From the Department of Nuclear Medicine and PET, The Prince of Wales and Sydney Children's Hospitals, Randwick, Australia.
Clin Nucl Med. 2024 Oct 1;49(10):e518-e520. doi: 10.1097/RLU.0000000000005422. Epub 2024 Aug 14.
A 6-month-old boy presented with a left parietal soft tissue swelling and CT findings of multiple calvarial lytic lesions. 18 F-FDG PET/CT demonstrated hypermetabolic lesions in the left parietal, right occipital, and right femoral bones. The left parietal lesion was excised, and pathology was consistent with Langerhans cell histiocytosis. Interim PET assessment following induction chemotherapy demonstrated a "mixed metabolic response" with discordant rise in metabolic activity of the right femoral lesion. Subsequent core biopsy of the femoral lesion revealed a non-Langerhans cell histiocytosis, likely juvenile xanthogranuloma. Here we describe a rare pediatric case of mixed histiocytosis, unveiled by serial 18 F-FDG PET/CT.
一位 6 个月大的男婴因左顶软组织肿胀和 CT 发现多处颅骨溶骨性病变就诊。18 F-FDG PET/CT 显示左顶叶、右枕叶和右股骨的高代谢病灶。左顶叶病变被切除，病理结果与朗格汉斯细胞组织细胞增生症相符。诱导化疗后的临时 PET 评估显示“混合代谢反应”，右侧股骨病变的代谢活性不一致升高。随后对股骨病变进行的核心活检显示为非朗格汉斯细胞组织细胞增生症，可能为幼年黄色肉芽肿。在此，我们描述了一例罕见的儿童混合组织细胞增生症病例，该病例由连续的 18 F-FDG PET/CT 揭示。
