Yamamoto Y, Isobe Y, Nishiyama Y, Takashima H, Ohkawa M, Kihara M, Matsusaka K, Miyauchi A, Kobayashi S, Tanabe M
Department of Radiology, Kagawa Medical University, Japan.
Clin Nucl Med. 1998 Jan;23(1):13-5. doi: 10.1097/00003072-199801000-00005.
A 16-year-old boy had a swollen neck that was a result of multiple endocrine neoplasia Type 2B (MEN 2B). CT revealed bilateral thyroid tumors, swelling of right cervical lymph nodes, and slight enlargement of the right adrenal gland. I-131 metaiodobenzylguanidine (MIBG) scintigraphy demonstrated increased uptake in the right adrenal gland and the left thyroid tumor, but no abnormal uptake in the right thyroid tumor and the right cervical lymph nodes. Postoperative pathologic findings were consistent with the diagnosis of right adrenal medullary hyperplasia, which is a precursor of pheochromocytoma. In patients with MEN 2B, I-131 MIBG scintigraphy in conjunction with CT of the adrenal glands should be performed to determine the disease stage of the adrenal medullae. In the cervical region, the diagnosis was medullary thyroid carcinoma (MTC) in both thyroid tumors and metastases in the right cervical lymph nodes. The right MTC was more aggressive than the left MTC. It is interesting that not all sites of known MTC take up I-131 MIBG to the same degree.
一名16岁男孩颈部肿胀，系2B型多发性内分泌腺瘤病（MEN 2B）所致。CT显示双侧甲状腺肿瘤、右侧颈部淋巴结肿大及右侧肾上腺轻度增大。I-131间碘苄胍（MIBG）闪烁显像显示右侧肾上腺及左侧甲状腺肿瘤摄取增加，但右侧甲状腺肿瘤及右侧颈部淋巴结未见异常摄取。术后病理结果与右肾上腺髓质增生的诊断相符，肾上腺髓质增生是嗜铬细胞瘤的前驱病变。对于MEN 2B患者，应行I-131 MIBG闪烁显像联合肾上腺CT检查以确定肾上腺髓质的疾病分期。在颈部区域，双侧甲状腺肿瘤诊断为甲状腺髓样癌（MTC），右侧颈部淋巴结为转移灶。右侧MTC比左侧MTC侵袭性更强。有趣的是，并非所有已知的MTC部位对I-131 MIBG的摄取程度都相同。
