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Integrated PET/CT of Salivary Gland Type Carcinoma of the Lung in 12 Patients

Sun Young Jeong1, Kyung Soo Lee1, Joungho Han2, Byung-Tae Kim3, Tae Sung Kim1, Young Mog Shim4 and Jhingook Kim4

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
2 Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
3 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
4 Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.


Figure 1
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  		Fig. 1A —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). Transverse lung window CT scan (5-mm section thickness) obtained at level of right middle lobar bronchus shows lobulated mass obliterating superior segmental bronchus of left lower lobe.

 

Figure 2
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  		Fig. 1B —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at left upper divisional bronchus show tumor has inhomogeneous mild 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value was 5.0.

 

Figure 3
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  		Fig. 1C —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at left upper divisional bronchus show tumor has inhomogeneous mild 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value was 5.0.

 

Figure 4
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  		Fig. 1D —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at left upper divisional bronchus show tumor has inhomogeneous mild 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value was 5.0.

 

Figure 5
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  		Fig. 1E —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). Gross pathologic specimen shows gray–tan mass consisting of intraluminal (arrows, superior segmental bronchus) and extraluminal (arrowheads) components of lesion. LLB = left lower lobar bronchus.

 

Figure 6
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  		Fig. 1F —Adenoid cystic carcinoma in 30-year-old man (patient 1 in Table 1). High-magnification photomicrograph shows that tumor consists of monotonous compact cells of cribriform (glandular) pattern with little atypism or mitotic activity. (H and E, x200)

 

Figure 7
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  		Fig. 2A —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). Transverse lung window CT scan (5-mm section thickness) obtained at level of bronchus intermedius shows lobulated mass (arrows) obliterating lingular divisional bronchus of left upper lobe. Also note areas of obstructive pneumonia (arrowhead).

 

Figure 8
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  		Fig. 2B —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has homogeneous high 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value (SUV) is 8.3. Also note FDG uptake in hilar node (arrowheads, C and D; maximum SUV is 5.7), which proved to be metastatic in surgical specimen.

 

Figure 9
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  		Fig. 2C —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has homogeneous high 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value (SUV) is 8.3. Also note FDG uptake in hilar node (arrowheads, C and D; maximum SUV is 5.7), which proved to be metastatic in surgical specimen.

 

Figure 10
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  		Fig. 2D —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has homogeneous high 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value (SUV) is 8.3. Also note FDG uptake in hilar node (arrowheads, C and D; maximum SUV is 5.7), which proved to be metastatic in surgical specimen.

 

Figure 11
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  		Fig. 2E —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). Gross pathologic specimen shows firm yellow–tan tumor with infiltrative intraluminal and extraluminal components of lesion (straight arrows) encircling lingular divisional bronchus of left upper lobe. Also note enlarged intrapulmonary node (curved arrow) and area of obstructive pneumonia (arrowhead). Li = lingular divisional bronchus.

 

Figure 12
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  		Fig. 2F —Adenoid cystic carcinoma in 45-year-old man (patient 3 in Table 1). High-magnification photomicrograph shows that tumor consists of solid (white arrows) and glandular (large black arrows) areas. Solid area contains cells having less cribriform pattern (small arrows), whereas glandular area contains cells having more cribriform pattern (arrowheads). Also note moderate to high cellular atypism in solid area. (H and E, x100)

 

Figure 13
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  		Fig. 3A —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). Transverse lung window CT scan (5-mm section thickness) obtained at level of suprahepatic inferior vena cava shows lobulated mass (arrows) in left lower lobe. Also note postobstructive mucus plugging (arrowhead).

 

Figure 14
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  		Fig. 3B —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has little 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 1.5.

 

Figure 15
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  		Fig. 3C —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has little 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 1.5.

 

Figure 16
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  		Fig. 3D —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). CT (B), PET (C), and PET/CT (D) images obtained at similar level to A show tumor has little 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 1.5.

 

Figure 17
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  		Fig. 3E —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). Gross pathologic specimen shows yellow–tan tumor (arrows) occupying posterior basal segmental bronchus of left lower lobe. M = mucus within dilated bronchi distal to tumor nodule.

 

Figure 18
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  		Fig. 3F —Low-grade mucoepidermoid carcinoma in 63-year-old woman (patient 10 in Table 1). High-magnification photomicrograph shows tumor composed of mixture of glands, cysts, and solid areas. These areas show little mitotic activity, nuclear pleomorphism, or necrosis (low-grade malignancy). (H and E, x100)

 

Figure 19
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  		Fig. 4A —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). Transverse mediastinal window CT scan (5-mm section thickness) obtained at level of right middle lobar bronchus shows mass (arrows) obliterating lingular divisional bronchus of left upper lobe. Left lower lobe (arrowhead) is partly atelectatic due to extraluminal extension of tumor.

 

Figure 20
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  		Fig. 4B —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). CT (B), PET (C) and PET/CT (D) images obtained at similar level to A show tumor has avid and homogeneous 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 23.4.

 

Figure 21
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  		Fig. 4C —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). CT (B), PET (C) and PET/CT (D) images obtained at similar level to A show tumor has avid and homogeneous 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 23.4.

 

Figure 22
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  		Fig. 4D —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). CT (B), PET (C) and PET/CT (D) images obtained at similar level to A show tumor has avid and homogeneous 18F-FDG uptake (arrows, C and D). Maximum standardized uptake value is 23.4.

 

Figure 23
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  		Fig. 4E —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). Gross pathologic specimen shows yellow–tan mass containing intraluminal (arrow) and extraluminal (arrowheads) components of lesion. LLB = left lower lobar bronchus, ULB = left upper lobar bronchus.

 

Figure 24
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  		Fig. 4F —High-grade mucoepidermoid carcinoma in 48-year-old man (patient 6 in Table 1). High-magnification photomicrograph shows tumor composed mainly of squamous and intermediate cells with few mucin-secreting cells. There is nuclear pleomorphism and hyperchromatism (high-grade malignancy). (H and E, x100)

 

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