J Korean Soc Radiol.  2011 Nov;65(5):473-477.

Oncocytic Schneiderian Papilloma Presenting as an Intensely Hypermetabolic Lesion of the Maxillary Sinus on 18F-Fluorodeoxyglucose Positron Emission Tomography/CT: A Case Report and Literature Review

• Lee SK
• Rho BH
• Kwon SY

Abstract

A 54-year-old man presented with an incidentally identified intensely hypermetabolic lesion (SUVmax: 22.2 g/mL) in the left maxillary sinus on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed for cancer screening. The mass was well circumscribed and showed solid enhancement on contrast-enhanced CT. Histological examination of the mass was consistent with oncocytic schneiderian papilloma. It is of prime importance to recognize that a sinonasal lesion with intense hypermetabolism on 18F-FDG PET/CT does not necessarily signify malignancy. Oncocytic schneiderian papilloma should be included in the differential diagnosis of an intensely hypermetabolic and solidly enhancing mass of the nasal cavities or paranasal sinuses.

MeSH Terms

Diagnosis, Differential
Early Detection of Cancer
Electrons
Fluorodeoxyglucose F18
Humans
Maxillary Sinus
Middle Aged
Nasal Cavity
Papilloma
Paranasal Sinuses
Fluorodeoxyglucose F18

Figure

• 

  Fig. 1 An axial 18F-FDG PET/CT image demonstrates an intensely hypermetabolic mass (SUVmax: 22.2 g/mL) (arrow) in the left maxillary sinus. Note.-18F-FDG PET = 18F-fluorodeoxyglucose positron emission tomography, SUVmax = maximum standardized uptake value

• 

  Fig. 2 Axial (A) and coronal reformatted (B) non-enhanced CT images show a mass (arrows) that is indistinguishable from mucosal thickening and secretion, and shows isoattenuation compared to adjacent muscles and brain parenchyma. Axial (C) and coronal reformatted (D) contrast-enhanced CT images reveal that the mass enhances, and thus becomes clearly recognizable. No significant bone destruction is noted.

• 

  Fig. 3 A low power view of the tumor (A) reveals a diffuse papillary pattern of growth (arrows) [hematoxylin-eosin (HE), × 100]. A high power view (B) demonstrates multilayers of columnar epithelial cells with abundant eosinophilic and granular cytoplasm (arrows) (HE, × 400). Immuno-histochemical staining (C) shows a strong expression of glucose transporter 1 (Glut-1) at the cell membrane (original magnification, × 400).

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