Bohuslavizki K H, Klutmann S, Sonnemann U, Thoms J, Kröger S, Werner J A, Mester J, Clausen M
Abteilung für Nuklearmedizin, Universitätskrankenhauses Eppendorf, Hamburg.
Laryngorhinootologie. 1999 Aug;78(8):445-9. doi: 10.1055/s-2007-996906.
The occult primary tumor remains an important diagnostic problem in patients with lymph node metastases despite a large variety of imaging modalities. Therefore, the aim of our study was to evaluate the impact of F-18-FDG-positron-emission-tomography (PET) in these patients.
The study group included a total of 28 patients aged 39 to 84 years with cervical lymph node metastases of a histologically confirmed squamous cell carcinoma (n = 24) or an undifferentiated carcinoma (n = 4). All patients received 370 MBq F-18-FDG intravenously, and whole-body images were acquired at 60 min p.i. with an ECAT EXACT 47 (921) (Siemens, CTI). All lesions were evaluated either by histology or by CT/MRI.
In 12 patients PET did not reveal suspected tumorous lesions. In contrast in 16/28 patients PET showed focal tracer accumulations corresponding to potential primary tumor sites located in the lungs (n = 7), in the region of the tonsilla palatina (n = 5), in the submandibular gland (n = 1), in the nasopharynx (n = 1), in the larynx (n = 1), or at the base of the tongue (n = 1). In nine out of these 16 patients, the primary was confirmed in the lungs in 5 patients, in the larynx, at the base of the tongue, in the nasopharynx, and the tonsilla palatina in one patient each, respectively. Moreover, in 6 out of 16 patients, PET was false-positive. One patient refused further evaluation of PET findings.
In approximately one third of all patients, PET detected the primary tumor site, which significantly influenced further therapeutic procedures. Thus, F-18-FDG-PET may be a valuable diagnostic tool in the detection of the primary tumor in patients with cervical lymph node metastases.
尽管有各种各样的成像方式，但隐匿性原发肿瘤仍是有淋巴结转移患者的一个重要诊断问题。因此，我们研究的目的是评估F-18-FDG正电子发射断层扫描（PET）对这些患者的影响。
研究组共纳入28例年龄在39至84岁之间的患者，其颈部淋巴结转移为组织学确诊的鳞状细胞癌（n = 24）或未分化癌（n = 4）。所有患者静脉注射370 MBq F-18-FDG，注射后60分钟用ECAT EXACT 47（921）（西门子，CTI）进行全身显像。所有病变均通过组织学或CT/MRI进行评估。
12例患者PET未显示可疑肿瘤病变。相比之下，16/28例患者PET显示局灶性示踪剂聚集，对应于潜在的原发肿瘤部位，位于肺部（n = 7）、腭扁桃体区域（n = 5）、下颌下腺（n = 1）、鼻咽（n = 1）、喉部（n = 1）或舌根（n = 1）。在这16例患者中的9例中，原发肿瘤得到确诊，其中5例在肺部，1例分别在喉部、舌根、鼻咽和腭扁桃体。此外，16例患者中有6例PET结果为假阳性。1例患者拒绝进一步评估PET检查结果。
在所有患者中约有三分之一，PET检测到了原发肿瘤部位，这对进一步的治疗程序有显著影响。因此，F-18-FDG-PET可能是检测颈部淋巴结转移患者原发肿瘤的一种有价值的诊断工具。
