OtherClinical Investigations

Overexpression of Glut1 in Lymphoid Follicles Correlates with False-Positive 18F-FDG PET Results in Lung Cancer Staging

Jin-Haeng Chung, Kyung-Ja Cho, Seung-Sook Lee, Hee Jong Baek, Jong-Ho Park, Gi Jeong Cheon, Chang-Woon Choi and Sang Moo Lim
Journal of Nuclear Medicine June 2004, 45 (6) 999-1003;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    18F-FDG PET of mediastinal lymph nodes. (A) 18F-FDG PET image of TP lymph node in 64-y-old man. 18F-FDG PET scan shows hypermetabolic lung mass in right middle lobe with standardized uptake value (SUV) of 8.4 and small hypermetabolic lymph node in prevascular space with SUV of 6.3. Lymph node had high activity of 18F-FDG with focal appearance on 18F-FDG PET, so lesion was classified preoperatively as a metastatic lymph node. After surgery, adenocarcinoma and lymph node metastasis were proven on pathologic examination of surgical specimen. (B) 18F-FDG PET image of FP lymph node in 64-y-old man. 18F-FDG PET scan shows hypermetabolic lung mass in right upper lobe with SUV of 12.5 and small hypermetabolic lesion in right paratracheal lymph node with SUV of 4.3. Lymph node had high activity of 18F-FDG with focal appearance on 18F-FDG PET, so lesion was classified preoperatively as a metastatic lymph node. After surgery, squamous cell carcinoma was proven in the main mass, but there was no metastasis in lymph node.

  • FIGURE 2.
    FIGURE 2.

    Glut1 immunostaining in metastatic non-small cell carcinomas. (A) Squamous cell carcinoma with strong membranous Glut1 immunostaining (STAIN, ×200). (B) Adenocarcinoma with focal cytoplasmic Glut1 immunostaining (immunostain, ×200).

  • FIGURE 3.
    FIGURE 3.

    Glut1 immunostaining in lymphoid follicles. Note intense linear membranous staining in lymphoid follicular cells and erythrocytes as an internal positive control (immunostain, ×200).

Tables

  • TABLE 1

    Number of Studied Lymph Nodes by Histologic Subtype and Results of 18F-FDG PET

    18F-FDG PETSQCCADCOthersTotal
    FN011112
    FP129627
    TN1419841
    TP1712231
    Total435117111

    • SQCC = squamous cell carcinoma; ADC = adenocarcinoma.

  • TABLE 2

    Features of Histologically Proven Negative Lymph Nodes

    PET resultsFP (n = 27)TN (n = 41)P value
    Size (mm)11.0 ± 2.99.7 ± 2.80.071
    Follicular hyperplasia2.7 ± 1.11.6 ± 0.7<0.001
    Glut1 score3.0 ± 0.81.5 ± 0.9<0.001
  • TABLE 3

    Features of Histologically Proven Positive Lymph Nodes

    PET resultsFN (n = 12)TP (n = 31)P value
    Size (mm)11.2 ± 2.713.3 ± 5.00.584
    Tumor volume (%)52.5 ± 31.267.9 ± 35.00.095
    Glut1 score1.8 ± 0.73.1 ± 0.9<0.001
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