Inflammatory Pseudotumor in the Epidural Space of the Lumbosacral Spine on F-18 FDG PET/CT

Document Type : Case report

Authors

1 Department of Nuclear Medicine, Konyang University Hospital, Daejeon, South Korea

2 Department of Pathology, Konyang University Hospital, Daejeon, South Korea

Abstract

An inflammatory pseudotumor (IPT) is a rare benign lesion, characterized by nonneoplastic proliferation of inflammatory cells and presence of intermingling collagen fibers. IPT commonly occurs in the lungs and orbita, while an intraspinal IPT is extremely rare. IPT can mimic both clinically and radiologically malignant processes, and making a definitive preoperative diagnosis is often difficult. Recently, 18-fluorine fluorodeoxyglucose (18F-FDG) has been reported to accumulate in IPT in the lung, spleen, liver, pancreas, colon, orbit, mediastinum, and mesentery. However, to the best of our knowledge, accumulation of 18F-FDG has not been reported in lumbosacral intraspinal IPT. Herein, we report a case of IPT in the epidural space of the lumbar spine, using the imaging findings of 18F-FDG positron emission tomography-computed tomography (PET/CT) and contrastenhanced magnetic resonance imaging (MRI). This is the first case of IPT in the epidural space, depicted by 18F-FDG PET/CT, which revealed a homogeneous, intense 18F-FDG uptake.

Keywords

Main Subjects

References

  1. Roberts GA, Eldridge PR, Mackenzie JM. Case report: inflammatory pseudotumor of the spine, with literature review. Br J Neurosurg. 1997; 11:570-2.
  2. Jeon YK, Chang KH, Suh YL, Jung HW, Park SH. Inflammatory myofibroblastic tumor of the central nervous system: clinicopathologic analysis of 10 cases. J Neuropathol Exp Neurol. 2005;64:254-9.
  3. Kovach SJ, Fischer AC, Katzman PJ, Salloum RM, Ettinghausen SE, Madeb R, et al. Inflammatory myofibroblastic tumors. Journal of Surgical Oncology. 2006; 94: 385–91.
  4. Hausler M, Schaade L, Ramaekers VT, Doenges M, Heimann G, Sellhaus B. Inflammatory pseudotumors of the central nervous system: report of 3 cases and a literature review. Hum Pathol. 2003;34:253–62.
  5. Tresser N, Rolf C, Cohen M. Plasma cell granulomas of the brain: pediatric case presentation and review of the literature. Child’s Nerv Syst. 1996;12:52–7.
  6. Gilliard C, De Coene B, Lahdou JB, Boutsen Y, Noël H, Godfraind C. Cervical epidural pseudotumor and multifocal fibrosclerosis: case report and review of the literature. J Neurosurg Spine. 2000;93:152-6.
  7. Roberts G, Farrell M, Allcutt D. Spinal inflammatory pseudotumors. Br J Neurosurg. 2001; 15:197-8.
  8. Seol JH, Kim SS, Kim JE, Lee SH, Won JY. Inflammatory pseudotumor in the epidural space of the thoracic spine: a case report and literature review of MR imaging findings. AJNR Am J Neuroradiol. 2005;26:2667-70.
  9. Sailler LJ, Porte L, Ollier SM, Astudillo LM, Couret BG, Catalaa I, et al. Giant cell arteritis and spinal cord compression; an overlap syndrome?. Mayo Clin Proc. 2006;81:89-91.
  10. Kato S, Murakami H, Demura S, Yoshioka K, Okamoto Y, Hayashi H, et al. Epidural inflammatory pseudotumor in the thoracic spine in a patient with polymyalgia rheumatic. Spine J. 2012; 12(6):e1-4.
  11. Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO. Inflammatory pseudotumor: the great mimicker. AJR Am Roentgenol. 2012;198(3):217-27.
  12. Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor): a clinicopathologic and immunohistochemical study of 84 Am J Surg Pathol. 1995; 19: 859-72.
  13. Jeong JH, Cho IH, Kong EJ, Chun KA, Kim YJ, Kim JH. 18F-FDG PET/CT in inflammatory pseudotumor of the colon causing intussusception. Ann Nucl Med. 2011;25: 447-50.
  14. Kawamura E, Habu D, Tsushima H, Torii K, Kawabe J, Ohsawa M, et al. A case of hepatic inflammatory pseudotumor identified by FDG-PET. Ann Nucl 2006; 20: 321-3.
  15. Sato M, Takasaka I, Okumura T, Shioyama Y, Asato Y, Yoshimi F, et al. F-18 fluorodeoxyglucose accumulation in an inflammatory pseudotumor of the spleen. Ann Nucl Med. 2007; 21: 521-4.
  16. Huellner MW, Schwizer B, Burger I, Fengels I, Schläpfer R, Bussmann C, et al. Inflammtory pseudotumor of the lung with high FDG uptake. Clin Nucl Med. 2010; 35: 722-3.
  17. Alongi F, Bolognesi A, Gajate AM, Motta M, Landoni C, Berardi G, et al. Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: case report and literature review. Tumori. 2010; 96: 322-6.
  18. Obrzut SL, Halpern BS, Monchamp T, Grabski K, Watts WJ, Czernin J. The role of 2-Deoxy- 2[18F] fluoro-D-glucose positron emission tomography/ computed tomography in monitoring the immunosuppressive therapy response of inflammatory myofibroblastic tumor. Mol Imaging Biol. 2004; 6: 126-30.
  19. Aizawa T, Sato T, Tanaka Y, Kishimoto K, Watanabe M, Kokubun S. Intrameduallry plasma cell granuloma in the cervicothoracic spine: case report. J Neurosurg. 2002;92:235-8.
  20. Boutarbouch M, Arkha Y, Rifi L, Derraz S, El Ouahabi A, El Khamlichi A. Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman; case report and review of the literature. Surg Neurol. 2008; 69:302-5.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 2, Issue 2 - Serial Number 2
October 2014
Pages 138-142

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