Abstract:
A 57 years old woman was diagnosed with well-differentiated lung neuroendocrine tumor (NET) by laboratory assessment, computed tomography (CT), contrast-enhanced magnetic resonance imaging (MRI) and bronchoscophy with transbroncial biopsy of nodular lung lesion located in the right lower lobe. Staging Ga-68 positron emission tomography-CT (PET-CT) showed two pathological uptake regions in the superior segment of the right lung lower lobe (SUVmax: 80.61) and 6th thoracic vertebral body (SUVmax: 3.70). Contrast-enhanced MRI findings suggested that vertebral lesion may be compatible with atypical hemangioma or osseous metastasis due to T1 isointensity, T2 hyperintensity and contrast-enhancement on the lesion. Therefore, characteristic imaging findings of hemangioma were seen on axial and sagittal or coronal sections of CT, respectively called as \'polka dot\' and \'corduroy cloth\'. Thus the mild vertebral Ga-68 DOTATATE uptake was accepted as false positive finding. Surgical intervention was decided. She underwent a right lung lobectomy. The last follow-up of the patient was done 2 years after the initial diagnosis. The follow-up Ga-68 DOTATATE PET-CT revealed no pathological increased uptake in the whole-body except the 6th vertebra showing similar uptake (SUVmax: 3.50) with the previous scan without size increase on CT. The patient was asymptomatic with normal serum chromogranin A level.
摘要:
一名57岁的女性通过实验室评估被诊断为高分化肺神经内分泌肿瘤(NET),计算机断层扫描(CT),位于右下叶的结节性肺病变的增强磁共振成像(MRI)和支气管镜活检。分期Ga-68正电子发射断层扫描(PET-CT)显示右肺下叶上段(SUVmax:80.61)和第6胸椎椎体(SUVmax:3.70)有两个病理摄取区。MRI造影结果提示椎体病变可能与T1等强度引起的非典型血管瘤或骨转移有关。病变的T2高强度和对比增强。因此,血管瘤的特征性影像学表现可见于CT的轴向和矢状面或冠状面,分别称为“波尔卡圆点”和“灯芯绒布”。因此,轻度的椎骨Ga-68DOTATATE摄取被认为是假阳性发现。决定手术干预。她接受了右肺叶切除术。患者的最后一次随访是在最初诊断后2年进行的。随访的Ga-68DOTATATEPET-CT显示,除第6椎骨显示与先前扫描相似的摄取(SUVmax:3.50)外,全身无病理性摄取增加。患者无症状,血清嗜铬粒蛋白A水平正常。