Interesting images
Primary pseudomyogenic hemangioendothelioma of bone on 18F-FDG PET/MRI
Hemangioendotelioma pseudomiogénico del hueso en 18F-FDG PET/RM
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
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The [<span class="elsevierStyleSup">18</span>F]AlF-NOTA-FAPI-04 PET/CT images (G–L: anterior view of the maximum intensity projection and fusion PET/CT) showed moderate to intense FAPI uptake in the same location mentioned above. [<span class="elsevierStyleSup">18</span>F]AlF-NOTA-FAPI-04 PET/CT imaging revealed higher uptake values in multiple muscles of the patient compared to <span class="elsevierStyleSup">18</span>F-FDG PET /CT. In addition, the FAPI uptake in the nasopharyngeal lesions was more intense than the FDG uptake.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zhenyan Ye, Yutang Yao, Jun Yin, Ying Kou, Meng Zhao, Zhuzhong Cheng" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Zhenyan" "apellidos" => "Ye" ] 1 => array:2 [ "nombre" => "Yutang" "apellidos" => "Yao" ] 2 => array:2 [ "nombre" => "Jun" "apellidos" => "Yin" ] 3 => array:2 [ "nombre" => "Ying" "apellidos" => "Kou" ] 4 => array:2 [ "nombre" => "Meng" "apellidos" => "Zhao" ] 5 => array:2 [ "nombre" => "Zhuzhong" "apellidos" => "Cheng" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X23001129" "doi" => "10.1016/j.remn.2023.11.002" "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/S2253654X23001129?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380892300099X?idApp=UINPBA00004N" "url" => "/22538089/0000004300000002/v1_202403210524/S225380892300099X/v1_202403210524/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2253808924000090" "issn" => "22538089" "doi" => "10.1016/j.remnie.2024.02.003" "estado" => "S300" "fechaPublicacion" => "2024-03-01" "aid" => "1471" "copyright" => "Sociedad Española de Medicina Nuclear e Imagen Molecular" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2024;43:115-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Incidental detection by <span class="elsevierStyleSup">18</span>F-FDG PET/CT of a thyroid metastasis caused by rectal adenocarcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "115" "paginaFinal" => "116" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hallazgo casual mediante <span class="elsevierStyleSup">18</span>F-FDG PET/TC de una metástasis tiroidea causada por adenocarcinoma de recto" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1048 "Ancho" => 1874 "Tamanyo" => 166312 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT study showing maximum intensity projection (MIP) image (A), cross-sectional fusion PET/CT (B) and CT (C) of the cervicothoracic region, as well as ultrasound image of the neck (D).</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The MIP image (A) shows high intensity and heterogeneous uptake corresponding to a primary tumor of the rectum (thick arrow), focal deposits (thin arrow) in relation to pararectal lymph node dissemination and in both iliac chains, as well as focal uptake (arrowhead) of high intensity that appears to be in the middle-inferior 1/3 of the right thyroid lobe. The fusion (B) and CT (C) images corroborate that this lesion depends on said thyroid lobe, presenting a nodular morphology and dimensions of 20 mm x 17 mm. Given the probability of corresponding to a malignant tumour lesion, a cervical ultrasound study was recommended (D), observing a heterogeneous solid lesion with irregular and imprecise edges with a hypoechoic center. Subsequent pathological characterization indicated that it was a thyroid metastasis from colorectal adenocarcinoma.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Mangas Losada, I. García Megías, X. Boulvard Chollet, L. Romero Robles, P. Garrastachu Zumarán, R. Ramírez Lasanta" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Mangas Losada" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "García Megías" ] 2 => array:2 [ "nombre" => "X." "apellidos" => "Boulvard Chollet" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Romero Robles" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Garrastachu Zumarán" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Ramírez Lasanta" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X23001087" "doi" => "10.1016/j.remn.2023.10.001" "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/S2253654X23001087?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000090?idApp=UINPBA00004N" "url" => "/22538089/0000004300000002/v1_202403210524/S2253808924000090/v1_202403210524/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Primary pseudomyogenic hemangioendothelioma of bone on <span class="elsevierStyleSup">18</span>F-FDG PET/MRI" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "117" "paginaFinal" => "118" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Naifeng Hou, Chengzhong Fan" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Naifeng" "apellidos" => "Hou" ] 1 => array:4 [ "nombre" => "Chengzhong" "apellidos" => "Fan" "email" => array:1 [ 0 => "chengzhong.fan@scu.edu.cn" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemangioendotelioma pseudomiogénico del hueso en <span class="elsevierStyleSup">18</span>F-FDG PET/RM" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2215 "Ancho" => 2925 "Tamanyo" => 411085 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT (A and B) revealed a huge mass on the sacrum with a maximal diameter of 6.9 cm. Bone destruction (arrows) and pathological new bone formation (arrowheads) on the sacrum and lower left tibia could be seen locally. The bone scintigraphy (C and D) showed two foci in the sacrum and lower left tibia (arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 47-year-old man presented with pain of the sacrum and left ankle for 1 year was admitted. Physical examination showed sacrum and left ankle have tenderness during palpation. Laboratory tests including blood routine, tumor markers, and liver and renal function were unremarkable. CT revealed a huge mass on the sacrum. Meanwhile, bone destruction and pathological new bone formation on the sacrum and lower left tibia could be seen locally. The bone scintigraphy showed two foci in the sacrum and lower left tibia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/MRI was performed to evaluate the scope, malignant degree, possible sources of the lesions and baseline examination before treatment (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). On the MIP image, only intense uptake of the sacrum and the left distal tibia could be seen. The lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images. No skin, subcutaneous fat or muscles lesions were seen. Then, the biopsies on the lesions of left tibia and sacrum were performed. The pathological results indicated that the tumor cells were positive for ERG and CD31 and negative for desmin and CD34, corresponding pseudomyogenic hemangioendothelioma. No meaningful FOSB gene translocations were detected. The patient then underwent adriamycin regimen chemotherapy and sacral radiotherapy. Pseudomyogenic hemangioendothelioma (PMH) is a rare tumor with indolent behavior which usually occurs in the soft tissue, and predominantly affects males in the second to fourth decades of life. 25% of the cases are associated with concurrent bone involvement. Immunohistochemistry shows that the neoplastic cells usually express ERG, and CD31 and are negative for CD34, desmin, and S100.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> And the fusion of the SERPINE1 and FOSB genes has been documented in several reported cases.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In this case, we report the imaging findings of PMH on <span class="elsevierStyleSup">18</span>F-FDG PET/MRI for the first time. Different from PET/CT, the application of MRI provides us with more information about tumor boundaries and tumor components. This is important for the diagnosis of bone or soft tissue tumors and may have more advantages than CT. In this case, the performance of MRI, hypointensity signal on T1WI and hyperintensity signal on T2WI, suggested that the lesion may be giant cell tumor of bone, multiple myeloma or chordoma.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, its size was larger and <span class="elsevierStyleSup">18</span>F-FDG affinity was higher, which may be related to the fact that the tumor had more malignant cells and required more glucose uptake. <span class="elsevierStyleSup">18</span>F- FDG PET/MRI findings in this report offered distinctive image of PMH, with multiple small lesions located in a single distal lower limb and a large lesion located in the sacrum with the same metabolic level.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study was supported by the 1·3·5 project for Disciplines of Excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (NO. 2018HXFH002).</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">There are no potential conflicts of interest to disclose by any of the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2215 "Ancho" => 2925 "Tamanyo" => 411085 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT (A and B) revealed a huge mass on the sacrum with a maximal diameter of 6.9 cm. Bone destruction (arrows) and pathological new bone formation (arrowheads) on the sacrum and lower left tibia could be seen locally. The bone scintigraphy (C and D) showed two foci in the sacrum and lower left tibia (arrows).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2076 "Ancho" => 3341 "Tamanyo" => 484325 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The MIP image of <span class="elsevierStyleSup">18</span>F-FDG PET/CT (A) revealed intense avidity in the sacrum and the left distal tibia (arrowheads). On the axial, coronal and sagittal (B–D) views of MRI, PET and fused PET/MRI, the lesions were hypointensity signal on T1-weighted images and hyperintensity signal on T2-weighted images (arrows). The sacral lesion showed heterogeneous increased 18F-FDG uptake with a maximum SUV of 12.51. The metabolic level of tibial focus is consistent with that of sacrum, with an SUVmax of 11.95.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.Y. Jo" 1 => "C.D. Fletcher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAT.0000000000000050" "Revista" => array:6 [ "tituloSerie" => "Pathology" "fecha" => "2014" "volumen" => "46" "paginaInicial" => "95" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24378391" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "FOSB is a useful diagnostic marker for pseudomyogenic hemangioendothelioma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.P. Hung" 1 => "C.D. Fletcher" 2 => "J.L. Hornick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAS.0000000000000795" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "596" "paginaFinal" => "606" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28009608" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chordoma: (18)F-FDG PET/CT and MRI imaging features" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.T. Olson" 1 => "D.E. Wenger" 2 => "P.S. Rose" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-021-03723-w" "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2021" "volumen" => "50" "paginaInicial" => "1657" "paginaFinal" => "1666" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33521875" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004300000002/v1_202403210524/S2253808923000988/v1_202403210524/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004300000002/v1_202403210524/S2253808923000988/v1_202403210524/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808923000988?idApp=UINPBA00004N" ]
