Ondik M P, Kang J, Bayerl M G, Bruno M, Goldenberg D
Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA.
J Laryngol Otol. 2009 May;123(5):575-8. doi: 10.1017/S0022215108003988. Epub 2008 Oct 31.
Positron emission tomography with 18F-fluorodeoxyglucose (18FDG) has been increasingly used in the diagnostic investigation of patients with neoplasms of the head and neck. Positron emission tomography and computed tomography have also proven useful for surveillance of thyroid cancers that no longer concentrate radioiodine. However, certain benign or inflammatory lesions can also accumulate 18F-fluorodeoxyglucose and lead to misdiagnosis.
We review and discuss the pitfalls of using positron emission tomography and computed tomography for surveillance of thyroid cancer.
We present the case of a 48-year-old woman who was diagnosed with a laryngeal neoplasm on integrated positron emission tomography and computed tomography scanning, after a routine ultrasound demonstrated an enlarged thyroid nodule. On physical examination, she had a laryngeal mass overlying an immobile vocal fold. The mass was biopsied and found to harbour a Teflon granuloma.
Positron emission tomography positive Teflon granulomas have previously been reported in the nasopharynx and vocal folds, and should be considered in the differential diagnosis of patients who have undergone prior surgery involving Teflon injection. It is important for otolaryngologists and radiologists to recognise potential causes of false positive positron emission tomography and computed tomography findings, including Teflon granulomas.
18F-氟脱氧葡萄糖正电子发射断层扫描（18FDG-PET）在头颈部肿瘤患者的诊断检查中应用越来越广泛。正电子发射断层扫描和计算机断层扫描也已被证明对不再摄取放射性碘的甲状腺癌监测有用。然而，某些良性或炎性病变也可摄取18F-氟脱氧葡萄糖并导致误诊。
我们回顾并讨论使用正电子发射断层扫描和计算机断层扫描监测甲状腺癌的陷阱。
我们报告一例48岁女性病例，在常规超声显示甲状腺结节增大后，其在正电子发射断层扫描和计算机断层扫描联合检查中被诊断为喉部肿瘤。体格检查时，她在固定的声带上方有一个喉部肿物。对该肿物进行活检，发现为聚四氟乙烯肉芽肿。
之前已有关于鼻咽部和声带出现正电子发射断层扫描阳性聚四氟乙烯肉芽肿的报道，对于曾接受聚四氟乙烯注射手术的患者进行鉴别诊断时应考虑到这一点。耳鼻咽喉科医生和放射科医生认识到包括聚四氟乙烯肉芽肿在内的正电子发射断层扫描和计算机断层扫描假阳性结果的潜在原因很重要。
