Scar sarcoidosis on 18FFDG PET/CT

18Flabeled fluoro2deoxyglucose positron emission tomography/ computed tomography (18FFDG PET/CT) is an important imaging modality in the clinical workup of patients with chronic inflammatory disorders which present quite often with a fever of unknown origin. Sarcoidosis is a multisystem chronic inflammatory disorder with a wide clinical spectrum that can involve different organs. The diagnosis of sarcoidosis is usually based on the observation of noncaseating granulomas in biopsy specimens and exclusion of other granulomatous diseases. Skin involvement can occur in 2025% of sarcoidosis cases. However, scar involvement in sarcoidosis is a rare condition. Herein, we present a case of multisystem sarcoidosis in a 45yearold woman, who was previously treated with steroids and was in remission for 8 months. The patient presented with multiple skin nodules on the chest and back, a history of intermittent fever, headache, and mild itching at the abdominal scar site for 3 months. Blood investigations revealed elevated serum angiotensinconverting enzyme levels. The 18FFDG PET/CT revealed a metabolically active involvement of the cutaneous tissue (posthysterectomy scar), apart from other sites of involvement. Biopsy of the scar site revealed multiple epithelioid cell granulomas with giant cells surrounding the collagenous fibers of the scar tissue