睾丸嗜铬细胞瘤并多发淋巴结及肺转移18F-FDG PET/CT特征1例并文献复习

目的：探讨睾丸异位嗜铬细胞瘤的18F-氟-2-脱氧葡萄糖(18F-fluroro-2-deoxyglucose，18F-FDG)正电子发射断 层成像-计算机断层成像(positron emission tomography and computed tomography，PET/CT)特点，以提高对其诊断水平。 方法：报告1例病理确诊为异位嗜铬细胞瘤并多发淋巴结及肺转移的患者资料。结果：患者有典型的血压升高症状， 血儿茶酚胺及尿香草扁桃酸值显著升高。PET/CT检查发现患者右侧睾丸糖代谢增高的软组织结节，邻近伴1个子 灶，右侧精索可见糖代谢增高的肿块，双侧腹股沟区及腹膜后多发糖代谢增高的淋巴结，右肺下叶后基底段糖代谢 增高的结节，全身多处可见糖代谢弥漫性增高的棕色脂肪影；右侧睾丸异位嗜铬细胞瘤原发灶与转移灶切除后PET/ CT检查则可见棕色脂肪组织糖代谢增高表现消失。结论：PET/CT检查对异位嗜铬细胞瘤原发灶的定位诊断、临床分 期与疗效评估有着较好的价值，而棕色脂肪组织的18F-FDG摄取增高对异位嗜铬细胞瘤的定性诊断具有一定的提示作用。

18F-FDG PET/CT features on paraganglioma of testis with multiple lymph node and lung metastasis: A case report and literature review

Objective: To determine the clinicopathological and imaging features in 18F-fluoro-2- deoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET/CT) for paraganglioma of testis, and to increase the diagnostic accuracy. Methods: A case of paraganglioma of testis with multiple lymph node and lung metastasis were reported. PET/CT and pathological fi ndings in the case were retrospectively analyzed. Results: The patient presented with high blood pressure, high level of catecholamine, and urinary vanillylmandelic acid. The patient underwent 18F-FDG PET/CT, which showed the features including the right testis nodule with a star lesion nearby, the right spermatic cord, the lymphadenopathy of bilateral inguinal and retroperitoneum, the posterior basal segment of right lung nodule, and a lot of brown adipose tissues (BAT) in the whole body with intense FDG uptake. 18F-FDG PET/CT showed that the intense FDG uptake of the BAT disappeared after the excision of the right testis and metastasis of paraganglioma. Conclusion: PET/CT shows great value in localization diagnose, clinical staging and curative evaluation. PET/CT plays a helpful role in revealing the BAT with 18F-DG avidity in the patients with paraganglioma with elevated blood pressure, high level catecholamine, and urinary vanillylmandelic acid.