Department of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
Clin Nucl Med. 2011 Mar;36(3):248-51. doi: 10.1097/RLU.0b013e318208f746.
A 42-year-old man with a history of chronic smoking and alcoholism was suspected to harbor a malignancy involving the perioral region and the scalp. He underwent an F-18 FDG PET/CT scan which revealed abnormal F-18 FDG accumulation in the oral mucosa and lips, extending to the nose, scalp, and bilateral cervical lymph nodes. Further work-up ultimately revealed the lesions to be secondary to pemphigus vegetans. Pemphigus vegetans is a rare variant of pemphigus vulgaris, an autoimmune bullous cutaneous disorder and involves mainly the flexural regions of the body. Unlike pemphigus vulgaris, lesions of pemphigus vegetans present as heaped up, eroded, and ulcerative plaques in the intertriginous regions of the body. Occasional lesions may be present on scalp and elsewhere in the Hallopeau variant of the disease. The use of F-18 FDG PET in the field of oncology is rapidly evolving; however, it is not tumor specific. The integration of CT into PET has increased the specificity of this modality. Nevertheless, there are many physiologic and benign conditions that may result in high accumulation of FDG, and may mimic malignancy. Familiarity with F-18 FDG-avid nonmalignant lesions may extend the use of F-18 FDG PET imaging beyond the field of oncology. To the best of our knowledge, this is the first description of PET/CT findings in pemphigus vegetans.
一位 42 岁的男性，有慢性吸烟和酗酒史，被怀疑患有涉及口周和头皮的恶性肿瘤。他接受了 F-18 FDG PET/CT 扫描，结果显示口腔黏膜和嘴唇异常积聚 F-18 FDG，延伸至鼻子、头皮和双侧颈部淋巴结。进一步检查最终显示这些病变是天疱疮的继发表现。天疱疮是寻常型天疱疮的一种罕见变异，是一种自身免疫性大疱性皮肤病，主要累及身体的弯曲部位。与寻常型天疱疮不同，天疱疮的病变表现为堆积、侵蚀和溃疡的斑块，位于身体的皱褶部位。在 Hallopeau 变异型疾病中，偶尔会在头皮和其他部位出现病变。F-18 FDG PET 在肿瘤学领域的应用正在迅速发展；然而，它不是肿瘤特异性的。CT 与 PET 的结合提高了这种方式的特异性。尽管如此，有许多生理和良性情况可能导致 FDG 高度积聚，并可能模拟恶性肿瘤。熟悉 F-18 FDG 摄取的非恶性病变可能会扩大 F-18 FDG PET 成像在肿瘤学领域之外的应用。据我们所知，这是天疱疮的 PET/CT 表现的首次描述。
