Clinical History
This is a 36 year-old male patient with probable cholangiocarcinoma.
Technique
The patient was administered 10 mCi of F18 labeled Fluorodeoxyglucose and 45 minutes post infusion whole body
imaging was performed. Multiple table positions were utilized and a volume 3D reconstruction was performed with
standard coronal, sagittal and transaxial images.
Findings
The whole body study demonstrates multiple abnormal foci of uptake. Increased uptake is identified in both axilla with
abnormal uptake also identified in the cervical, thoracic, and lumbar spine and pelvis. Abnormal uptake is seen in the lower
cervical spine, in the mid thoracic spine at approximately the level of T5, T6, and T8, and in the lower lumbar spine at
approximately T10 and T12, and possibly L1. There is also abnormal uptake identified in the left iliac crest, and in the region
of the SI joints bilaterally. There are two abnormal foci of uptake seen posterior upper ribs. There is a focus of abnormal
uptake seen in the region of subcarinal nodes, however no CT study of this area is available for comparison. There is
intense uptake of activity in the liver including the region of the porta and medial aspect of the left lobe of the liver. There
is also abnormal uptake seen inferior to the liver, in the region of the head of the pancreas, and periaortic nodes to the left
of midline and possibly mesenteric nodes in the right abdomen.
Impressions
MULTIPLE ABNORMAL SITES OF FDG UPTAKE AS DESCRIBED ABOVE. MRI COULD BE USEFUL TO EVALUATE THE
ABNORMAL SITES IDENTIFIED IN THE THORACIC AND LUMBAR SPINE IF CLINICALLY INDICATED. THIS
DISTRIBUTION OF ABNORMAL UPTAKE WOULD BE SOMEWHAT UNUSUAL FOR CHOLANGIOCARCINOMA, AND
THIS WIDE DISTRIBUTION OF ACTIVITY IN VARIOUS NODES AND BONE COULD BE SEEN IN LYMPHOMA,
MELANOMA, OR METASTATIC DISEASE FROM LUNG OR COLON.
Comments
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