Primary pulmonary artery sarcoma with intrapulmonary metastases based on PET/CT imaging: a case report and literature review.

Primary pulmonary artery sarcoma is an extremely rare and highly aggressive malignant tumor of cardiovascular system. It is usually misdiagnosed as pulmonary thromboembolism due to its atypical clinical features and similar clinical symptoms. Different from published reports, our case received both enhanced CT and 18F-FDG PET/CT examination before the pathologic result, and lung metastases had already occurred at the time of diagnosis. We herein reported a case of 41-year-old female patient who suffered from cough and chest tightness for more than a month. Laboratory examination indicated that both blood routine and tumor markers were within the normal range, and only the D-dimer slightly elevated. Contrast-enhanced chest computed tomography showed right pulmonary artery lesion and multiple nodular located right upper lung, the lesion was mild heterogeneous enhancement. No obvious abnormalities were found in deep vein of bilateral lower extremities on ultrasonography. In order to confirm the nature of these lesions, PET/CT scan was performed, which revealed stripe hypermetabolism in right pulmonary artery and nodular hypermetabolism in right upper lung, and the rest of the whole-body PET imaging were negative, a diagnosis of primary pulmonary artery malignancy with pulmonary metastases was made, and pulmonary thromboembolism was ruled out. Biopsy of right pulmonary lesions was performed and histopathological examination indicated pulmonary artery sarcoma. She only received palliative conservative medical treatment because the disease was late stage according to the tumor-node-metastasis (TNM) staging system, and did not acceptable surgical treatment, and was in good health during recent follow-up. Our study suggested that 18F-FDG PET/CT image is a good approach for the diagnosis of pulmonary artery sarcoma and could provide adjunct value for further treatment.

18F-Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with bilateral macronodular adrenal hyperplasia.

Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia (AIMAH) is a rare bilateral adrenocorticotropic hormone (ACTH)-independent nodular adrenal hyperplastic disease. Most patients with AIMAH are usually asymptomatic and only a small percentage present with subclinical or apparent Cushing's syndrome caused by excessive corticosteroid secretion. Herein, we reported the case of a 51-year-old female with bilateral macronodular adrenal hyperplasia with mild fluorodeoxyglucose uptake based on PET/CT imaging findings. Her symptoms resolved after surgical resection of the right adrenal gland.

Identification of a Gene-Related Risk Signature in Melanoma Patients Using Bioinformatic Profiling.

INTRODUCTION: Gene signature has been used to predict prognosis in melanoma patients. Meanwhile, the efficacy of immunotherapy was correlated with particular genes expression or mutation. In this study, we systematically explored the gene expression pattern in the melanoma-immune microenvironment and its relationship with prognosis. METHODS: A cohort of 122 melanoma cases with whole-genome microarray expression data were enrolled from the Gene Expression Omnibus (GEO) database. The findings were validated using The Cancer Genome Atlas (TCGA) database. A principal component analysis (PCA), gene set enrichment analysis (GSEA), and gene oncology (GO) analysis were performed to explore the bioinformatic implications. RESULTS: Different gene expression patterns were identified according to the clinical stage. All eligible gene sets were analyzed, and the 8 genes (GPR87, KIT, SH3GL3, PVRL1, ATP1B1, CDAN1, FAU, and TNFSF14) with the greatest prognostic impact on melanoma. A gene-related risk signature was developed to distinguish patients with a high or low risk of an unfavorable outcome, and this signature was validated using the TCGA database. Furthermore, the prognostic significance of the signature between the classified subgroups was verified as an independent prognostic predictor of melanoma. Additionally, the low-risk melanoma patients presented an enhanced immune phenotype compared to that of the high-risk gene signature patients. CONCLUSIONS: The gene pattern differences in melanoma were profiled, and a gene signature that could independently predict melanoma patients with a high risk of poor survival was established, highlighting the relationship between prognosis and the local immune response.