1
|
Shiraishi K, Sakane S, Hara K, Koshino Y, Ago H, Endo A, Ooi S. Diffuse bone marrow uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography with copper-deficiency anemia. Radiol Case Rep 2024; 19:2965-2968. [PMID: 38737170 PMCID: PMC11087691 DOI: 10.1016/j.radcr.2024.03.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 05/14/2024] Open
Abstract
A 59-year-old man with pancytopenia underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography for suspected carcinomatosis. The scan revealed diffuse bone marrow uptake, prompting further investigation. Bone marrow analysis revealed no malignant cells; however, erythroblasts with cytoplasmic vacuolization were observed. Subsequent testing showed low serum copper and ceruloplasmin levels, indicating copper deficiency. Copper supplementation resulted in significant improvement in cytopenia. Notably, the bone marrow uptake on subsequent scans decreased significantly. This case highlights the importance of considering copper deficiency as a potential cause of diffuse bone marrow uptake of 18F-fluorodeoxyglucose on positron emission tomography/computed tomography.
Collapse
Affiliation(s)
- Kamma Shiraishi
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| | - Satoshi Sakane
- Department of Laboratory Medicine, Matsue Red Cross Hospital, Shimane, Japan
| | - Kentaro Hara
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| | - Yasuyuki Koshino
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| | - Hiroatsu Ago
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| | - Akira Endo
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| | - Shinji Ooi
- Department of Hematology, Matsue Red Cross Hospital, Shimane, Japan
| |
Collapse
|
2
|
Zhao Q, Dong A, Zuo C, Fang Y. Intense FDG Uptake in Well-Differentiated Inflammatory Liposarcoma of the Retroperitoneum. Clin Nucl Med 2024; 49:685-687. [PMID: 38598478 DOI: 10.1097/rlu.0000000000005232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
ABSTRACT Inflammatory variant of well-differentiated liposarcoma is a rare subtype of liposarcoma, and its imaging features have been rarely reported. We describe FDG PET/CT findings in a case of well-differentiated inflammatory liposarcoma. The tumor showed no detectable fat and intense FDG uptake and caused diffuse FDG uptake of the bone marrow due to paraneoplastic leukemoid reaction. Microscopically, there were extensive inflammatory infiltrates in the tumor, which may contribute to the intense FDG uptake. This case indicates that although well-differentiated liposarcoma usually shows low-grade FDG uptake, inflammatory variant of well-differentiated liposarcoma can show intense FDG uptake mimicking high-grade liposarcoma.
Collapse
Affiliation(s)
- Qian Zhao
- From the Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Aisheng Dong
- Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Changjing Zuo
- Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yu Fang
- Department of Urology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| |
Collapse
|
3
|
Izumiya Y, Odaka H, Kikuchi T, Takita Y, Tokairin T. Mesenchymal-epithelial transition factor exon 14 skipping mutation-positive granulocyte colony-stimulating factor-producing lung adenocarcinoma mimicking lung abscess: A case report. Respirol Case Rep 2024; 12:e01419. [PMID: 38919814 PMCID: PMC11196950 DOI: 10.1002/rcr2.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing lung tumours are rare, with their imaging features and effective treatments remaining elusive. Similarly, mesenchymal-epithelial transition (MET) exon 14 skipping mutations are also uncommon. Herein, we report a case of G-CSF-producing lung adenocarcinoma positive for a MET exon 14 skipping mutation, mimicking lung abscess. A 61-year-old man presented with cough and high fever. Contrast-enhanced chest computed tomography revealed a mass with a cavity and internal fluid accumulation. The patient initially underwent diagnostic treatment for a lung abscess but was ultimately diagnosed with lung adenocarcinoma positive for a MET exon 14 skipping mutation. Following tepotinib therapy, the primary lesion shrank, and serum G-CSF levels decreased, leading to a diagnosis of G-CSF-producing lung cancer. G-CSF-producing lung tumours can present imaging findings that mimic lung abscesses. Tepotinib therapy may be effective for patients with MET exon 14 skipping mutation, including those with G-CSF-producing lung cancer.
Collapse
Affiliation(s)
- Yuka Izumiya
- Department of Respiratory MedicineJapanese Red Cross Akita HospitalAkitaJapan
| | - Hidesato Odaka
- Department of Respiratory MedicineJapanese Red Cross Akita HospitalAkitaJapan
| | - Toru Kikuchi
- Post Graduate Clinical Education CenterJapanese Red Cross Akita HospitalAkitaJapan
| | - Yuri Takita
- Department of Respiratory MedicineJapanese Red Cross Akita HospitalAkitaJapan
| | - Takuo Tokairin
- Department of PathologyJapanese Red Cross Akita HospitalAkitaJapan
| |
Collapse
|
4
|
Tohyama T, Hosobe H, Kobayashi T, Murakami T, Fujimoto Y, Hayashi T, Matsumoto T, Asakawa T, Omori M. A case of granulocyte-colony-stimulating factor-producing gallbladder cancer with lymph node metastasis together with a literature review. Clin J Gastroenterol 2023; 16:732-742. [PMID: 37258993 DOI: 10.1007/s12328-023-01816-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
The granulocyte-colony-stimulating factor (G-CSF) glycoprotein stimulates precursor cell proliferation and differentiation in the bone marrow. Various G-CSF-producing tumors have been reported; they showed early progression and an extremely poor prognosis. Here, we report a case of G-CSF-producing gallbladder cancer with lymph node metastasis. In addition, we reviewed 30 previous case reports of G-CSF-producing gallbladder cancers to elucidate the characteristics and most appropriate treatment. During a routine visit to her local doctor for monitoring of diabetes and hypertension, a 68-year-old female was found to have an elevated white-blood-cell (WBC) count and C-reactive protein (CRP) level, and a gallbladder mass. Laboratory tests revealed a high serum G-CSF level, and imaging revealed a tumor of the gallbladder with regional lymphadenopathy. We diagnosed a G-CSF-producing gallbladder cancer and performed liver resection of segment IVa/V: regional lymph node dissection with extrahepatic bile duct resection. Pathologically, the tumor was a poorly differentiated squamous cell carcinoma. G-CSF immunostaining for tumor cells was positive. She is alive without recurrence at 16 months after surgery. If a patient exhibits a gallbladder tumor, with an elevated WBC count and CRP level but no symptoms of infection, a G-CSF-producing gallbladder cancer should be suspected; radical resection should be performed immediately after diagnosis.
Collapse
Affiliation(s)
- Taiji Tohyama
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan.
| | - Hirotaka Hosobe
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Teruki Kobayashi
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Takayoshi Murakami
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Yoshimi Fujimoto
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Tatsuro Hayashi
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Takamasa Matsumoto
- Department of Surgery, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Toru Asakawa
- Department of Radiology, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| | - Masako Omori
- Department of Pathology, Kurashiki Medical Center, Bakuro-cho, Kurashiki, Okayama, 710-8522, Japan
| |
Collapse
|
5
|
Yoshida N, Eto K, Horinouchi T, Shiraishi S, Kanemitsu K, Ofuchi T, Tajiri T, Adachi Y, Horino T, Morito A, Mitsuura C, Maeda Y, Hara Y, Matsumoto C, Baba H. Prognostic value of 18F-fluorodeoxyglucose uptake in the bone marrow on pretreatment positron emission tomography/computed tomography in patients with esophageal cancer who underwent esophagectomy. Esophagus 2023; 20:660-668. [PMID: 37129700 DOI: 10.1007/s10388-023-01011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Increased 18F-fluorodeoxyglucose (FDG) uptake in the bone marrow (BM) on positron emission tomography/computed tomography (PET/CT) clinically reflects increased BM metabolism owing to systemic inflammation, bacterial infection, anemia, and cytokine-producing tumors. The association between FDG uptake in the BM and prognosis after esophagectomy for esophageal cancer has not been investigated. METHODS This study included 651 patients who underwent PET/CT before any treatment and McKeown esophagectomy for esophageal cancer between June 2007 and August 2021. The pretreatment degree of FDG uptake in the BM was evaluated using a visual assessment criterion. Patients were divided into low- and high-FDG uptake groups. We retrospectively investigated whether the degree of FDG uptake in the BM was associated with clinicopathological and surgical backgrounds, blood parameters, and prognosis. RESULTS High FDG uptake in the BM was significantly associated with elevated white blood cell and neutrophil counts, increased C-reactive protein levels, decreased hemoglobin, serum albumin, and total cholesterol levels. High FDG uptake in the BM was an independent predictor of worse overall survival in clinical stages 0-II esophageal cancer (hazard ratio, 2.27; 95% confidence interval, 1.097-4.695; P = 0.027). Worse overall survival was also associated with advanced age, low American Society of Anesthesiologists physical status, an advanced clinical stage, and high intraoperative blood loss. CONCLUSION Increased FDG uptake in the BM on pretreatment PET/CT may be a surrogate indicator of various clinically disadvantageous backgrounds and may act as a predictor of poor prognosis after esophageal cancer surgery.
Collapse
Affiliation(s)
- Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
- Division of Translational Research and Advanced Treatment Against Gastrointestinal Cancer, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
| | - Kojiro Eto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Tomo Horinouchi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Shinya Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Kosuke Kanemitsu
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Takashi Ofuchi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Takuya Tajiri
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Yuki Adachi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Taichi Horino
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Atsushi Morito
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Chishou Mitsuura
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Yuto Maeda
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Yoshihiro Hara
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Chihiro Matsumoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan
| |
Collapse
|
6
|
Choi KJ, Kim KC, Kim EJ. A case of granulocyte colony-stimulating factor producing lung adenocarcinoma with anaplastic lymphoma kinase gene rearrangements. Respir Med Case Rep 2023; 46:101885. [PMID: 38222868 PMCID: PMC10784633 DOI: 10.1016/j.rmcr.2023.101885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/01/2023] [Accepted: 06/02/2023] [Indexed: 01/16/2024] Open
Abstract
A 49-year-old woman was diagnosed with lung adenocarcinoma, stage IIIB, with increased leukocytes and neutrophils. Positron emission tomography showed dense uptake in right lung, but not in the bone marrow or bone. Biopsy revealed positive anaplastic lymphoma kinase (ALK) gene rearrangements. First-line ALK inhibitor, crizotinib, was used for 9 weeks and its effect was limited. Second-line ALK inhibitor did not show effect. Positive immunostaining and high serum granulocyte colony-stimulating factor (G-CSF) levels confirmed G-CSF-producing lung adenocarcinoma. The patient died after 4.5 months of diagnosis. This is the first reported case of G-CSF-producing lung cancer with ALK rearrangements.
Collapse
Affiliation(s)
- Keum-Ju Choi
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Kyung Chan Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, South Korea
| | - Eun Jin Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, South Korea
| |
Collapse
|