« Du gris clair au gris foncé… » Exploration de la carcinose péritonéale par TEP-TDM

FDG or Fdopa PET/CT is a powerful imaging technique for detection and characterization of peritoneal carcinomatosis. Diagnosis features and main differential diagnoses are presented from clinical reports.     

Intérêt de la TEP/TDM dans le diagnostic de la carcinose péritonéale : à propos d’une observation

PET/CT is a significant examination recognized in the detection of tumors and their metastases. Through a rare case of peritoneal carcinomatosis complicating an endometrial carcinoma, the authors discuss utility of FDG-PET/CT in the diagnosis and follow-up of this disease.     

TEP/TDM au FDG et hibernome : à propos d’un cas

Hibernoma is a rare benign tumour of soft tissue, generally asymptomatic, usually discovered in young adults. It is a form of lipoma that originates from brown adipose tissue. Its diagnosis is based on histology, the main differential diagnoses being lipoma and liposarcoma. Its appearance on FDG PET/CT has being described only in few case reports. We report here the case of a 68-year-old patient with ENT cancer in whom an adipose tumour in the left axilla has been discovered on CT performed for staging. The diagnosis of hibernoma was suggested in the report of FDG PET/CT examination and was consistent with results of other imaging modalities. On MRI, contrast enhancement was observed after gadolinium contrast injection, which was not typical for a lipoma. On PET/CT, the FDG uptake by the adipose tumour was very intense (SUVmax = 16), which is characteristic for hibernoma that derives from brown adipose tissue. Imaging was unable to distinguish between hibernoma and liposarcoma. The diagnosis of benign mixed hibernoma-lipoma was ascertained on histopathology after complete resection of the tumour. Elements favouring hibernoma over liposarcoma are present in this observation: high avidity for FDG (SUVmax > 10) and a fluctuating intensity of uptake, SUVmax of the tumour increasing from 16 to 48 within 16 months in the presented case. A high SUVmax on FDG PET in an adipose tumour on CT seems to be more suggestive of a benign tumour, hibernoma, than of its malignant counterpart, liposarcoma.     

TEP/TDM au FDG et toxicité pulmonaire à la bléomycine : à propos d’un cas clinique

Patients treated with bleomycin should be frequently monitored during and after treatment. Actually this treatment can cause pulmonary toxicity and may progress to pulmonary fibrosis. Extreme care is required in patients with a severe deterioration of renal function or impaired lung function. PET/CT can be a useful tool for the early diagnosis of this complication. We report a case of bleomycin-induced pneumonitis and discovered during a PET/CT performed for evaluation of Hodgkin's disease.