Miyake Kanae K, Nakamoto Yuji, Kataoka Tatsuki R, Ueshima Chiyuki, Higashi Tatsuya, Terashima Tsuyoshi, Nakatani Koya, Saga Tsuneo, Minami Shunsuke, Togashi Kaori
1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
2 Department of Radiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
AJR Am J Roentgenol. 2016 Dec;207(6):1288-1296. doi: 10.2214/AJR.15.14964. Epub 2016 Sep 22.
The objective of this study was to investigate the clinical, morphologic, and pathologic features associated with increased F-FDG uptake in benign schwannomas.
Twenty-two schwannomas in 22 patients (age range, 25-81 years) who had FDG PET or PET/CT scans and subsequently underwent surgical re-section were retrospectively analyzed. The maximum standardized uptake value (SUV) was compared with patient age, sex, tumor location (gastrointestinal vs nongastrointestinal origin), tumor size, gross appearance, intratumoral cellularity, intratumoral infiltration of inflammatory cells, presence of peritumoral lymphoid cuffs, and expression status of glucose transporters 1 and 3 on tumor cells.
The SUV of schwannomas ranged from 1.5 to 17.3 (median, 3.7). Significantly higher SUV was observed in gastrointestinal schwannomas (n = 4) compared with nongastrointestinal schwannomas (n = 18, p = 0.007) and in schwannomas with peritumoral lymphoid cuffs (n = 5) compared with those without peritumoral lymphoid cuffs (n = 17, p = 0.001). A significant correlation was seen between tumor location and the presence of peritumoral lymphoid cuffs (p < 0.001). Age, sex, tumor size, gross appearance, intratumoral cellularity, intratumoral inflammatory cell infiltration, and expression status of glucose transporters 1 and 3 on tumor cells had no significant correlation with SUV.
Gastrointestinal schwannomas and schwannomas with peritumoral lymphoid cuffs may be associated with elevated FDG uptake. Knowledge of the features of schwannomas associated with increased uptake may be helpful to avoid misinterpretation of benign schwannomas as malignancy.
本研究的目的是调查与良性神经鞘瘤中F-FDG摄取增加相关的临床、形态学和病理学特征。
回顾性分析22例患者（年龄范围25 - 81岁）的22个神经鞘瘤，这些患者均进行了FDG PET或PET/CT扫描，随后接受了手术切除。将最大标准化摄取值（SUV）与患者年龄、性别、肿瘤位置（胃肠道起源与非胃肠道起源）、肿瘤大小、大体外观、瘤内细胞密度、瘤内炎症细胞浸润、瘤周淋巴袖套的存在以及肿瘤细胞上葡萄糖转运蛋白1和3的表达状态进行比较。
神经鞘瘤的SUV范围为1.5至17.3（中位数为3.7）。与非胃肠道神经鞘瘤（n = 18）相比，胃肠道神经鞘瘤（n = 4）的SUV显著更高（p = 0.007）；与无瘤周淋巴袖套的神经鞘瘤（n = 17）相比，有瘤周淋巴袖套的神经鞘瘤（n = 5）的SUV显著更高（p = 0.001）。肿瘤位置与瘤周淋巴袖套的存在之间存在显著相关性（p < 0.001）。年龄、性别、肿瘤大小、大体外观、瘤内细胞密度、瘤内炎症细胞浸润以及肿瘤细胞上葡萄糖转运蛋白1和3的表达状态与SUV均无显著相关性。
胃肠道神经鞘瘤和有瘤周淋巴袖套的神经鞘瘤可能与FDG摄取升高有关。了解与摄取增加相关的神经鞘瘤特征可能有助于避免将良性神经鞘瘤误诊为恶性肿瘤。
