18F FDG PET/CT imaging of trichoblastoma of the knee

Nguyen, Ba D.; DiCaudo, David J.

doi:10.1016/j.remnie.2018.04.004

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Hallazgos en la PET/TC con 18F-FDG" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 684 "Ancho" => 1200 "Tamanyo" => 223915 ] ] "descripcion" => array:1 [ "en" => "Hematoxylin and eosin staining (A) showed a tumor composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate,<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> and a low mitotic activity (less than 1/10 HPF). On immunohistochemical analysis (B) the tumor cells were positive for desmin, smooth muscle actin, and anaplastic lymphoma kinase (ALK). The alteration of the ALK gene (CD246) have generally been reported to have no effect on prognosis, local recurrence, distant metastasis and overall survival, although some studies have detected a tendency to a better prognosis.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alicia Díaz Silván, Ana Allende Riera, Dolores Cabello García, Olga Vilahomat Hernández, Eva Martínez Gimeno" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Alicia" "apellidos" => "Díaz Silván" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Allende Riera" ] 2 => array:2 [ "nombre" => "Dolores" "apellidos" => "Cabello García" ] 3 => array:2 [ "nombre" => "Olga" "apellidos" => "Vilahomat Hernández" ] 4 => array:2 [ "nombre" => "Eva" "apellidos" => "Martínez Gimeno" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X18300908" "doi" => "10.1016/j.remn.2018.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X18300908?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380891830051X?idApp=UINPBA00004N" "url" => "/22538089/0000003800000003/v1_201905020850/S225380891830051X/v1_201905020850/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "Interesting images" "titulo" => "18F FDG PET/CT imaging of trichoblastoma of the knee" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "192" "paginaFinal" => "194" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ba D. Nguyen, David J. DiCaudo" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Ba D." "apellidos" => "Nguyen" "email" => array:1 [ 0 => "Nguyen.ba@mayo.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "David J." "apellidos" => "DiCaudo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Radiology, Nuclear Medicine Division, Mayo Clinic Arizona, Scottsdale, AZ, USA" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Dermatology, Mayo Clinic Arizona, Scottsdale, AZ, USA" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "PET/TC con 18F-FDG en paciente con Tricoblastoma de rodilla" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1767 "Ancho" => 1300 "Tamanyo" => 211498 ] ] "descripcion" => array:1 [ "en" => "Axial, sagittal and coronal CT (row A, circles) and fused PET/CT (row B, circles) images showing a tracer-avid ovoid nodule of the left knee. Corresponding axial and sagittal MR images (row C, arrows) of the trichoblastoma." ] ] ] "textoCompleto" => "A 62-year old man had an established diagnosis of POEMS syndrome with peripheral polyneuropathy, hepatosplenomegaly, diabetes, monoclonal gammopathy treated with autologous stem cell transplant, and scleroderma. The patient has been monitored with stability by cross-sectional imaging for 6 years until the onset of a progressively enlarging non-tender nodular lesion of the left knee. A wholebody 18F-FDG PET/CT was performed in search of any potential osseous/soft tissue plasmacytoma or other new malignant lesion. PET/CT detected a tracer-avid focus of the left knee (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, row A & B). MR imaging showed a well-defined multiseptated lesion, in the subcutaneous fat, anterior and lateral to the patellar tendon measuring 0.9cm×2.1cm×1.8cm with increased signal on fluid sensitive sequences, higher signal to muscles on T1 images and absent contrast enhancement (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, row C). Ultrasound depicted a hypoechoic lesion with no internal vascularity. Surgery and pathology showed a tumor with basaloid islands and peripheral palisading within a fibrous to fibromucinous stroma. The immunostaining results, ruling out basal cell carcinoma, were compatible with trichoblastoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>Cutaneous manifestations of POEMS syndrome are, in the decreasing order of frequency, hyperpigmentation, hemangioma, hypertrichosis, acrocyanosis, white nails, sclerodermoid changes, Raynaud phenomenon and erythema.<a class="elsevierStyleCrossRef" href="#bib0025">1</a> Trichoblastoma, an incidental occurrence in this presented case of POEMS syndrome, is a benign slow-growing cutaneous tumor which may occur at any site with hair follicles predominantly at the head and neck. Usually appearing as a solitary non-ulcerated flesh-colored small skin nodule, it is frequently evaluated by dermatologists and rarely documented on anatomic and functional imaging. A few cases have been radiographically demonstrated incidentally in the breast or upper extremity secondary to an exceptionally large size.<a class="elsevierStyleCrossRefs" href="#bib0030">2–4</a> Trichoblastoma may simulate a rare malignant skin lesion due to 18F-FDG uptake in the context of a progressively enlarging nodular tumor in a patient with POEMS syndrome. With the histologic feature overlap with basal cell carcinoma, the diagnosis of trichoblastoma should be established by a complete surgical resection allowing a comprehensive immunostaining assessment.<a class="elsevierStyleCrossRef" href="#bib0035">3</a>In summary, the authors present a tracer-avid trichoblastoma, which was suspicious for malignancy on 18F-FDG PET/CT imaging. Histologic immunostaining is necessary for the identification of this benign cutaneous neoplasm.Conflict of interestThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Nguyen BD, DiCaudo DJ. PET/TC con 18F FDG en paciente con Tricoblastoma de rodilla. Rev Esp Med Nucl Imagen Mol. 2019;38:192–194." ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1767 "Ancho" => 1300 "Tamanyo" => 211498 ] ] "descripcion" => array:1 [ "en" => "Axial, sagittal and coronal CT (row A, circles) and fused PET/CT (row B, circles) images showing a tracer-avid ovoid nodule of the left knee. Corresponding axial and sagittal MR images (row C, arrows) of the trichoblastoma." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 557 "Ancho" => 1500 "Tamanyo" => 300313 ] ] "descripcion" => array:1 [ "en" => "Histopathologic features of the resected trichoblastoma. (A) Well demarcated nodular tumor arising in the subcutis (hematoxylin-eosin; original magnification: 40×). (B) Basaloid epithelial tumor islands surrounded by dense fibrous stroma (hematoxylin-eosin; original magnification: 100×)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous manifestations in patients with POEMS syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.Y. Miest" 1 => "N.I. Comfere" 2 => "A. Dispenzieri" 3 => "C.M. Lohse" 4 => "R.A. el-Azhary" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2013" "volumen" => "52" "paginaInicial" => "1349" "paginaFinal" => "1356" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiology pathology conference of Brooke Army Medical Center: trichoblastoma of breast" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Craig" 1 => "L.T. Bui-Mansfield" 2 => "J.D. Lusk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Imaging" "fecha" => "2009" "volumen" => "33" "paginaInicial" => "311" "paginaFinal" => "313" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trichoblastoma of the breast detected by screening mammography: a diagnostic pitfall" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.C. Sherley-Dale" 1 => "N. Chachlani" 2 => "D.S. Sanders" 3 => "R.A. Carr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2010" "volumen" => "34" "paginaInicial" => "748" "paginaFinal" => "754" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Giant trichoblastoma mimicking malignancy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Ogata" 1 => "S. Tanaka" 2 => "T. Goto" 3 => "T. Iijima" 4 => "H. Kawano" 5 => "M. Sasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Orthop Trauma Surg" "fecha" => "1999" "volumen" => "119" "paginaInicial" => "225" "paginaFinal" => "227" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000003/v1_201905020850/S2253808918300338/v1_201905020850/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000003/v1_201905020850/S2253808918300338/v1_201905020850/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808918300338?idApp=UINPBA00004N"]

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