From the Nuclear Medicine Department, NOVA Diagnóstico por Imagem, João Pessoa.
Internal Medicine Department, Universidade Federal da Paraíba-UFPE, João Pessoa, Brazil.
Clin Nucl Med. 2020 Nov;45(11):868-870. doi: 10.1097/RLU.0000000000003277.
A 35-year-old woman with rectal neuroendocrine tumor, Ki-67 proliferation index less than 2%, and a mediastinal mass on CT postoperatively was referred for restaging with PET/CT Ga-DOTATATE. The examination showed uptake on the pelvic lymph node and mediastinal mass. Because of differences in lesions' SUVs and clinical presentation, the hypothesis of lymphoma for the mediastinal mass was raised, and F-FDG PET/CT was performed, which showed glycolytic hypermetabolism in the mediastinal mass and absence of hypermetabolism in pelvic lymph nodes. Transthoracic biopsy of the mass revealed atypical large-cell lymphoid proliferation, and immunohistochemistry study was compatible with Castleman disease.
一位 35 岁女性，直肠神经内分泌肿瘤，Ki-67 增殖指数小于 2%，术后 CT 发现纵隔肿块，行 Ga-DOTATATE PET/CT 检查行分期。检查显示盆腔淋巴结和纵隔肿块摄取。由于病变 SUV 值和临床表现不同，提出纵隔肿块为淋巴瘤的假说，并进行 F-FDG PET/CT 检查，显示纵隔肿块葡萄糖代谢增高，盆腔淋巴结无代谢增高。肿块经胸壁活检显示非典型大细胞淋巴样增生，免疫组化研究符合血管滤泡性淋巴结增生症。
