组织细胞坏死性淋巴结炎18F-FDG PET/CT表现

目的 观察组织细胞坏死性淋巴结炎（HNL）¹⁸F-FDG PET/CT表现。方法 回顾性分析11例经病理证实HNL患者的¹⁸F-FDG PET/CT及临床表现，分区域选取¹⁸F-FDG摄取最高的病变淋巴结54枚，分析其最大径、位置与最大标准摄取值（SUV_max）的相关性。结果 11例HNL中，7例受累淋巴结呈全身性分布，4例仅颈部和/或腋窝淋巴结受累；11例颈部淋巴结均受累，9例腋窝淋巴结受累；受累淋巴结呈卵圆形，最大短径均<2.30 cm，密度多均匀，且无融合趋势；¹⁸F-FDG PET/CT显像见不同程度放射性摄取，SUV_max为1.22~23.34，中位SUV_max为5.56（2.37，9.87）。8例发热患者中，6例中轴骨摄取高于肝脏。淋巴结最大短径、最大长径均与SUV_max呈低度正相关（r=0.496，P<0.001；r=0.347，P=0.010），所在位置与SUV_max无明显相关（r=0.019，P=0.892）。结论 HNL于¹⁸F-FDG PET/CT显像主要表现为全身多发淋巴结轻、中度肿大，颈部及腋窝淋巴结多受累及代谢增高，伴或不伴中轴骨代谢增高。¹⁸F-FDG PET/CT可用于评估HNL患者全身淋巴结受累、判断疾病活动度及辅助活检定位。

18F-FDG PET/CT findings of histiocytic necrotizing lymphadenitis

Objective To observe the ¹⁸F-FDG PET/CT manifestations of histiocytic necrotizing lymphadenitis (HNL). Methods ¹⁸F-FDG PET/CT imaging and clinical manifestations of 11 patients with HNL confirmed by pathology were retrospectively analyzed. Fifty-four lymph nodes with the highest ¹⁸F-FDG uptakes were selected from different aeras, and the correlations of the maximum diameter, location and maximum standard uptake value (SUV_max) were analyzed. Results The involved lymph nodes distributed in the whole body in 7 patients, while the lesions only involved lymph nodes in the neck and/or axillary. Involved lymph nodes in the neck were detected in all 11 cases, while in the axillary in 9 cases. The involved lymph nodes were oval-shaped, with the maximum short diameter less than 2.30 cm and uniform density, without trend of fusion. ¹⁸F-FDG PET/CT imaging showed different degrees of radioactive uptake, SUV_max ranged from 1.22 to 23.34, and the median SUV_max was 5.56 (2.37, 9.87). In 8 patients with fever, axial bone uptake was higher than that of liver in 6 patients. The maximum short diameter and the maximum long diameter of lymph nodes were positively low correlated with SUV_max (r=0.496, P<0.001; r=0.347, P=0.010). There was no correlation of SUV_max and location (r=0.019, P=0.892). Conclusion HNL mainly manifested as multiple mild to moderate lymph nodes enlargement distributed in the whole body, esp. neck and axillary lymph nodes involvement with increased metabolism, accompanied with increased axial bone metabolism or not on ¹⁸F-FDG PET/CT imaging. ¹⁸F-FDG PET/CT could be used to evaluate systemic lymph node involvement, assess the activity of lesions and guiding biopsy.