Koukalová R, Szturz P, Svobodová I, Stulík J, Řehák Z
Klin Onkol. 2016;29(3):216-9. doi: 10.14735/amko2016216.
Amyloidosis is a disease characterized by deposits of abnormal protein known as amyloid in various organs and tissues. It can be classified into systemic or localized forms, the latter of which is less frequent. Deposition of amyloidogenic monoclonal light chains leads to the most common type of this disease called light-chain (AL) amyloidosis. (18)F-FDG positron emission tomography/ computed tomography hybrid imaging (FDG-PET/ CT) demonstrates tracer uptake usually in all patients with localized amyloidosis as opposed to the systemic form.
Herein, we present a case of an otherwise healthy 56-year-old women diagnosed with a nasal polyp on the right side. The biopsy results were consistent with amyloidosis. FDG-PET/ CT imaging revealed a pathological, metabolically active lesion measuring 11 × 9 mm with a maximum standardized uptake value (SUV(max)) of 3.47. No other distant pathological changes were identified. After a radical resection, the patient has been regularly followed-up with clinical and imaging methods (MRI, FDG-PET/ CT), both of which repeatedly showed normal findings with disease-free survival of 27 months. Thus, FDG-PET/ CT imaging plays an important role not only for obtaining the right diagnosis but also in the follow-up of patients after surgical resection. In accordance with the literature, this case report confirms that FDG-PET/ CT imaging holds promise as an auxiliary method for distinguishing between localized and systemic forms of amyloidosis.
淀粉样变性是一种以在各种器官和组织中沉积异常蛋白质(即淀粉样蛋白)为特征的疾病。它可分为系统性或局限性形式,后者较为少见。淀粉样生成单克隆轻链的沉积导致了这种疾病最常见的类型,即轻链(AL)淀粉样变性。(18)F-FDG正电子发射断层扫描/计算机断层扫描混合成像(FDG-PET/CT)显示,与系统性淀粉样变性不同,通常所有局限性淀粉样变性患者的示踪剂均有摄取。
在此,我们报告一例56岁健康女性,诊断为右侧鼻息肉。活检结果与淀粉样变性一致。FDG-PET/CT成像显示一个大小为11×9mm、最大标准化摄取值(SUV(max))为3.47的病理性、代谢活跃病变。未发现其他远处病理性改变。根治性切除术后,对患者进行了定期的临床和影像学随访(MRI、FDG-PET/CT),两者均反复显示正常结果,无病生存期为27个月。因此,FDG-PET/CT成像不仅在正确诊断中发挥重要作用,而且在手术切除后患者的随访中也发挥重要作用。根据文献,本病例报告证实FDG-PET/CT成像有望作为区分局限性和系统性淀粉样变性的辅助方法。