18F-fluorodeoxyglucose positron emission tomography might be useful for diagnosis of hepatic amyloidosis

Figures & data

Table 1 Laboratory data on first visit to Chiba University Hospital

Component	Result	Normal values	Component	Result	Normal values	Component	Result	Normal values
WBC, ×10^3/μL	5.8	4.0–9.0	TP, g/dL	6.9	6.5–8.2	HBsAg	(−)	(−)
Hemoglobin, g/dL	15.0	12.0–16.0	Alb, g/dL	4.4	3.9–5.1	Anti-HBs*	(−)	(−)
Platelets, ×10^3/μL	221	150–350	AST, IU/L	34	13–33	Anti-HBc*	(−)	(−)
PT–INR*	1.22	0.86–1.06	ALT, IU/L	22	8–42	Anti-HCV	(−)	(−)
PT%*	74	81–121	LDH, IU/L	217	119–229	ANA	×40	<×160
NH3, μg/dL*	48	12–66	ALP, IU/L	678	115–359	AMA*	(−)	(−)
T chol, mg/dL	188	125–219	γ-GTP, IU/L	330	10–47	AMA-M2*	(−)	<7.0
BUN, mg/dL	14	8–20	T bil, mg/dL	0.8	0.2–1.2	ASMA*	(−)	(−)
Cre, mg/dL	0.86	0.47–0.79	D bil, mg/dL	0.2	0.0–0.2
CRP, mg/dL	0.0	≤0.2	IgM, mg/dL	58	35–220
AFP, ng/mL*	5.5	≤8	IgG, mg/dL	1,013	870–1,700

Note:

* These data were obtained later.

Abbreviations: WBC, white blood cells; PT/INR, prothrombin time international normalized ratio; NH₃, ammonia; T chol, total cholesterol; BUN, blood urea nitrogen; Cre, creatinine; CRP, C-reactive protein; AFP, alpha-fetoprotein; TP, total protein; Alb, albumin; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDH, lactate dehydrogenase; ALP, alkaline phosphatase; γ-GTP, gamma-glutamyl transpeptidase; T bil, total bilirubin; D bil, direct bilirubin; IgM, immunoglobulin M; IgG, immunoglobulin G; HBsAg, hepatitis B (HB) surface antigen; anti-HBs, HB surface antibody; anti-HBc, HB core antibody; anti-HCV, hepatitis C virus antibody; ANA, antinuclear antibody; AMA, antimitochondrial antibody; M2, pyruvate dehydrogenase complex-E2 (PDC-E2); ASMA, antismooth muscle antibody; (−), negative.

Figure 1 Contrast-enhanced CT revealed hepatomegaly and heterogeneity of contrast staining.

Notes: (A) Plain phase. (B) Early phase. Narrow intrahepatic portal vessels are shown (white arrow). (C) Late phase. Hepatic vessels are unclear. (D) FDG-PET/CT revealed heterogeneous uptake of FDG into the liver. SUV maximum range was: 3.2–3.7; 2.8–3.2; and 1.6–2.5 in the left, right lobes of the liver, and the spleen, respectively.
Abbreviations: CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography; SUV, standard uptake value.

Figure 2 MRCP (A) and ERCP (B and C) revealed narrowed whole intrahepatic bile ducts with smooth walls (white arrows).

Abbreviations: MRCP, magnetic resonance cholangiopancreatography; ERCP, endoscopic retrograde cholangiopancreatography.

Figure 3 Liver biopsy showing deposition of amyloid protein.

Notes: Hematoxylin and eosin stain, original magnification 20× (A) and 100× (B); Congo red stain, 20× (C) and 100× (D).