Concomitant pulmonary and thyroid tumors identified by FDG PET/CT and immunohistochemical techniques
Concomitant pulmonary and thyroid tumors identified by FDG PET/CT and immunohistochemical techniques
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通过 FDG PET/CT 和免疫组织化学技术鉴定并发肺肿瘤和甲状腺肿瘤
DOI：
10.1186/1477-7819-9-119
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发表时间：
2011-10-06
影响因子：
3.2
通讯作者：
Liu, Jia
中科院分区：
文献类型：
--
作者：
Zhu, Guangwen;Li, Hong;Liu, Jia
背景甲状腺和肺双原发性乳头状腺癌的确切诊断更是罕见，据我们所知，文献中未见[18 F]-2-氟-2-脱氧-D-葡萄糖-正电子发射断层扫描/X线CT（FDG PET/CT）结合手术标本免疫组化（IHC）的报道。我们报告一位56岁男性，因咳嗽三个月而出现甲状腺及肺部FDG PET/CT异常，此异常表现可能会导致误诊，而不需手术标本。行FDG PET/CT检查，肺、甲状腺切除标本行HE染色和免疫组化染色。PET/CT：肺肿瘤SUVmax：3.69，延迟：5.17;甲状腺肿瘤SUVmax 19.97。HE显示乳头状腺癌，但原发性肺腺癌与转移性腺癌的组织学鉴别有时很困难，因为它们的表型相似。肺肿瘤：细胞角蛋白20（CK 20）（-）、甲状腺球蛋白（Tg）（-）、细胞角蛋白7（CK 7）（+）、甲状腺转录因子-1（TTF-1）（+）;甲状腺肿瘤：CK 7（+）、TTF-1（+）、甲状腺球蛋白（+）、CK 20（-）。因此，最终诊断为甲状腺和肺双原发性腺癌。结论FDG PET/CT对多原发性肿瘤具有初步诊断能力;最终诊断应采用标本经肿瘤特异性标志物免疫组化获得。因此，可以设计和实施有效的治疗方法。
BackgroundThe exact diagnosis of double primary papillary adenocarcinoma of thyroid and lung is even rarer, to our knowledge no report in the literature by [18F]-2-fluoro-2-deoxy-D-glucose-positron emission tomography/X-ray CT(FDG PET/CT) with surgical specimens immunohistochemistry(IHC). We report a patient with abnormal FDG PET/CT in thyroid and lung, this unusual presentation may lead to misdiagnosis without surgical specimens IHC.Case presentationA 56-year-old man with coughing three months. FDG PET/CT was performed, and resection specimens of lung and thyroid were detected by hematoxylin eosin staining (HE) and IHC. PET/CT: lung tumor SUVmax: 3.69, delay: 5.17; and thyroid tumor SUVmax 19.97. HE reveal papillary adenocarcinoma, but histological differentiation of primary pulmonary adenocarcinoma from metastatic adenocarcinoma is sometimes difficult because of their phenotypic similarities. So IHC was performed, the IHC of lung tumor: cytokeratin 20 (CK20)(-), thyroglobulin(Tg)(-), cytokeratin7(CK7)(+), thyroid transcription factor-1 (TTF-1)(+); thyroid tumor: CK7(+), TTF-1(+), thyroglobulin (+), CK20(-). Therefore, the final diagnosis was double primary adenocarcinomas of thyroid and lung.ConclusionFDG PET/CT has preliminary diagnostic capacity of multiple primary tumors; the final diagnosis should be adopted for specimens after tumor-specific markers IHC to obtain. Consequently, effective therapeutic approaches can be designed and conducted.