Chang Chian A, Kumar Beena, Nandurkar Deepali
From the Department of Nuclear Medicine (CAC, DN); and Department of Anatomical Pathology (BK), Monash Health, Melbourne, Australia.
Medicine (Baltimore). 2015 Jun;94(23):e412. doi: 10.1097/MD.0000000000000412.
Progressive transformation of the germinal centers (PTGC) is a benign reaction pattern in lymph nodes. An association with Hodgkin disease (HD) has been reported and PTGC may precede, coexist, or present after the diagnosis of HD. This case report describes a patient who presented with unprovoked pulmonary embolism and subsequent investigations showed a solitary abdominal mass, which was subsequently proven to be PTGC. PTGC is usually avid on fluorine-18-labeled fluorodeoxyglucose positron emission tomography with computed tomography for attenuation correction and may be mistaken for neoplastic disease. Being a reactive etiology, the metabolic activity is generally low with a low maximum standardized uptake value (SUVmax), but in our case, the metabolic activity and corresponding SUVmax were relatively high making the diagnosis difficult, as most clinicians would consider a high metabolically active process more likely malignant. Recognition of PTGC is important, as it is not a malignant process. Owing to its reported associations, however, patients with this diagnosis will likely require regular surveillance.
生发中心进行性转化（PTGC）是淋巴结中的一种良性反应模式。已有报道称其与霍奇金病（HD）相关，且PTGC可能在HD诊断之前、同时存在或在HD诊断之后出现。本病例报告描述了一名患者，该患者无故出现肺栓塞，随后的检查显示有一个孤立的腹部肿块，后来证实为PTGC。PTGC在用于衰减校正的氟-18标记氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描中通常表现为摄取活跃，可能会被误诊为肿瘤性疾病。作为一种反应性病因，其代谢活性通常较低，最大标准化摄取值（SUVmax）也较低，但在我们的病例中，代谢活性和相应的SUVmax相对较高，这使得诊断困难，因为大多数临床医生会认为代谢活跃程度高的病变更可能是恶性的。认识PTGC很重要，因为它不是恶性过程。然而，由于其已报道的相关性，患有这种诊断的患者可能需要定期监测。
