[18F]-FDG PET/CT in a case of metastatic extrahepatic bile duct cancer from sigmoid carcinoma
- PDF / 340,904 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 6 Downloads / 163 Views
IMAGE OF THE MONTH
[18F]-FDG PET/CT in a case of metastatic extrahepatic bile duct cancer from sigmoid carcinoma Honghong Liu 1 & Haodan Dang 1 & Jing Ning 1 & Xirui Huang 2 & Yue Wu 3 & Baixuan Xu 1 Received: 14 July 2020 / Accepted: 1 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
A 65-year-old male patient had resections of primary sigmoid adenocarcinoma and liver metastasis in January 2006 and October 2017 respectively. The hilar cholangiectasis was demonstrated on MRI 8 months after the last operation with unconspicuous clinical symptoms and even normal carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels. In this scenario, [18F]-FDG PET/CT (Biograph 64, Siemens, Knoxville, TN, Germany) was performed so as to get a better understanding of its pathogeny. The maximal intensity projection (MIP) image showed significantly increased FDG uptake in the right upper abdomen
(Fig. 1a, arrow). A nodule with a size of 2.1 cm × 1.7 cm × 2.6 cm was found in the hilar bile duct (Fig. 1b–d, arrow) on CT and its SUVmax was 37.7 on PET and fused PET/CT (Fig. 1e–j, arrow). The hilar nodule turned out to be a metastasis from sigmoid carcinoma by postoperative histopathology. H&E-stained photomicrographs indicated the glandular arrangement of morphologically heterogeneous cancer cells (Fig. 1k, × 40; and l, × 200). Besides, immunohistochemical examination showed a strong positive staining for CDX-2 (Fig. 1m, × 40) and villin (Fig. 1n, × 40), and focal positive staining for CK20 (Fig. 1o, × 40).
This article is part of the Topical Collection on Image of the month. Honghong Liu is the first author. * Baixuan Xu [email protected] Honghong Liu [email protected]
Yue Wu [email protected]
1
Department of Nuclear Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
2
Department of Pathology, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
3
Siemens Healthineers Ltd, Beijing 100102, China
Haodan Dang [email protected] Jing Ning [email protected] Xirui Huang [email protected]
Eur J Nucl Med Mol Imaging
In clinic, bile duct metastases are extremely rare and easily misdiagnosed [1–4]. To our best knowledge, this case is the first report initially detected by PET/CT. Some researchers indicated the probability of intraductal metastases in the patient with a history of colorectal cancer [5]. Accordingly, this is a similar case. Surgery is the primary treatment of metastatic extrahepatic lesions, which may fail to improve patients’ prognosis, though [5].
Compliance with ethical standards Conflict of interest Yue Wu is employed at Siemens Healthcare Ltd. All other authors of this manuscript declare no relationships with any company and no financial interests related to the subject matter of the article. Informed consent Informed written consent was obtained from the patient for the publication of this image of the month and related images and histopathological data.
Eur J Nucl Med Mol Imaging
Re
Data Loading...
