This case reports elevated 18F-FDG and low 68Ga-FAPI-04 activity in a patient with eosinophilic liver infiltration, suggesting immune checkpoint inhibitors may induce such conditions.
A 70-year-old man, who underwent radical surgery for left lower lung squamous cell carcinoma 4 years ago and received sintilimab therapy 3 months ago for suspected hilar lymph node metastasis, presented with multiple liver lesions detected by MRI. Laboratory tests showed abnormally elevated eosinophil count with 4.89×10 9 /L. 18 F-FDG PET/CT imaging demonstrated significantly high FDG-avid in the liver lesions, while 68 Ga-FAPI-04 PET/MRI imaging revealed slight FAPI uptake. Histopathological examination of the liver biopsy indicated chronic granulomatous inflammation with necrosis and a large number of eosinophils. Combining with these tests, eosinophilic liver infiltration induced by the immune checkpoint inhibitor was diagnosed.
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Sun et al. (2025) studied this question.
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