Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Ann Nucl Med. 2012 Dec;26(10):835-9. doi: 10.1007/s12149-012-0644-x. Epub 2012 Aug 15.
A 26-year-old female who had had a hydatidiform mole at 20 years of age showed high levels of serum human chorionic gonadotropin. Because pelvic ultrasound did not show any gestational sac in her uterus, she was suspected to have had an extrauterine pregnancy and a spontaneous abortion. About 6 months later, a pulmonary nodule in the patient's right upper lung field was found on a routine chest X-ray film. Contrast- enhanced CT scans revealed a solitary lobulated nodule 2.0 × 1.3 × 3.0 cm in diameter in the S2 segment of the right lung. CT suggested a vessel malformation. Positron emission tomography using 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG-PET) was performed and showed weak FDG accumulation (SUVmax = 2.0) in the nodule, which did not positively indicate malignancy. Because a follow-up CT showed a rapid increase in the size of the nodule, partial resection of S2 segment in the right upper lobe was performed. The histopathological diagnosis was a metastasis from choriocarcinoma. The tumor consisted largely of necrosis and hemorrhage, and it was considered to be a major cause of the unusual FDG-PET and CT findings.
一位 26 岁的女性，20 岁时曾患有葡萄胎，血清人绒毛膜促性腺激素水平升高。由于盆腔超声检查未在其子宫内发现妊娠囊，故怀疑其患有异位妊娠和自然流产。大约 6 个月后，患者常规胸片显示右上肺野有一个肺结节。增强 CT 扫描显示右肺 S2 段有一个直径 2.0×1.3×3.0cm 的孤立分叶状结节。CT 提示血管畸形。使用 2-脱氧-2-[(18)F]氟-D-葡萄糖（FDG-PET）进行正电子发射断层扫描显示结节内有较弱的 FDG 聚集（SUVmax=2.0），但不能明确提示恶性肿瘤。由于随访 CT 显示结节大小迅速增大，行右上肺 S2 段部分切除术。组织病理学诊断为绒毛膜癌转移。肿瘤主要由坏死和出血组成，这被认为是 FDG-PET 和 CT 结果异常的主要原因。
