Clinical, Morphologic, and Pathologic Features Associated With Increased FDG Uptake in Schwannoma
Clinical, Morphologic, and Pathologic Features Associated With Increased FDG Uptake in Schwannoma
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DOI：
10.2214/ajr.15.14964
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发表时间：
2016-12-01
影响因子：
5
通讯作者：
Togashi, Kaori
中科院分区：
文献类型：
--
作者：
Miyake, Kanae K.;Nakamoto, Yuji;Togashi, Kaori
目标。本研究的目的是探讨与良性神经鞘瘤摄取F-18-FDG增加相关的临床、形态和病理特征。对22例患者(年龄25-81岁)的22例神经鞘瘤患者进行了FDGPET或PET/CT扫描，并进行了手术切除。比较最大标准化摄取值(SUVmax)与患者的年龄、性别、肿瘤部位(胃肠道与非胃肠道起源)、肿瘤大小、大体形态、瘤内细胞密度、瘤内炎细胞浸润、瘤周淋巴袖带的存在以及肿瘤细胞上葡萄糖转运蛋白1和3的表达情况。结果：神经鞘瘤的SUVmax范围为1.5~17.3(中位数3.7)。胃肠道神经鞘瘤(n=4)较非胃肠道神经鞘瘤(n=18，p=0.007)及有淋巴袖套的神经鞘瘤(n=5)较无淋巴袖套的神经鞘瘤(n=17，p=0.001)的最大血流速度明显升高。肿瘤的位置和瘤周淋巴袖带的存在有显著的相关性(p<；0.001)。年龄、性别、肿瘤大小、大体形态、瘤内细胞密度、瘤内炎性细胞浸润、瘤细胞上葡萄糖转运蛋白1和3的表达状态与SUVmax无明显相关性。结论胃肠神经鞘瘤和伴有瘤周淋巴袖带的神经鞘瘤可能与FDG摄取升高有关。了解与摄取增加相关的神经鞘瘤的特征可能有助于避免将良性神经鞘瘤误解为恶性肿瘤。
OBJECTIVE. The objective of this study was to investigate the clinical, morphologic, and pathologic features associated with increased F-18-FDG uptake in benign schwannomas.MATERIALS AND METHODS. Twenty-two schwannomas in 22 patients (age range, 25-81 years) who had FDG PET or PET/CT scans and subsequently underwent surgical resection were retrospectively analyzed. The maximum standardized uptake value (SUVmax) was compared with patient age, sex, tumor location (gastrointestinal vs nongastrointestinal origin), tumor size, gross appearance, intratumoral cellularity, intratumoral infiltration of inflammatory cells, presence of peritumoral lymphoid cuffs, and expression status of glucose transporters 1 and 3 on tumor cells.RESULTS. The SUVmax of schwannomas ranged from 1.5 to 17.3 (median, 3.7). Significantly higher SUVmax was observed in gastrointestinal schwannomas (n = 4) compared with nongastrointestinal schwannomas (n = 18, p = 0.007) and in schwannomas with peritumoral lymphoid cuffs (n = 5) compared with those without peritumoral lymphoid cuffs (n = 17, p = 0.001). A significant correlation was seen between tumor location and the presence of peritumoral lymphoid cuffs (p < 0.001). Age, sex, tumor size, gross appearance, intratumoral cellularity, intratumoral inflammatory cell infiltration, and expression status of glucose transporters 1 and 3 on tumor cells had no significant correlation with SUVmax.CONCLUSION. Gastrointestinal schwannomas and schwannomas with peritumoral lymphoid cuffs may be associated with elevated FDG uptake. Knowledge of the features of schwannomas associated with increased uptake may be helpful to avoid misinterpretation of benign schwannomas as malignancy.