Crizotinib-associated hepatic and renal cysts: a case report with MRI findings

IF 2.2 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Saki Yamamoto, Toshimi Kawahata, Sota Masuoka, Ayako Takigami, Hiroyuki Fujii, Toshikazu Takasaki, Mizuho Saito, Mitsuru Matsuki, Makoto Maemondo, Harushi Mori
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Abstract

We report a case of a man in his 60s with ROS1 fusion-positive lung adenocarcinoma who developed multiple cystic lesions in both the kidneys and liver during crizotinib treatment. The patient presented with fever, abdominal pain, and oliguria. Contrast-enhanced CT revealed new cystic lesions in both the kidneys and liver, with some showing thick walls, septa, and hyperdense contents. MRI demonstrated heterogeneous signal intensities on T2-weighted images and mixed low to high signal intensities on T1-weighted images. Some cysts displayed T2 hypointense and T1 hyperintense areas along the cyst walls, with diffusion restriction predominantly at the periphery of the masses. Percutaneous drainage of the cysts was performed, and cytology revealed an increase in the number of cells, including neutrophils. However, no malignant cells or microorganisms were detected. Based on these imaging findings and laboratory results, the patient was diagnosed with crizotinib-associated renal and hepatic cysts. Symptoms improved after crizotinib discontinuation, and follow-up imaging showed cyst regression. This is the first report describing MRI findings for crizotinib-associated hepatic cysts. Characteristic MRI findings, such as T2 hypointensity/T1 hyperintensity along the cyst walls and diffusion restriction predominantly at the periphery of the masses, suggesting hemorrhagic components, may help differentiate crizotinib-associated cysts from other lesions, including metastases and abscesses.

Graphical abstract

Abstract Image

Abstract Image

克唑替尼相关的肝和肾囊肿:1例MRI结果报告。
我们报告一例60多岁的ROS1融合阳性肺腺癌患者在克唑替尼治疗期间肾脏和肝脏出现多发性囊性病变。患者表现为发热、腹痛和少尿。增强CT显示肾脏和肝脏出现新的囊性病变,部分显示壁厚、间隔和高密度内容物。MRI显示t2加权图像信号强度不均,t1加权图像信号强度高低混合。部分囊肿沿囊肿壁呈T2低信号区和T1高信号区,扩散限制主要在肿块周围。经皮对囊肿进行引流,细胞学检查显示细胞数量增加,包括中性粒细胞。但未检出恶性细胞或微生物。基于这些影像学表现和实验室结果,患者被诊断为与克唑替尼相关的肾和肝囊肿。停用克唑替尼后症状改善,随访影像显示囊肿消退。这是第一份描述克里唑替尼相关肝囊肿MRI表现的报告。特征性MRI表现,如沿囊肿壁T2低/T1高,扩散限制主要在肿块周围,提示出血性成分,可能有助于区分克唑替尼相关囊肿与其他病变,包括转移和脓肿。
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来源期刊
Abdominal Radiology
Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
8.30%
发文量
334
期刊介绍: Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits
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