Anal and Rectal Syphilis on F-18 FDG PET/CT

摘要

A 59-year-old man was referred for F-18 fluorodeoxy-glucose (FDG) PT/CT to characterize pulmonary nodules. Although the lung lesions were negative, an unsuspected increased FDG uptake was detected in the distal rectum, anus, and regional lymph-adenopathy. On physical examination a nonpuralent maculopapular exanthema, mainly on the chest, was identified. Anorectal examination and colonoscopy were negative; however the patient recognized a risky sexual behavior. Lymphadenopathy was not palpable. HIV antibody test was negative. Rapid plasma reagin and chromato-graphic immunoassay (SmarTest) were positive for syphilis. The patient was treated with benzylpenicillin with complete remission of the skin lesions. A new RPR test after therapy was negative.