Clinical relevance of thyroid fluorodeoxyglucose-whole body positron emission tomography incidentaloma.
Fluorodeoxyglucose (FDG) whole body positron emission tomography (PET) scan is increasingly used in the diagnostic work-up or follow-up of patients. In these conditions, positive PET scans with unexpected hot spots within the thyroid region could be defined as thyroid FDG-PET incidentaloma (in analogy with unexpected sonographic thyroid nodules). We describe eight consecutive patients referred to the endocrine department because of thyroid "hot spots," incidentally detected by whole body FDG-PET scan (September 1999 to March 2001). Using ultrasound, fine needle aspiration cytology (FNAC), and histology reports, we tried to identify the pathology underlying thyroid FDG-PET incidentaloma. FNAC showed an indication for surgery in all patients. Surgery has been performed in 7 patients. Malignancy was correctly identified in five patients: two medullary thyroid carcinomas, one with lymph node invasion, and three papillary thyroid carcinomas with invasion through the thyroid capsule in two of the PTC cases. In two patients with a positive FDG-PET scan, FNAC pointed to follicular neoplasms, and final histology reports showed follicular adenoma. In the remaining patient, FNAC revealed a follicular lesion, but surgery has not yet been performed. In conclusion, a small series of consecutive thyroid FDG-PET incidentaloma cases is presented and suggests a high rate of clinically relevant malignancies.
Van den Bruel
Annick
A
Laboratory and Clinic of Experimental Medicine and Endocrinology, Universitaire Ziekenhuizen Gasthuisberg, B-3000 Leuven, Belgium.
Maes
Alex
A
De Potter
Tom
T
Mortelmans
Luc
L
Drijkoningen
Maria
M
Van Damme
Bo
B
Delaere
Pierre
P
Bouillon
Roger
R
D000236:Adenoma / Q000000981:diagnostic imaging; D000368:Aged; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18