在死性肺质中使用PET/CT引导的活检:一个诊断突破
Anurag Jain1, Kunal Kumar2, Divya Gupta3
1Department of Nuclear Medicine, Command Hospital, Lucknow, Uttar Pradesh, India.
概括
诊断中心死性肺瘤可能具有挑战性. 这一案例凸显了从此类病变中获取诊断组织样本的困难,强调了综合临床,成像和组织学相关性的必要性.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 一名60岁的非吸烟男性出现胸痛,咳和体重减轻.
- 最初的胸部X射线图显示了可疑的右上叶质量.
- 先进的成像证实了一个大,代谢活跃的病变,暗示恶性瘤.
研究的目的:
- 描述一个充满挑战的肺癌诊断案例.
- 为了说明从死瘤中获得组织的困难.
- 强调将成像与临床和组织学发现的相关性的重要性.
主要方法:
- 使用了对比增强计算机断层扫描 (CT) 和全身18F-氧糖正子发射断层扫描 (FDG PET).
- 进行了辐射内支气管超声波 (EBUS) 引导的横支气管肺活检.
- 在初步结果不确定的情况下,CT引导的皮肤透析活检进行.
主要成果:
- 图像检测显示出一个具有高代谢活性的大型状质量 (SUVmax 8.4).
- 最初的EBUS导向活检给出了不确定的组织病理学结果.
- 随后的CT导向活检只发现了死细胞物质,缺乏可活的瘤细胞.
结论:
- 中枢死的瘤带来了重大的诊断挑战.
- 重复的活检试图可能无法产生诊断组织.
- 图像,临床表现和组织学的综合相关性对于诊断至关重要.
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