Resection of a Solitary Pulmonary Metastasis from Prostatic Adenocarcinoma Misdiagnosed as a Bronchocele: Usefulness of 18F-Choline and 18F-FDG PET/CT

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Presentation transcript:

Resection of a Solitary Pulmonary Metastasis from Prostatic Adenocarcinoma Misdiagnosed as a Bronchocele: Usefulness of 18F-Choline and 18F-FDG PET/CT Jérémie Calais, MD, David Lussato, MD, Jean Menard, MD, Eric De Kerviler, MD, PhD, Pierre Mongiat-Artus, MD, PhD, Yves Castier, MD, PhD, Pascal Merlet, MD, PhD Journal of Thoracic Oncology Volume 9, Issue 12, Pages 1826-1829 (December 2014) DOI: 10.1097/JTO.0000000000000270 Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Thoracic computed tomography (CT) showed lobular and round mass in the right middle lobe of 46 × 43 mm (A) with an average radiodensity compatible with tissue, blood, or sticky liquid (+41 Hounsfield unit) as seen on tissular window (B). A bronchus was centering the mass (C). Classic finger-in-glove sign was observed in lower and distal part of the mass (D). Radiological first diagnosis was a bronchocele, and follow-up CT at 1 year remained absolutely stable with millimeter accuracy. Journal of Thoracic Oncology 2014 9, 1826-1829DOI: (10.1097/JTO.0000000000000270) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 A, 3D Maximum intensity projection 18F-Choline positron emission tomography (PET) anterior view with salivary, hepatic, pancreatic, renal, and vesical physiological uptake. B, Coronal fused 18F-Choline PET/computed tomography (CT) on tissular window. C, Axial fused 18F-Choline PET/CT on lung window centered on the lung mass. 18F-Choline PET/CT scan was negative in the prostatic, pelvic lymph node, and skeletal areas. There was an intense homogeneous 18F-Choline uptake (SUVmax = 9.8) into the bronchocele which was perfectly stable in size with a millimeter accuracy compared with previous thorax CT scans. Journal of Thoracic Oncology 2014 9, 1826-1829DOI: (10.1097/JTO.0000000000000270) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 A, 3D Maximum intensity projection 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) anterior view with cerebral, myocardial, hepatic, renal, and vesical physiological uptake. B, Coronal fused 18F-FDG PET/computed tomography (CT) on tissular window. C, Axial fused 18F-FDG PET/CT on lung window centered on the lung mass. 18F-FDG PET/CT scan was also negative in the prostatic, pelvic lymph node, and skeletal areas. There was a homogeneous FDG uptake (SUVmax = 6) into the bronchocele still stable in size and shape. Journal of Thoracic Oncology 2014 9, 1826-1829DOI: (10.1097/JTO.0000000000000270) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Macroscopically, the tumor was whitish, lobular, and sharply delineated. A, Microscopically, the tumoral glands were fused, lined by a single layer of malignant cells with a polyadenoid architecture (HES × 200; B). Immunohistochemical staining by anti-prostatic acid phosphatase antibody was positive on all tumoral cells (× 200; C). Journal of Thoracic Oncology 2014 9, 1826-1829DOI: (10.1097/JTO.0000000000000270) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions