Computed Tomography and PET/CT Features Of Pulmonary Hamartomas

Abstract

Background: In this study, we aimed to examine the Computed Tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT) findings of the pulmonary hamartomas Methods: Histopathologically (after surgical excisional, transbronchial, or transthoracic biopsy) proven pulmonary hamartomas in our institute between 2007 and 2013 were reviewed retrospectively. The CT and PET/CT images were interpreted regarding the lesion diameter, number, location, components and standardized uptake values (SUVmax). Results: A total of 22 (2 endobronchial and 20 parenchymal) hamartomas detected in 21 (11 males and 10 females) patients (an endobronchial and a parenchymal lesion in the same patient). Right lung (63,7%) involvement was common than left lung (36,4%) and upper lobes (50%) involvement than lower lobes (25%). 54,5% of the lesions has smooth margins while 40,9% have lobulated contour and 4.5% had irregular margins. Fat density was observed in 54,5% and calcification in 40.9%. In 18.2% of the lesions neither fat density nor calcification was seen. There was no FDG uptake in 5 lesions. Mean SUVmax value was 1.6±1.0 (range between 0 and 3,2). A SUVmax value > 2.5 was observed in 5 ones Conclusion: Our results were generally consistent with previous reports. But we found a higher female/male ratio and and more common upper lobes involvement of pulmonary hamartoma

Washout-Computed Tomography Discriminates Pulmonary “Fat-poor” Hamartomas From Neuroendocrine Neoplasms

“…Furthermore, in the secondary analysis, among patients who had undergone PET/CT, we documented that 10 of 37 NENs (9 typical-NENs and 1 atypical-NENs, 27%) did not show significant uptake of 18FDG with a mean SUV value of 1.62 ± 0.45 but all these lesions presented a pathological attenuation curve on CECT with significant wash-in associated with wash-out in the delayed phase. 18FDG-PET/CT is undoubtedly a valuable tool in the differential diagnosis between NENs and HAs, but it is known in the literature that there could be both the possibility of a weak uptake for some HA [30][31][32] and a scarce or completely absent uptake for some NENs, 32,33 especially if well differentiated, with few count of mitoses, and low expression of GLUT-1 (ranges from 62% to 86%). 34 Moreover, using 68Ga-DOTATOC, the detection rate in typical-NENs is 100%, whereas it ranges from 50% to 85% in atypical-NENs in relation to the somatostatin-receptor expression.…”