Suga K, Tsukamoto K, Nishigauchi K, Kume N, Matsunaga N, Hayano T, Iwami T
Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan.
J Nucl Med. 1996 Aug;37(8):1361-4.
We encountered a patient with pheochromocytoma associated with a catecholamine-induced cardiomyopathy that developed recurrently bilateral and unilateral pulmonary edema. The diagnosis of pheochromocytoma was made by elevated plasma catecholamine levels and the intense tumor [123I]MIBG uptake and was confirmed at the time of surgery. The patient showed reduced myocardial [123I]MIBG uptake with left ventricular dysfunction, and endomyocardial biopsy findings were consistent with the diagnosis of catecholamine-induced cardiomyopathy. After tumor resection, plasma levels of catecholamine were normalized, and pulmonary edema never recurred, although cardiac dysfunction did not show an improvement on echocardiography. Myocardial and lung [123I]MIBG uptake increased when compared to uptake levels on preoperative scans, but myocardial uptake was still below normal. These findings indicated that over-secreted catecholamines influenced both the heart and lungs. Pheochromocytoma can induce cardiac and lung injuries, and [123I]MIBG scanning may contribute not only to tumor characterization but also to assessing and monitoring the influence of catecholamines on the heart and lungs.
我们遇到一位患有嗜铬细胞瘤并伴有儿茶酚胺诱导性心肌病的患者，该患者反复出现双侧和单侧肺水肿。嗜铬细胞瘤的诊断依据是血浆儿茶酚胺水平升高以及肿瘤对[123I]间碘苄胍（MIBG）的强烈摄取，并在手术时得到证实。患者表现出心肌对[123I]MIBG摄取减少以及左心室功能障碍，心内膜活检结果与儿茶酚胺诱导性心肌病的诊断一致。肿瘤切除后，儿茶酚胺的血浆水平恢复正常，尽管超声心动图显示心脏功能障碍没有改善，但肺水肿再也没有复发。与术前扫描的摄取水平相比，心肌和肺部的[123I]MIBG摄取增加，但心肌摄取仍低于正常水平。这些发现表明，过量分泌的儿茶酚胺对心脏和肺部均有影响。嗜铬细胞瘤可导致心脏和肺部损伤，[123I]MIBG扫描不仅有助于肿瘤的特征描述，还有助于评估和监测儿茶酚胺对心脏和肺部的影响。
