Cancer Research and Treatment

Case Report

F-18 FDG PET-positive Fibrous Dysplasia in a Patient with Intestinal Non-Hodgkin's Lymphoma: Mi Kim, Hyeong Su Kim, Jung Han Kim, Joo Hyun Jang, Kook Jin Chung, Mi Kyung Shin, Hee Sung Hwang, Byung Chun Kim, So Young Jung; Cancer Res Treat. 2009;41(3):171-174. Published online September 28, 2009; DOI: https://doi.org/10.4143/crt.2009.41.3.171

Fibrous dysplasia (FD) is a common benign bone disorder of an unclear etiology. It is known that FD can appear without an increased FDG uptake on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). However, there are also several reports that FD showed increased FDG uptake and this mimicked malignant bone involvement on FDG-PET. Herein we describe a case of biopsy-proven FDG-PET positive FD in a patient with intestinal non-Hodgkin's lymphoma (NHL). A 45-year-old woman was diagnosed with intestinal NHL, which was removed by right hemicolectomy. After the operation, the FDG-PET/CT scan showed hypermetabolic activity in the right transverse process of the T10 vertebra. The patient then received a total of 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy every 3 weeks. After completion of the planned chemotherapy, the 2^nd FDG-PET/CT showed increased FDG uptake (SUVmax=6.0 g/mL) of the previous bone lesion. The MR images revealed a T1-hypointense lesion with sharp borders in the same region, and this showed homogenous contrast enhancement on the fat-suppressed T1-weighted images. After the radiologic studies were carefully reviewed, the bone lesion was assumed to be benign such as FD. We performed bone biopsy and the histological examination confirmed the diagnosis of FD. In conclusion, bone lesions with FDG uptake need to be carefully interpreted when evaluating patients with known malignancy.

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Acta Haematologica.2021; 144(2): 212. CrossRef
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International Journal of Oncology.2020;[Epub] CrossRef
Extensive polyostotic fibrous dysplasia evaluated for malignant transformation with99mTc-MDP bone scan and18F-FDG PET/CT
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Jongho Kim, Wengen Chen, Charles Resnik, Vasken Dilsizian, Qing Chen, Amy S. Kimball
Clinical Nuclear Medicine.2015; 40(4): 325. CrossRef
Fibrous dysplasia mimicking vertebral bone metastasis on 18F-FDG PET/computed tomography in a patient with tongue cancer
Ibrahim Guler, Alaaddin Nayman, Gonca Kara Gedik, Mustafa Koplay, Oktay Sari
The Spine Journal.2015; 15(6): 1501. CrossRef
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Sudhir Suman KC, Punit Sharma, Harmandeep Singh, Chandrasekhar Bal, Rakesh Kumar
Nuclear Medicine and Molecular Imaging.2012; 46(4): 318. CrossRef

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Original Article

FDG-PET in Mediastinal Nodal Staging of Non-small Cell Lung Cancer: Correlation of False Results with Histopathologic Finding: Hee Jong Baek, Jin Haeng Chung, Jong Ho Park, Jae Ill Zo, Gi Jeong Cheon, Chang Woon Choi, Sang Moo Lim, Soo Yong Choi, Jong Myeon Hong, Jang Soo Hong; Cancer Res Treat. 2003;35(3):232-238. Published online June 30, 2003; DOI: https://doi.org/10.4143/crt.2003.35.3.232

Abstract PDF

PURPOSE
Mediastinal staging of non-small cell lung cancer can be markedly improved by FDG-PET scan, but the problem of false staging of mediastinal nodes by PET scan in non-small cell lung cancer has not yet been overcome. The aim of this study was to identify the mechanism underlying the false staging of mediastinal nodes by FDG-PET in the case of non-small cell lung cancer. MATERIALS AND METHODS: To evaluate the factors determining the FDG uptake in mediastinal nodes, FDG-PET was performed preoperatively, and mediastinal dissection with pulmonary resection was performed in 62 patients with NSCLC. GLUT-1 expression was studied by immunohistochemistry of the mediastinal nodes (n=111, true positive 31, true negative 41, false positive 27, false negative 12) using the anti-GLUT-1 antibody. The size, percentage of tumor (tumor ratio), labeling index (rate of stained tumor), staining intensity of the tumor, level of follicular hyperplasia, and staining intensity of the follicle center in the mediastinal node were also studied. RESULTS: There was no significant difference in size among the 4 nodal groups (TP, TN, FP, FN), nor in the tumor ratio of the metastatic nodes between the TP and FN groups. The labeling index and staining intensity of the TP group were higher than those of the FN group (Mann-Whitney test, p=.001, p=.007) in the case of the metastatic nodes. The level of follicular hyperplasia of the FP group was higher than that of the TN group in the case of the non-metastatic nodes (p=.000). CONCLUSION: These results suggest that in mediastinal staging of non-small cell lung cancer by FDG-PET, the FN node is associated with low uptake of FDG due to low expression of GLUT-1, and that the FP node is associated with a high level of follicular hyperplasia as a result of there being a reactive change to an inflammatory and/or immune reaction. This is the first report on the mechanism underlying the false results that are sometimes obtained, and which constitute a major problem in the clinical application of FDG-PET to the mediastinal staging of non-small cell lung cancer.

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Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer
Hongsik Kim, Song-Yi Choi, Tae-Young Heo, Kyeong-Rok Kim, Jisun Lee, Min Young Yoo, Taek-Gu Lee, Joung-Ho Han
World Journal of Clinical Cases.2024; 12(5): 931. CrossRef
Associations between GLUT expression and SUV values derived from FDG-PET in different tumors—A systematic review and meta analysis
Hans-Jonas Meyer, Andreas Wienke, Alexey Surov, Pankaj K Singh
PLOS ONE.2019; 14(6): e0217781. CrossRef

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