18F-FDG-PET/CT findings in primary pulmonary mixed squamous cell and glandular papilloma

Abstract

A 55-year-old female had an abnormal shadow on chest radiograph. Computed tomography (CT) revealed a 26-mm tumor mass in the left upper lobe. No malignant findings were obtained by bronchoscopic cytology or histopathological diagnostics, but on positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) examination the maximum SUV was 9.01 in accordance with the tumor mass shadow on CT. Video-assisted thoracoscopic surgery was performed as clinically suspected of lung cancer, and the diagnosis was pulmonary mixed squamous cell and glandular papilloma (PMSGP). Primary PMSGP is extremely rare, and this is the first to describe the PET findings of this disease.

Mixed Squamous Cell and Glandular Papilloma of the Lung in a 64-Year-Old Woman

“…Most of the previously reported cases presented with a central rather than peripheral location; we found only 4 cases of peripherally located lesions, including our case [3,4,6]. Mixed papilloma located centrally can lead to bronchial obstruction or irritating manifestations such as cough, dyspnea, bleeding, or fever.…”

“…The most common symptom was coughing, but no presenting symptoms were specific to the mixed papillomas. We found 6 additional cases of mixed papilloma, which were not included in Tryfon's review, and most of them were Korean or Japanese patients, excepting only one case [3-8]. …”

“…Because of its location, size, and tumor characteristics, mixed papillomas are usually suspected to be malignant lesions before a histopathological examination. PET/CT findings of these tumors have rarely been reported [3]. The malignant lesions usually have high maximal SUV.…”

A Solitary Mixed Squamous Cell and Glandular Papilloma of the Lung

“…Thus far, only 18 cases have been reported in the English literature. [1][2][3][4][5][6][7][8][9] The incidence of mixed papilloma has a male sex predilection (16:3), and most (75%) …”

“…Abiko, et al initially described the PET findings of this disease, showing highly increased FDG accumulation (maximum standardized uptake value, 9.01). 3) We suggest considering mixed papilloma as a possible diagnosis in cases with PET results positive for a solitary pulmonary nodule. Squamous cell and mixed papillomas have the potential to develop into a carcinoma.…”