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18 F-FDG PET/CT in Pediatric ALK-Positive Histiocytosis With Isolated CNS Involvement.
Karan Singh1, Kevin London, Jessica Ryan2
1From the Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia.
Clinical Nuclear Medicine
|June 11, 2024
Summary
A rare case of ALK-positive histiocytosis presented as focal seizures in an 11-year-old girl. Imaging revealed a temporal lobe lesion, confirmed by PET/CT and subsequent biopsy.
Area of Science:
- Neurology
- Pediatric Oncology
- Radiology
Background:
- Focal impaired awareness seizures can be caused by various brain pathologies.
- Accurate diagnosis requires integrating clinical presentation with advanced imaging and molecular testing.
Observation:
- An 11-year-old girl experienced focal impaired awareness seizures.
- MRI revealed a left temporal lobe lesion with vasogenic edema.
- 18F-FDG PET/CT showed intense focal uptake in the lesion without systemic hypermetabolism.
Findings:
- Histopathology and molecular analysis confirmed the lesion as anaplastic lymphoma kinase-positive (ALK-positive) histiocytosis.
- The PET/CT findings correlated with the localized nature of the disease.
Implications:
- This case highlights the utility of 18F-FDG PET/CT in evaluating brain lesions of unclear etiology.
- Early diagnosis of ALK-positive histiocytosis is crucial for appropriate management and treatment planning in pediatric patients.
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