Focal Pulmonary 18F-fluorodeoxyglucose Accumulation Without Corresponding Computed Tomography Abnormalities due to Intravenous Injection Passing Through the Lower Limb Varicose Veins
BT Kung, CP Wong, TK Au Yong, CM Tong
Hong Kong J Radiol 2013;16:301-6
DOI: 10.12809/hkjr1312098
A 58-year-old woman with bilateral lower limb varicose veins and Burkitt lymphoma underwent positron-emission tomography/computed tomography (PET-CT) to exclude lymphoma relapse. PET-CT images did not show any suspicious lesion suggestive of malignancy. However, intense 18F-fluorodeoxyglucose (FDG) uptake focus was detected in the left lung without a corresponding CT abnormality. Follow-up PET-CT 7 weeks later showed disappearance of the 18F-FDG–avid left lung focus, although another new 18F-FDG–avid focus without a corresponding CT abnormality was detected in the right lung. It is possible that these artefacts were due to 18F-FDG–avid microembolus formations, probably related to intravenous 18F-FDG injection into the left foot passing through the varicose veins of the leg. Care should be taken to avoid misinterpreting PET-CT images should a similar situation be encountered in the future.
中文摘要
靜脈注射18F-氟脫氧葡萄糖經曲張的下肢靜脈誘發藥物局灶性肺沉積而電腦斷層掃描無相應異常
龔本霆、黃治平、歐陽定勤、唐卓敏
一名患雙側下肢靜脈曲張和Burkitt淋巴瘤的58歲女性，接受正電子發射斷層掃描/電腦斷層掃描（PET-CT）以排除淋巴瘤復發。PET-CT圖像並無顯示任何惡性可疑灶，但檢測到左肺有18F-氟脫氧葡萄糖（FDG）強烈濃聚，而CT掃描無相應異常。七星期後隨訪PET-CT顯示左肺18F-FDG濃聚灶消失，但右肺發現另一全新18F-FDG濃聚灶無伴相應CT掃描異常。該假象可能起因於18F-FDG微栓子的形成，形成原因或許與往左足靜脈注射的18F-FDG流經左腿曲張的靜脈有關。假如將來遇到類似的情況，應小心避免誤讀PET-CT圖像。