Jung Hee Soo, Moon Seok Jun, Kim Yun Mi, Kang Hye Rim, Lee Seok Mo, Jung Soo Jin, Choi Seok Jin, Kim Tae Kyoon, Kwon Min Jeong, Park Jeong Hyun, Lee Soon Hee
Department of Internal Medicine, College of Medicine, Inje University, Busan 614-735, Republic of Korea.
Department of Nuclear Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan 614-735, Republic of Korea.
Case Rep Oncol Med. 2015;2015:164280. doi: 10.1155/2015/164280. Epub 2015 Mar 30.
(123)I-Metaiodobenzylguanidine ((123)I-MIBG) scintigraphy is a widely used functional imaging tool with a high degree of sensitivity and specificity in diagnosis of pheochromocytoma. However, rare cases of false positive reactions have been reported. A 67-year-old male patient was admitted with epigastric pain. Abdominal computed tomography (CT) revealed a heterogeneous left adrenal mass 6 cm in diameter; following hormone testing, (123)I-MIBG scintigraphy was performed to determine the presence of pheochromocytoma, which confirmed eccentric uptake by a large left adrenal gland mass. Chest CT and PET-CT confirmed metastatic lymphadenopathy; therefore, endobronchial ultrasound transbronchial needle aspiration was performed. Metastatic carcinoma of unknown origin was suspected from a lymph node biopsy, and surgical resection was performed for definitive diagnosis and correction of excess hormonal secretion. A final diagnosis of undifferentiated adrenal malignant tumor was rendered, instead of histologically malignant pheochromocytoma, despite the uptake of (123)I-MIBG demonstrated by scintigraphy.
（123）I-间碘苄胍（（123）I-MIBG）闪烁扫描术是一种广泛应用的功能成像工具，在嗜铬细胞瘤的诊断中具有高度的敏感性和特异性。然而，已有罕见的假阳性反应病例报道。一名67岁男性患者因上腹部疼痛入院。腹部计算机断层扫描（CT）显示左肾上腺有一个直径6厘米的不均匀肿块；激素检测后，进行了（123）I-MIBG闪烁扫描术以确定嗜铬细胞瘤的存在，结果证实左肾上腺一个大肿块有偏心摄取。胸部CT和PET-CT证实有转移性淋巴结病；因此，进行了支气管内超声引导下经支气管针吸活检。淋巴结活检怀疑为不明来源的转移性癌，并进行了手术切除以明确诊断并纠正激素分泌过多。尽管闪烁扫描术显示有（123）I-MIBG摄取，但最终诊断为未分化肾上腺恶性肿瘤，而非组织学上恶性的嗜铬细胞瘤。
