睾丸嗜铬细胞瘤并多发淋巴结及肺转移^18F-FDGPET/CT特征1例并文献复习

18F-FDG PET/CT features on paraganglioma of testis with multiple lymph node and lung metastasis: A case report and literature review

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。

Objective： 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 fi ndings 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.