Kanae K Miyake1,2, Yuji Nakamoto1, Tatsuki R Kataoka3, Chiyuki Ueshima3, Tatsuya Higashi4, Tsuyoshi Terashima5, Koya Nakatani6, Tsuneo Saga1,7, Shunsuke Minami8, Kaori Togashi1. 1. 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan. 2. 2 Department of Radiology, Rakuwakai Otowa Hospital, Kyoto, Japan. 3. 3 Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan. 4. 4 Shiga Medical Center Research Institute, Shiga, Japan. 5. 5 Department of Diagnostic Pathology, Shiga Medical Center for Adults, Shiga, Japan. 6. 6 Department of Diagnostic Radiology, Kurashiki Central Hospital, Okayama, Japan. 7. 7 Diagnostic Imaging Group, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan. 8. 8 Department of Radiology, Shiga Medical Center for Adults, Shiga, Japan.
Abstract
OBJECTIVE: The objective of this study was to investigate the clinical, morphologic, and pathologic features associated with increased 18F-FDG uptake in benign schwannomas. MATERIALS AND METHODS: Twenty-two schwannomas in 22 patients (age range, 25-81 years) who had FDG PET or PET/CT scans and subsequently underwent surgical re-section were retrospectively analyzed. The maximum standardized uptake value (SUVmax) was compared with patient age, sex, tumor location (gastrointestinal vs nongastrointestinal origin), tumor size, gross appearance, intratumoral cellularity, intratumoral infiltration of inflammatory cells, presence of peritumoral lymphoid cuffs, and expression status of glucose transporters 1 and 3 on tumor cells. RESULTS: The SUVmax of schwannomas ranged from 1.5 to 17.3 (median, 3.7). Significantly higher SUVmax was observed in gastrointestinal schwannomas (n = 4) compared with nongastrointestinal schwannomas (n = 18, p = 0.007) and in schwannomas with peritumoral lymphoid cuffs (n = 5) compared with those without peritumoral lymphoid cuffs (n = 17, p = 0.001). A significant correlation was seen between tumor location and the presence of peritumoral lymphoid cuffs (p < 0.001). Age, sex, tumor size, gross appearance, intratumoral cellularity, intratumoral inflammatory cell infiltration, and expression status of glucose transporters 1 and 3 on tumor cells had no significant correlation with SUVmax. CONCLUSION: Gastrointestinal schwannomas and schwannomas with peritumoral lymphoid cuffs may be associated with elevated FDG uptake. Knowledge of the features of schwannomas associated with increased uptake may be helpful to avoid misinterpretation of benign schwannomas as malignancy.
OBJECTIVE: The objective of this study was to investigate the clinical, morphologic, and pathologic features associated with increased 18F-FDG uptake in benign schwannomas. MATERIALS AND METHODS: Twenty-two schwannomas in 22 patients (age range, 25-81 years) who had FDG PET or PET/CT scans and subsequently underwent surgical re-section were retrospectively analyzed. The maximum standardized uptake value (SUVmax) was compared with patient age, sex, tumor location (gastrointestinal vs nongastrointestinal origin), tumor size, gross appearance, intratumoral cellularity, intratumoral infiltration of inflammatory cells, presence of peritumoral lymphoid cuffs, and expression status of glucose transporters 1 and 3 on tumor cells. RESULTS: The SUVmax of schwannomas ranged from 1.5 to 17.3 (median, 3.7). Significantly higher SUVmax was observed in gastrointestinal schwannomas (n = 4) compared with nongastrointestinal schwannomas (n = 18, p = 0.007) and in schwannomas with peritumoral lymphoid cuffs (n = 5) compared with those without peritumoral lymphoid cuffs (n = 17, p = 0.001). A significant correlation was seen between tumor location and the presence of peritumoral lymphoid cuffs (p < 0.001). Age, sex, tumor size, gross appearance, intratumoral cellularity, intratumoral inflammatory cell infiltration, and expression status of glucose transporters 1 and 3 on tumor cells had no significant correlation with SUVmax. CONCLUSION:Gastrointestinal schwannomas and schwannomas with peritumoral lymphoid cuffs may be associated with elevated FDG uptake. Knowledge of the features of schwannomas associated with increased uptake may be helpful to avoid misinterpretation of benign schwannomas as malignancy.
Authors: Stefan Niebisch; Holger Staab; Sebastian Ullrich; Karl-Titus Hoffmann; Osama Sabri; René Thieme; Katrin Schierle; Christian Wittekind; Ines Gockel Journal: Int J Surg Case Rep Date: 2019-03-30