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氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）中不典型结节病累及：一例报告

An atypical sarcoidosis involvement in FDG PET/CT: A case report.

作者信息

Robin Philippe, Benigni Paolo, Feger Benoit, Salaun Pierre-Yves, Abgral Ronan

机构信息

Département de Médecine Nucléaire, EA3878 (GETBO) IFR 148, Centre Hospitalier Régional Universitaire de Brest, France Département d'Anatomie Pathologique, Centre Hospitalier Régional Universitaire de Brest Service d'Oto-Rhino-Laryngologie, Clinique Pasteur, Brest, France.

出版信息

Medicine (Baltimore). 2016 Dec;95(52):e5700. doi: 10.1097/MD.0000000000005700.

DOI:10.1097/MD.0000000000005700
PMID:28033265
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5207561/
Abstract

RATIONALE

Sarcoidosis is an idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis which involve various organs. Laryngeal involvement is extremely rare, with a prevalence of about 0.5 to 1%.

DIAGNOSES

Here we present a case of laryngeal involvement of sarcoidosis demonstrated on F-Fluorodesoxyglucose Positron-Emission Tomography/Computed Tomography (FDG PET/CT).

PATIENT CONCERNS

A 63 year-old man suffering from dysphonia was referred to our department for characterization of laryngeal lesion suspicious for cancer with non-informative biopsy, the sample was not sufficient for diagnosis.

INTERVENTIONS

FDG PET/CT showed a pathological uptake on the right vocal cord, but also highlighted a bilateral uptake in intrathoracic hilar lymphadenopathy areas, typically found in several inflammatory diseases.

OUTCOMES

New laryngeal targeted biopsies revealed non-caseating epithelioid granulomas suggesting sarcoidosis involvement. After 6 months of systemic steroid treatment, FDG PET/CT showed a significant decrease of the laryngeal uptake.

LESSONS

This case shows the usefulness of FDG PET/CT to accurately assess inflammatory activity in rare extra-pulmonary sarcoidosis involvement. Moreover, this case emphasizes that FDG PET/CT is an interesting tool for assessing therapeutic efficacy of inflammatory diseases such as sarcoidosis.

摘要

原理

结节病是一种特发性全身性炎症性肉芽肿疾病，由上皮样细胞和多核巨细胞组成，坏死极少，可累及多个器官。喉部受累极为罕见，患病率约为0.5%至1%。

诊断

在此，我们报告一例通过氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）显示的结节病喉部受累病例。

患者情况

一名63岁男性，因声音嘶哑就诊于我科，其喉部病变活检结果不明确，样本不足以诊断，怀疑为癌症。

干预措施

FDG PET/CT显示右侧声带存在病理性摄取，同时还突出显示了双侧胸腔内肺门淋巴结病变区域的摄取，这在几种炎症性疾病中较为常见。

结果

新的喉部靶向活检显示非干酪样上皮样肉芽肿，提示结节病受累。经过6个月的全身类固醇治疗后，FDG PET/CT显示喉部摄取显著降低。

经验教训

该病例显示了FDG PET/CT在准确评估罕见的肺外结节病受累炎症活动方面的有用性。此外，该病例强调FDG PET/CT是评估结节病等炎症性疾病治疗效果的一种有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/c7e8f875a952/medi-95-e5700-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/d73a8c547182/medi-95-e5700-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/35952784608b/medi-95-e5700-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/c7e8f875a952/medi-95-e5700-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/d73a8c547182/medi-95-e5700-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/35952784608b/medi-95-e5700-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/5207561/c7e8f875a952/medi-95-e5700-g003.jpg

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