[18F-FDG PET/CT Features on Paraganglioma of Testis With Multiple Lymph Node and Lung Metastasis: A Case Report and Literature Review]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Oct 28;43(10):1164-1168. doi: 10.11817/j.issn.1672-7347.2018.10.019.
[Article in Chinese]

Abstract

To determine the clinicopathological and imaging features in 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET/CT) for paraganglioma of testis, and to increase the diagnostic accuracy. Methods: A case of paraganglioma of testis with multiple lymph node and lung metastasis were reported. PET/CT and pathological findings in the case were retrospectively analyzed. Results: The patient presented with high blood pressure, high level of catecholamine, and urinary vanillylmandelic acid. The patient underwent 18F-FDG PET/CT, which showed the features including the right testis nodule with a star lesion nearby, the right spermatic cord, the lymphadenopathy of bilateral inguinal and retroperitoneum, the posterior basal segment of right lung nodule, and a lot of brown adipose tissues (BAT) in the whole body with intense FDG uptake. 18F-FDG PET/CT showed that the intense FDG uptake of the BAT disappeared after the excision of the right testis and metastasis of paraganglioma. Conclusion: PET/CT shows great value in localization diagnose, clinical staging and curative evaluation. PET/CT plays a helpful role in revealing the BAT with 18F-DG avidity in the patients with paraganglioma with elevated blood pressure, high level catecholamine, and urinary vanillylmandelic acid.

目的:探讨睾丸异位嗜铬细胞瘤的18F-氟-2-脱氧葡萄糖(18F-fluroro-2-deoxyglucose,18F-FDG)正电子发射断层成像-计算机断层成像(positron emission tomography and computed tomography,PET/CT)特点,以提高对其诊断水平。方法:报告1例病理确诊为异位嗜铬细胞瘤并多发淋巴结及肺转移的患者资料。结果:患者有典型的血压升高症状,血儿茶酚胺及尿香草扁桃酸值显著升高。PET/CT检查发现患者右侧睾丸糖代谢增高的软组织结节,邻近伴1个子灶,右侧精索可见糖代谢增高的肿块,双侧腹股沟区及腹膜后多发糖代谢增高的淋巴结,右肺下叶后基底段糖代谢增高的结节,全身多处可见糖代谢弥漫性增高的棕色脂肪影;右侧睾丸异位嗜铬细胞瘤原发灶与转移灶切除后PET/CT检查则可见棕色脂肪组织糖代谢增高表现消失。结论:PET/CT检查对异位嗜铬细胞瘤原发灶的定位诊断、临床分期与疗效评估有着较好的价值,而棕色脂肪组织的18F-FDG摄取增高对异位嗜铬细胞瘤的定性诊断具有一定的提示作用。.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Fluorodeoxyglucose F18*
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Neoplasm Staging
  • Paraganglioma / diagnostic imaging*
  • Paraganglioma / surgery
  • Positron Emission Tomography Computed Tomography*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Testicular Neoplasms* / diagnostic imaging
  • Testicular Neoplasms* / surgery
  • Testis / diagnostic imaging*
  • Testis / surgery

Substances

  • Fluorodeoxyglucose F18