Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Oncocytic Schneiderian Papilloma Presenting as an Intensely Hypermetabolic Lesion of the Maxillary Sinus on $^{18}F$-Fluorodeoxyglucose Positron Emission Tomography/CT: A Case Report and Literature Review

$^{18}F$-Fluorodeoxyglucose 양전자방출전산화단층촬영술에서 상악동의 강한 과대사성 병변으로 발현한 종양세포성 Schneiderian 유두종: 증례 보고 및 문헌 고찰

  • Lee, Sang-Kwon (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Rho, Byung-Hak (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kwon, Sun-Young (Department of Pathology, Dongsan Medical Center, Keimyung University School of Medicine)
  • 이상권 (계명대학교 의과대학 동산병원 영상의학과학교실) ;
  • 노병학 (계명대학교 의과대학 동산병원 영상의학과학교실) ;
  • 권선영 (계명대학교 의과대학 동산병원 병리과학교실)
  • Published : 2011.11.01
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Abstract

A 54-year-old man presented with an incidentally identified intensely hypermetabolic lesion ($SUV_{max}$: 22.2 g/mL) in the left maxillary sinus on $^{18}F$-fluorodeoxyglucose positron emission tomography/computed tomography ($^{18}F$-FDG PET/CT) performed for cancer screening. The mass was well circumscribed and showed solid enhancement on contrast-enhanced CT. Histological examination of the mass was consistent with oncocytic schneiderian papilloma. It is of prime importance to recognize that a sinonasal lesion with intense hypermetabolism on $^{18}F$-FDG PET/CT does not necessarily signify malignancy. Oncocytic schneiderian papilloma should be included in the differential diagnosis of an intensely hypermetabolic and solidly enhancing mass of the nasal cavities or paranasal sinuses.

54세 남자가 암 검진을 위해 시행한 $^{18}F$-FDG 양전자방출전산화단층촬영술($^{18}F$-fluorodeoxyglucose positron emission tomography/CT; 이하 $^{18}F$-FDG PET/CT)에서 우연히 발견된 상악동의 강한 과대사성 병변($SUV_{max}$: 22.2 g/mL)을 주소로 내원하였다. 종양은 경계가 분명하였고, 조영증강 후 영상에서 고형성 조영증강을 보였다. 조직학적 소견은 종양세포성 schneiderian 유두종과 일치하였다. $^{18}F$-FDG PET/CT에서 강한 과대사를 보이는 비부비동 병변이 항상 악성종양을 시사하지는 않는다는 것을 인식하는 것은 중요하며, 종양세포성 schneiderian 유두종은 비강과 부비동의 강한 과대사성 병변으로서, 고형성 조영증강을 보이는 종양의 감별진단에 포함되어야 한다.

Keywords

References

  1. Hyams VJ. Papillomas of the nasal cavity and paranasal sinuses. A clinicopathological study of 315 cases. Ann Otol Rhinol Laryngol 1971;80:192-206 https://doi.org/10.1177/000348947108000205
  2. Barnes L, Bedetti C. Oncocytic Schneiderian papilloma: a reappraisal of cylindrical cell papilloma of the sinonasal tract. Hum Pathol 1984;15:344-351 https://doi.org/10.1016/S0046-8177(84)80033-7
  3. Kapadia SB, Barnes L, Pelzman K, Mirani N, Heffner DK, Bedetti C. Carcinoma ex oncocytic Schneiderian (cylindrical cell) papilloma. Am J Otolaryngol 1993;14:332-338 https://doi.org/10.1016/0196-0709(93)90091-K
  4. Cohen EG, Baredes S, Zuckier LS, Mirani NM, Liu Y, Ghesani NV. 18F-FDG PET evaluation of sinonasal papilloma. AJR Am J Roentgenol 2009;193:214-217 https://doi.org/10.2214/AJR.08.1656
  5. Lin FY, Genden EM, Lawson WL, Som P, Kostakoglu L. High uptake in schneiderian papillomas of the maxillary sinus on positron-emission tomography using fluorodeoxyglucose. AJNR Am J Neuroradiol 2009;30:428-430
  6. Lin E. FDG uptake in a benign paranasal sinus schneiderian papilloma. Clin Nucl Med 2007;32:338-339 https://doi.org/10.1097/01.rlu.0000257335.87168.47
  7. Udaka T, Shiomori T, Nagatani G, Hisaoka M, Kakeda S, Korogi Y, et al. Oncocytic schneiderian papilloma confined to the sphenoid sinus detected by FDG-PET. Rhinology 2007; 45:89-92
  8. Cook GJ. Pitfalls in PET/CT interpretation. Q J Nucl Med Mol Imaging 2007;51:235-243
  9. Gorospe L, Raman S, Echeveste J, Avril N, Herrero Y, Herna Ndez S. Whole-body PET/CT: spectrum of physiological variants, artifacts and interpretative pitfalls in cancer patients. Nucl Med Commun 2005;26:671-687 https://doi.org/10.1097/01.mnm.0000171779.65284.eb
  10. Ninomiya H, Oriuchi N, Kahn N, Higuchi T, Endo K, Takahashi K, et al. Diagnosis of tumor in the nasal cavity and paranasal sinuses with [11C]choline PET: comparative study with 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET. Ann Nucl Med 2004;18:29-34 https://doi.org/10.1007/BF02985611
  11. Shojaku H, Fujisaka M, Yasumura S, Ishida M, Tsubota M, Nishida H, et al. Positron emission tomography for predicting malignancy of sinonasal inverted papilloma. Clin Nucl Med 2007;32:275-278 https://doi.org/10.1097/01.rlu.0000257334.65253.cc
  12. Kim DJ, Chung JJ, Ryu YH, Hong SW, Yu JS, Kim JH. Adrenocortical oncocytoma displaying intense activity on 18F-FDG-PET: a case report and a literature review. Ann Nucl Med 2008;22:821-824 https://doi.org/10.1007/s12149-008-0199-z
  13. Noji T, Kondo S, Hirano S, Ambo Y, Tanaka E, Katoh C, et al. Intraductal oncocytic papillary neoplasm of the pancreas shows strong positivity on FDG-PET. Int J Gastrointest Cancer 2002;32:43-46 https://doi.org/10.1385/IJGC:32:1:43
  14. Lee SK, Rho BH, Woo SK. Hurthle cell neoplasm: correlation of gray-scale and power Doppler sonographic findings with gross pathology. J Clin Ultrasound 2010;38:169-176
  15. Tallini G. Oncocytic tumours. Virchows Arch 1998;433:5-12 https://doi.org/10.1007/s004280050209
  16. Brown RS, Goodman TM, Zasadny KR, Greenson JK, Wahl RL. Expression of hexokinase II and Glut-1 in untreated human breast cancer. Nucl Med Biol 2002;29:443-453 https://doi.org/10.1016/S0969-8051(02)00288-3
  17. Mamede M, Higashi T, Kitaichi M, Ishizu K, Ishimori T, Nakamoto Y, et al. [18F]FDG uptake and PCNA, Glut-1, and Hexokinase-II expressions in cancers and inflammatory lesions of the lung. Neoplasia 2005;7:369-379 https://doi.org/10.1593/neo.04577
  18. Kadowaki T, Yano S, Araki K, Tokushima T, Morioka N. A case of pulmonary typical carcinoid with an extensive oncocytic component showing intense uptake of FDG. Thorax 2011;66:361-362 https://doi.org/10.1136/thx.2010.135525