- 期刊
FDG PET/CT Demonstrates Malignant Fibrous Histiocytoma in a Patient with Nasopharyngeal Carcinoma after Radiation Therapy
氟－18-FDG正子電腦斷層造影偵測罕見鼻竇惡性纖維組織細胞瘤
摘要
一位25歲男性鼻咽癌病人，在接受8,2000 cGy放射線治療五年後因一鼻腔內凸出腫塊，被轉介至本院正子中心進行評估，氟－18去氧葡萄糖正子電腦斷層造影發現右鼻竇有一處葡萄糖代謝增加之病灶，推測為鼻咽癌復發。然經病理組織切片檢查發現是急性纖維組織細胞瘤，回顧文獻其致病原因可能和先前的放射治療有關。此結果提醒我們在判別這類曾接受過放射線治療病人的影像時，要將急性纖維組織細胞瘤列入鑑別診斷；氟－18去氧葡萄糖正子電腦斷層造影則是偵測出患身上是否患有第二種腫瘤（如急性纖維組織細胞瘤）之有效工具。再者，急性纖維組織細胞瘤是一種少見的惡性腫瘤，一般見於四肢及後腹腔，通常以單一無症狀的腫瘤呈現患者多為中老年人，少見於年輕人。本病例為一發生在年輕男性鼻咽癌病患，罕見之鼻竇惡性纖維組織細胞瘤報告。
並列摘要
A 25-year-old young male is a victim of undifferentiated nasopharyngeal carcinoma (NPC) s/p an 8,200 cGy external radiation therapy about 5 years ago, who was referred to our positron emission tomography (PET) center for evaluating a protruding mass in his nasal cavity. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging incidentally demonstrated a hypermetabolic lesion in the right nasal cavity and right maxillary sinus, which was suggestive of tumor recurrence. However, the surgical pathology report showed a picture of moderately differentiated sarcoma characterized by bizarre tumor giant cells, abnormal mitotic figure and intermixed with inflammatory cells. The immunohistochemical stains of the tumor cells showed positive for vimentin, which was compatible with malignant fibrous histiocytoma (MHF). Since radiation therapy is a well-known risk factor of MFH, which remind us that MFH should be ruled out in a NPC patient post radiotherapy and PET/CT scan is a valuable modality in detecting a second cancer, such as MFH. Furthermore, MFH usually happen to aged subgroup at limbs and retroperitoneum, our report presented rare case of a young male with MFH involving maxillary sinus and nasal cavity.
延伸閱讀
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