Aktas G E, Soyluoglu Demir S, Sarikaya A
Trakya University Medical Faculty Hospital, Department of Nuclear Medicine, Turkey.
Trakya University Medical Faculty Hospital, Department of Nuclear Medicine, Turkey.
Rev Esp Med Nucl Imagen Mol. 2016 Mar-Apr;35(2):118-20. doi: 10.1016/j.remn.2015.08.011. Epub 2015 Oct 27.
The (18)F-FDG PET/CT scan has been suggested for whole-body imaging to identify ectopic adrenocorticotrophic hormone secreting tumours, but there are some challenges involved. The case of a patient is presented, who was admitted with the pre-diagnosis of ectopic ACTH syndrome. On the CT, a nodular lesion was detected in the medial segment of the right lung. The FDG uptake of the lesion seemed to be increased visually, but was not pathological quantitatively (SUVmax: 1.8) on the PET/CT. There was also diffuse increased uptake (SUVmax: 14.2) in the enlarged adrenal glands. The lesion was reported as a possible malignant lesion with low FDG affinity, such as a low grade neuroendocrine tumour, while the diffuse enlarged adrenal glands with high uptake were interpreted as diffusely hyperplasic, due to Cushing's syndrome. The patient was treated with a surgical wedge resection. The histopathological diagnosis confirmed that the tumour was a grade 1 well-differentiated neuroendocrine carcinoma.
已建议采用（18）F-FDG PET/CT扫描进行全身成像，以识别异位促肾上腺皮质激素分泌肿瘤，但这也存在一些挑战。本文介绍了一名患者的病例，该患者入院时初步诊断为异位ACTH综合征。在CT上，右肺中叶发现一个结节性病变。该病变的FDG摄取在视觉上似乎增加，但在PET/CT上定量分析并非病理性增高（SUVmax：1.8）。增大的肾上腺也有弥漫性摄取增加（SUVmax：14.2）。该病变被报告为可能是具有低FDG亲和力的恶性病变，如低级别神经内分泌肿瘤，而摄取增加的弥漫性增大肾上腺被解释为由于库欣综合征导致的弥漫性增生。患者接受了手术楔形切除术。组织病理学诊断证实该肿瘤为1级高分化神经内分泌癌。
