Kairemo Kalevi, Wang Wei-Lien, Subbiah Vivek
Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Division of Pathology/Lab Medicine, Department of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
BMJ Case Rep. 2019 Apr 23;12(4):e218839. doi: 10.1136/bcr-2016-218839.
Malignant transformation of giant cell tumour of the bone is extremely rare. In addition, bone transformation in giant cell tumour may occur in different phases. With conventional X-rays, CT scans or MRIs, it may be challenging to distinguish among different phases of bone transformation, normal bone, soft tissue disease and bone disease (benign vs malignant lesions) and changes in multiple organs such as lung, liver and lymph nodes unless every lesion is biopsied, which is not practical. Molecular imaging with different isotopes (Tc-99m phosphonate, 2-deoxy-2-(F)fluoro-d-glucose and sodium fluoride-18) may help to better characterise the disease. We hypothesised that molecular imaging could offer qualitative and quantitative characterisation of all stages of bone formation, destruction, reactivity or neoplasia in a patient with giant cell tumour of the bone, and we present the first case of molecular imaging where bone formation was seen in multiple soft tissues, such as lungs, muscles, lymph nodes and liver.
骨巨细胞瘤的恶性转化极为罕见。此外，骨巨细胞瘤中的骨质改变可能发生在不同阶段。使用传统的X线、CT扫描或MRI，除非对每个病变进行活检（这并不实际），否则区分骨质改变的不同阶段、正常骨质、软组织疾病和骨疾病（良性与恶性病变）以及肺、肝和淋巴结等多个器官的变化可能具有挑战性。使用不同的同位素（锝-99m膦酸盐、2-脱氧-2-（氟）氟-D-葡萄糖和氟化钠-18）进行分子成像可能有助于更好地表征该疾病。我们假设分子成像能够对骨巨细胞瘤患者骨质形成、破坏、反应性或肿瘤形成的所有阶段进行定性和定量表征，并且我们展示了首例在多个软组织（如肺、肌肉、淋巴结和肝脏）中观察到骨质形成的分子成像病例。
