Mahmood Syed, Martinez de Llano Sofia R
Department of Radiology, Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Clin Nucl Med. 2008 Jul;33(7):510-2. doi: 10.1097/RLU.0b013e318177928a.
A 71-year-old man with newly diagnosed malignant mesothelioma was referred for an F-18 FDG PET/CT study to evaluate the extent of disease. PET showed mild FDG uptake in the right chest, corresponding to a lobulated, mass-like right pleural effusion versus thickening involving the entire right pleural space, and some mediastinal involvement, on the accompanying CT scan. In addition, marked FDG uptake was seen in the proximal left humerus, suspicious for an osseous metastasis. The corresponding CT scan findings of cortical thickening and a "Swiss cheese" appearance were most consistent with Paget disease. The intense FDG uptake in an osseous lesion on FDG-PET in our case reminds us of the variable nature of FDG uptake in Paget disease, the possibility of false-positive findings on FDG-PET in patients with cancer, and the usefulness of the fusion techniques in the evaluation of skeletal lesions, with the potential for discriminating between benign Paget disease and other pathologic bone findings.
一名71岁新诊断为恶性间皮瘤的男性患者被转诊进行F-18 FDG PET/CT检查以评估疾病范围。PET显示右胸部有轻度FDG摄取，对应于CT扫描显示的分叶状、肿块样右侧胸腔积液或整个右侧胸膜腔增厚，以及一些纵隔受累情况。此外，在左肱骨近端可见明显的FDG摄取，怀疑为骨转移。相应的CT扫描显示皮质增厚和“瑞士奶酪”样表现，这与佩吉特病最为相符。在我们的病例中，FDG-PET上骨病变处强烈的FDG摄取提醒我们，佩吉特病中FDG摄取具有多变性，癌症患者FDG-PET可能出现假阳性结果，以及融合技术在评估骨骼病变中的有用性，其有可能区分良性佩吉特病和其他病理性骨表现。
