCLC.