Tsuduki Etsu, Kawana Akihiko, Takeda Yuichiro, Kobayashi Nobuyuki, Kudo Koichiro, Nomura Tomokiyo, Morita Takatomo, Morita Toyohiko
Department of Respiratory Medicine, International Medical Center of Japan, 1-21-1, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 May;40(5):402-7.
A 64-year-old woman was admitted to our hospital for further examination of an abnormal shadow in the left lung, that had grown slowly for 9 years. Bronchial brushing cytology was performed under bronchoscopy, but was negative for malignancy and for other significant findings. 11C-Choline-positron emission tomography (11C-Choline-PET) showed medium-level uptake in the mass lesion in the S 6 lobe of the left lung, but 18F-fluorodeoxyglucose-positron emission tomography (18FDG-PET) did not yield any such result. These findings suggested the presence of a slowly growing benign tumor, or a neoplastic disease, such as a potentially malignant tumor or a low-grade malignancy. To arrive at a diagnosis, a left partial lobectomy was performed on January 29, 2001. The microscopic findings of this mass lesion showed a solid, hemorrhagic pattern; papillary projections into spaces covered or lined by cuboidal cells, and sheets of round to polygonal cells. The histological diagnosis of this tumor was a sclerosing hemangioma. Recently, 18FDG-PET has been proven to be a clinically useful tool for the detection and staging of malignant tumors, and the follow-up of malignant diseases after treatment; while 11C-choline was recently reported to be a new PET tracer used to visualize various malignancies. The uptake of 11C-choline in tumors represents the rate of tumor cell duplication. It is suggested that 11C-choline-PET may be useful in the diagnosis of sclerosing hemangioma, as in this case.
一名64岁女性因左肺异常阴影入院进一步检查，该阴影已缓慢生长9年。在支气管镜检查下进行了支气管刷检细胞学检查，但结果为恶性及其他显著发现均为阴性。11C-胆碱正电子发射断层扫描（11C-胆碱-PET）显示左肺S6叶肿块病变有中等程度摄取，但18F-氟脱氧葡萄糖正电子发射断层扫描（18FDG-PET）未得出任何此类结果。这些发现提示存在生长缓慢的良性肿瘤，或肿瘤性疾病，如潜在恶性肿瘤或低度恶性肿瘤。为明确诊断，于2001年1月29日进行了左肺部分叶切除术。该肿块病变的显微镜检查结果显示为实性、出血性模式；乳头状突起进入由立方体细胞覆盖或内衬的间隙，以及成片的圆形至多边形细胞。该肿瘤的组织学诊断为硬化性血管瘤。最近，18FDG-PET已被证明是一种临床上用于检测恶性肿瘤及其分期以及治疗后恶性疾病随访的有用工具；而11C-胆碱最近被报道为一种用于可视化各种恶性肿瘤的新型PET示踪剂。肿瘤中11C-胆碱的摄取代表肿瘤细胞复制率。提示11C-胆碱-PET可能像在本病例中一样，对硬化性血管瘤的诊断有用。
