FDG-PET and CT findings of activated brown adipose tissue in a patient with paraganglioma

Figures

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  Fig. 1. CT and FDG-PET/CT images of the pelvic paraganglioma and lymph node metastasis of the patient, a 17-year-old female. Axial CT images showed a hypervascular well-defined and lobulated mass (55 mm in long dia.) located dorsocaudal to the urinary bladder (A) and enhanced lymph node swelling (15 mm in short dia.) at the right internal obturator region (B, red arrow). C,D: Intensely high FDG accumulation in the tumor and the lymph node with SUVmax values of 24.7 and 20.8, respectively.

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  Fig. 2. CT and FDG-PET/CT images of activated mesenteric BAT. A: Axial non-contrast-enhanced CT showed increased attenuation of the visceral fat tissues. Contrast-enhanced CT showed early enhanced (B) and delayed washed out (C) and a spaghetti-like appearance in the mesentery. Intense FDG accumulation in the mesentery was observed (D, SUVmax = 8.1).

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  Fig. 3. Pre- and post-surgery FDG-PET MIP images. A: Pre-surgery MIP images showed FDG accumulation of BAT in almost the entire body. B: Almost all of the FDG accumulations except for a urinary extravasation (*) had disappeared after the surgery.

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  Fig. 4. Pathology of the pelvic paraganglioma. Macroscopic (A) and microscopic features of the pelvic paraganglioma are shown. H&E staining showed atypical cells with stippled chromatin arranged in cell nests (B). Immunohistochemistry showed positivity for chromogranin (C) and synaptophysin (D).