PERİANAL FİSTÜLDE PATOLOJİK FDG TUTULUMU: İKİ OLGU

Abstract

Perianal fistül, bir ucu makat çevresindeki cilde diğer ucu kalın barsağın son kısmına doğru uzanan tünel şeklindeki bir yapı olup anal kanaldaki mukus bezlerinin enfeksiyonu sonucu gelişir.Bu makalede primer malignitesi bulunan, evrelendirme ve tedavi planlaması amacıyla F -18 florodeoksiglukoz (F-18 FDG) Pozitron emisyon tomografisi /Bilgisayarlı tomografi (PET/BT) taramasında rastlantısal olarak perianal fistül tespit edilen iki vakanın görüntülerini sunmayı amaçladık.İlk olgumuz 57 yaşında Hodgkin lenfoma tamlı, evreleme ve tedavi planlanması amacıyla F-18 FDG PET/BT taraması yapılan bayan hasta idi.İkinci olgumuz ise 70 yaşında sigmoid kolon kanseri tamlı, evreleme ve tedavi planlanması amacıyla F-18 FDG PET/BT taraması yapılan erkek hasta idi. F-18 FDG PET/BT taramasında; her iki hastada sol perianal bölgede cilde ağızlaşan fistül traktı izlenmiş olup bu lokalizasyonda patolojik artmış F-18 FDG tutulumu izlendi. F-18 FDG, malign hastalıkların değerlendirilmesinde yaygın olarak kullanılan bir radyonüklid olmasına karşın malign olmayan benign enfeksiyon ve enflamatuar lezyonlarda da tutulan bir ajandır. F-18 FDG PET/BT, lezyonun metabolik aktivitesinin yanı sıra, anatomik lokalizasyonu hakkında da bilgi veren non-invaziv bir tanı yöntemidir.

Keywords

• F-18 FDG PET/BT
• perianal
• fistül

PATHOLOGICAL FDG UPTAKE IN PERIANAL FISTULA (Presentation of two cases)

Abstract

Perianal fistula is a tunnel-shaped formation extending from the last part of the colon to the skin surrounding the anus which develops following the infection of the mucous glands. In this article, our aim was to present the images of two cases in which perianal fistulas were detected incidentally during 18-fluorine-2-deoxyglucose-positron emission tomography / computed tomography (18 F- FDG PET/CT) scanning process. These patients have a history of primary malignancy and they were scanned primarily to determine the staging and treatment procedure. The first patient was a 57-year-old woman diagnosed with Hodgkin lymphoma and she was scanned by 18 F- FDG PET/CT imaging to determine the staging and treatment procedure.The second patient was a 70-year-old man diagnosed with sigmoid colon cancer and he was scanned by 18 F- FDG PET/CT imaging to determine the staging and treatment procedure. In 18 F- FDG PET/CT scanning, fistula tracts anastomosed to the skin were observed in both patients in the left perianal regions and in these locations, pathological increased 18 F-FDG uptake was seen. Although 18 F- FDG is a radionuclide generally used for evaluating the malignant diseases, this agent’s uptake was also seen in benign infections and inflammatory lesions which are not malignant.18 F FDG PET/BT is a non-invasive diagnostic method which provides information concerning the metabolic activity of the lesion and its location.

Keywords

• 18 F- FDG PET/CT
• perianal fistula

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