Nuclear Medicine and Molecular Imaging

  • 제42권5호
  • /
  • Pages.414-418
  • /
  • 2008
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  • 1869-3474(pISSN)
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  • 1869-3482(eISSN)
대한핵의학회 (The Korean Society of Nuclear Medicine)
권호 표지

우심방에 침범한 간세포암을 PET/CT로 진단한 1예

Hepatocellular Carcinoma with Right Atrial Invasion Detected by PET/CT

  • Kim, Ji-Hoon (Department of Internal Medicine, National Police Hospital) ;
  • Kim, Eun-Sil (Department of Internal Medicine, National Police Hospital) ;
  • Yu, Ji-Won (Department of Internal Medicine, National Police Hospital) ;
  • Ahn, Seok-Jin (Department of Internal Medicine, National Police Hospital) ;
  • Jung, Jun-Oh (Department of Internal Medicine, National Police Hospital) ;
  • Kim, So-Yon (Department of Internal Medicine, National Police Hospital) ;
  • Kim, Young-Jung (Department of Internal Medicine, National Police Hospital)
  • 발행 : 2008.10.31
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초록

간암의 정맥계 침범은 흔하나 심장 침범은 드물고 예후가 불량할 뿐 아니라 급사의 위험이 있다. 본 증례처럼 간세포암이 혈관계를 통해 우심방까지 전이된 경우 노작성 호흡곤란 같은 심부전에 의한 증상을 나타낼 수 있어서 간세포암의 간외 전이를 의심하기는 쉽지 않고, 원발 병소를 찾기 위해서 여러 가지 진단적 검사를 시행하여야 한다. F-18 FDG PET/CT는 기능적으로 암세포의 당대사 항진을 3차원적인 입체 영상으로 국소화하기 때문에 비침습적이며 경제적으로 간세포암의 침범 및 간외전이를 쉽게 확인할 수 있다. 저자들은 호흡곤란을 주소로 내원한 55세 남자 환자에서 PET/CT를 통해서 간세포암과 간세포암의 우심방 침범을 진단하는데 도움을 받았기에 이를 문헌고찰과 함께 보고하는 바이다.

The role of positron emission tomography (PET) with F-18 fluorodeoxyglucose (F-18 FDG) in the diagnosis of hepatocellulcar carcinoma (HCC) has been limited because of a variable FDG uptake in HCC. However, the usefulness of PET/CT for detecting extrahepatic metastasis and monitoring of the treatment response in HCC has been reported. A 55-year-old man with a hepatitis B surface antigen-positive, was admitted to our hospital due to dyspnea, general weakness and body weight loss for one month. Chest X-ray showed multiple reticulo-nodular densities on both lower lung fields, which implies metastatic lesions. F-18 FDG PET/CT revealed consecutively intense hypermetabolic mass in right hepatic lobe, inferior vena cava and right atrium. We report a case of HCC with IVC and right atrium invasion identified by F-18 FDG PET/CT.

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