Abstract
Pleomorphic Hyalinizing Angiectatic Tumor (PHAT) is a rare mesenchymal neoplasma. It is a pathological term describing a heterogeneous group of neoplasms of undetermined tumorigenesis and undefined malignancy. Based only on the morphological findings of histopathology, the biological potential of the tumor is indeterminate. Determination of glucose metabolism using FDG-PET revealed mildly increased FDG uptake in the tumor. We propose that FDG accumulation in the ectatic vessel, increased uptake of the pleomorphic cells and/or associated inflammatory cells, and increased permeability of the stroma lead to the imaging feature.
Highlights
Pleomorphic Hyalinizing Angiectatic Tumor (PHAT), first described by Smith et al in 1996 [1], is a rare lowgrade mesenchymal neoplasm that most often arises in the suprafascial subcutaneous areas of the extremities, and less frequently in the musculature of the limbs
PHAT describes a heterogeneous group of neoplasms of undetermined tumorigenesis, characterized by clusters of ectatic, fibrinlined, and thin-walled vessels that are surrounded by spindled or pleomorphic neoplastic cells with variable inflammatory components
Inflammation, and certain benign pathological variants can mimic the FDG-uptake properties observed in malignancy, contributing to the misinterpretation of FDG-PET images [7]
Summary
Pleomorphic Hyalinizing Angiectatic Tumor (PHAT), first described by Smith et al in 1996 [1], is a rare lowgrade mesenchymal neoplasm that most often arises in the suprafascial subcutaneous areas of the extremities, and less frequently in the musculature of the limbs. PHAT describes a heterogeneous group of neoplasms of undetermined tumorigenesis, characterized by clusters of ectatic, fibrinlined, and thin-walled vessels that are surrounded by spindled or pleomorphic neoplastic cells with variable inflammatory components. The neoplastic cells frequently have intracytoplasmic hemosiderin granules, intranuclear inclusions, and low mitotic activity [2,3,4,5]. Emission tomography (FDG-PET) has been used as an in vivo method for identifying tumor metabolism and biological activity, as well as a prognostic indicator for malignancy. FDG uptake in PHAT has not been adequately described in the literature
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