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. 2013 Feb 22;14(2):343–349. doi: 10.3348/kjr.2013.14.2.343

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Copyright © 2013 The Korean Society of Radiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 1 — F-18 FDG PET/CT and post hoc PET/MR images, and microscopic findings of primary meningeal melanomatosis.

A. Initial F-18 FDG PET/CT scan revealed hypermetabolic lesions along leptomeninges on frontal and temporal lobes bilaterally, and no other hypermetabolic lesion in whole body. B. Second pre-treatment F-18 FDG PET/CT scan revealed aggravation of hypermetabolic leptomeningeal lesions (arrows), compared with lesions on initial F-18 FDG PET/CT scan. C. Third post-treatment F-18 FDG PET/CT scan showed decreased F-18 FDG uptake and extent of hypermetabolic leptomeningeal lesions compared with lesions on pre-treatment F-18 FDG PET/CT. F-18 FDG PET/CT = F-18 fluorodeoxyglucose positron emission tomography/computed tomography. D. Initial post hoc PET/MR images showed more hypermetabolic leptomeningeal lesions, corresponding to enhancing lesions on T1-weighted contrast-enhanced MR images than unenhanced F-18 FDG PET/CT images. E, G. Pre-treatment post hoc PET/MR images revealed aggravation of hypermetabolic lesions (arrows) corresponded to enhancing lesions on T1-weighted contrast-enhanced MR images, compared with lesions on initial post hoc PET/MRI images. F. Post-treatment post hoc PET/MR images showed decreased F-18 FDG uptake and extent of hypermetabolic leptomeningeal lesions on PET images. Post-treatment contrast-enhanced T1-weighted MRI also showed slight decrease in size of enhancing leptomeningeal lesions, suggesting partial therapeutic response. F-18 FDG PET/CT = F-18 fluorodeoxyglucose positron emission tomography/computed tomography. H. Tumor cells showed eosinophilic cytoplasm with pleomorphic vesicular nuclei and prominent eosinophilic nucleoli. Prominent melanin pigments are also observed (HE, × 200). I. Tumor cells were immunohistochemically strongly positive for HMB-45 (× 200). J. Tumor cells were immunohistochemically strongly positive for S-100 (× 200). K. Ki-67 labeling index of tumor was approximately 10% (× 200). F-18 FDG PET/CT = F-18 fluorodeoxyglucose positron emission tomography/computed tomography.