Ergün E L, Lim E
Hacettepe University Medical Faculty, Department of Nuclear Medicine, Ankara, Turkey.
Rev Esp Med Nucl. 2006 May-Jun;25(3):188-92. doi: 10.1157/13088416.
A 40 year-old female was examined for complaints of left arm pain and restriction of movement in the left upper extremity for 3 months. Chest X-ray showed a mass in the left upper lung and the patient was evaluated with computed tomography that confirmed the significant mass in the left paratracheal region and also showed small nodules in both of the lungs. A whole-body FDG-PET scan was performed for the suspicion of malignancy. FDG-PET indicated high FDG accumulation in the lung lesions mainly in the left paratracheal region. FDG-PET findings were highly suspicious of malignancy so the patient had thoracoscopic biopsy of the lesion. The histological findings and immunohistochemistry tests were consistent with pulmonary epitheloid hemangioendothelioma (PEH). Epitheloid hemangioendothelioma (EH) is a systemic name that represents a rare type of malignant tumor of vascular endothelial origin, which can arise in bone, liver, soft-tissue, or lung. PEH is currently known as the lung form of EH. Consequently, our patient had resection of the left paratracheal mass. This report presents a rare case of histologically confirmed PEH, which showed increased FDG accumulation on FDG-PET study. PEH should be added to the other causes of increased FDG uptake.
一名40岁女性因左臂疼痛和左上肢活动受限3个月前来就诊。胸部X光显示左上肺有一个肿块，患者接受了计算机断层扫描评估，证实左气管旁区域有明显肿块，两肺也有小结节。因怀疑为恶性肿瘤，进行了全身FDG-PET扫描。FDG-PET显示肺部病变主要在左气管旁区域有高FDG摄取。FDG-PET结果高度怀疑为恶性肿瘤，因此患者接受了病变的胸腔镜活检。组织学检查结果和免疫组化检测与肺上皮样血管内皮瘤（PEH）一致。上皮样血管内皮瘤（EH）是一个统称，代表一种罕见的血管内皮源性恶性肿瘤，可发生于骨骼、肝脏、软组织或肺部。PEH目前被认为是EH的肺部表现形式。因此，我们的患者接受了左气管旁肿块切除术。本报告展示了一例经组织学证实的罕见PEH病例，该病例在FDG-PET研究中显示FDG摄取增加。PEH应被列入FDG摄取增加的其他原因之中。
