title: Relative low glycometabolism may also occur in invasive lung adenocarcinoma with visceral pleural invasion: case report and comments.
abstract: Lung cancer is the main cause of cancer deaths in the world and positron emission tomography (PET) is considered as the most accurate diagnosis and staging technique for lung cancer. For human cancers, fluorodeoxyglucose (FDG)-PET imaging of most primary and metastatic tumors will show significantly increased glucose uptake because high metabolic activity of cancer cells. But there still have the question of false negative or positive rates in diagnostic accuracy need to be considered.A 51 year old man was diagnosed a lung tumor in the right middle lobe without enlargement of lymph nodes by computed tomography (CT). The F-FDG-PET/CT presented 1 slight increased metabolism in the tumor region. After resection of the tumor, postoperative pathological examination confirmed that it was invasive lung adenocarcinoma and with visceral pleural invasion while showed relative low glucose absorption in PET/CT.A form of invasive lung adenocarcinoma was diagnosized. The tumor tissues were further confirmed by immunohistochemical assessments, which showed that thyroid transcription factor 1 (TTF-1 or NKX2-1) and Cytokeratin 7 (CK7) were all significant positive.Diagnosis of lung cancer even all other cancers by FDG-PET should be carefully considered the question of accuracy. Our case has added additional literature for us to considering the false-negative of lung cancer diagnosis by F-FDG-PET/CT.
authors.affiliation: From the Department of Thoracic Surgery, Tianjin Union Medicine Centre, 190 Jieyuan Road, Hongqiao District, Tianjin 300121 (CJ, YH, BY, HZ); Department of Respiratory Medicine, People's Hospital of Qitaihe City, 37 Shanhu Road, Qitaihe 154600, Heilongjiang (XH); Department of Pathology, Tianjin Union Medicine Centre, 190 Jieyuan Road, Hongqiao District, Tianjin 300121 (TT); and Department of Microbiology & Infectious Disease Center, School of Basic Medical Science, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, People's Republic of China (XC).
authors.forename: Chunyang
authors.initials: C
authors.lastname: Jiang
authors.forename: Youkui
authors.initials: Y
authors.lastname: Han
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Hu
authors.forename: Bingjun
authors.initials: B
authors.lastname: Yang
authors.forename: Tao
authors.initials: T
authors.lastname: Tang
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Chen
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism; D000077192:Adenocarcinoma of Lung; D005188:False Negative Reactions; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D010994:Pleura / Q000473:pathology*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18