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LETTER TO EDITOR
Year : 2012  |  Volume : 27  |  Issue : 3  |  Page : 210  

Fluorine-18 fluoro-2-deoxyglucose positron emission tomography/computed tomography in a case of suspected primary pericardial mesothelioma


1 Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication31-May-2013

Correspondence Address:
Bhagwant Rai Mittal
Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh-160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.112751

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How to cite this article:
Senthil R, Bhattacharya A, Rohit MK, Mittal BR. Fluorine-18 fluoro-2-deoxyglucose positron emission tomography/computed tomography in a case of suspected primary pericardial mesothelioma. Indian J Nucl Med 2012;27:210

How to cite this URL:
Senthil R, Bhattacharya A, Rohit MK, Mittal BR. Fluorine-18 fluoro-2-deoxyglucose positron emission tomography/computed tomography in a case of suspected primary pericardial mesothelioma. Indian J Nucl Med [serial online] 2012 [cited 2019 Nov 14];27:210. Available from: http://www.ijnm.in/text.asp?2012/27/3/210/112751

Sir,

A 26-year-old male patient, smoker for 10 years, presented with dyspnoea of 1 year duration. There was no history suggestive of asbestos exposure. Chest X-ray showed cardiomegaly and 2-D echocardiography showed diffuse pericardial thickening. Fine needle aspiration cytology (FNAC) from the pericardial thickening demonstrated adenocarcinoma. He was suspected to have an unknown primary malignancy with pericardial metastasis. Fluorine-18 ( 18 F) fluoro-2-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to look for primary malignancy. It showed intense FDG uptake in heterogeneously enhancing soft-tissue lesion involving the entire pericardium [Figure 1]. No abnormal thickening/FDG uptake was seen in pleura. The uptake in the left supraclavicular region was an artifact due to i.v contrast. No abnormal focus of FDG uptake was seen elsewhere in the body to suggest a possible site of primary. Thus, a primary tumor of the pericardium, possibly primary malignant pericardial mesothelioma was suspected. Patient died before the confirmation of the diagnosis.
Figure 1: Fluorine-18 FDG positron emission tomography/computed tomography images showing intense FDG uptake in heterogeneously enhancing soft tissue lesion involving the entire pericardium. No abnormal thickening/FDG uptake is seen in pleura

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Primary pericardial mesotheliomas are very rare tumors constituting less than 1% of all mesotheliomas. [1],[2] These tumors are known to mimic adenocarcinoma on FNAC. [3],[4] Absence of abnormal uptake to suggest primary malignancy at distant site in 18 F-FDG PET/CT reinforces the possibility of primary pericardial mesothelioma in these cases.

 
   References Top

1.Hillerdal G. Malignant mesothelioma 1982: Review of 4710 published cases. Br J Dis Chest 1983;77:321-43.  Back to cited text no. 1
    
2.Sharaf El-Dean MZ, Bakshi NA, Giraldo AA. Pathologic quiz case: A patient with Down syndrome presenting with "idiopathic" pericarditis. Primary pericardial malignant mesothelioma. Arch Pathol Lab Med 2004;128:e107-8.  Back to cited text no. 2
    
3.Whitaker D. The cytology of malignant mesothelioma. Cytopathology 2000;11:139-51.  Back to cited text no. 3
    
4.Horie M, Noguchi S, Tanaka W, Yoshihara H, Kawakami M, Suzuki M, et al. Primary malignant pericardial mesothelioma mimicking pericardial metastasis from adenocarcinoma. J Thorac Oncol 2010;5:2012-4.  Back to cited text no. 4
    


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