肺内淋巴瘤的PET/CT影像表现分型

目的 总结恶性淋巴瘤(ML)肺侵犯的PET/CT影像学表现类型和特点,为正确诊断提供依据.方法 78例有肺侵犯的ML患者均经病理活组织检查证实,其中非霍奇金淋巴瘤(NHL)47例,霍奇金淋巴瘤(HL)10例,病理分型不明确的淋巴瘤21例.31例是因诊断不明确而;行PET/CT检查,发现并经病理检查确诊为ML,另47例已明确诊断者行PET/CT检查以了解肿瘤全身侵犯情况或有无复发、评价疗效.分析所有患者的PET/CT影像表现.结果 ML肺侵犯的影像表现形式各异,且同一病例可以同时出现不同的病变类型,大致可分为:(1)结节及肿块型(46例,含7例空洞型);(2)纤维索条及斑片型(29例);(3)胸膜心包侵犯型(23例);(4)双肺弥漫型(12例);(5)节段性或全肺不张型(9例);(6)环绕支气管肺门型(7例).除全身淋巴结组织和肺侵犯以外,还有其他部位的累及:骨皮质和骨髓内5例,胃3例,皮下软组织3例,乳腺1例,肾1例,肝1例,喉部1例.结论 PET/CT可以较准确地发现ML对肺的侵犯,显示病灶大小、形态和分布及肿瘤活性,为淋巴瘤的诊断和准确分期提供帮助.

The imaging pattern of lung involvement in malignant lymphoma by PET/CT

Objective The value and imaging pattern of 18F-fluorodeoxyglucose (FDG) PET/CT in specific evaluation of lung involvement in patients with malignant lymphoma (ML) have not been well documented in the current literature. The purpose of this study was to perform pattern analysis and to highlight the advantages of FDG PET/CT in such patients. Methods The FDG PET/CT results of 78 malignant lymphoma cases with lung involvement were retrospectively investigated. These included 47 cases of non-Hodgkin's lymphoma (NHL), 10 cases of Hodgkin's lymphoma (HL) and 21 cases of unclassified lymphoma. Thirty-one lymphoma cases were confirmed after having undergone FDG PET/CT for initially uncertain clinical diagnosis. Forty-seven cases with known lymphoma underwent FDG PET/CT for staging, re-staging and monitoring. Results Six imaging patterns on FDG PET/CT were classified in 78 cases of malignant lymphoma with lung involvement: (1) nodular or mass-like pattern (46/78);(2)fibrous or patchy infiltrative pattern (29/78); (3) pleural and pericardial involvement (23/78); (4) bilateral diffuse parenchymal lung disease (12/78); (5) segmental or lobar pulmonary atelectasis (9/78); (6) circumscribing hilar lymphadenopathy (7/78). More than 1 pattern could coexist in a patient. Besides lymph nodes and lung involvement, other organs of lymphoma disease included: bone marrow and cortex, stomach, subcutaneously soft tissue, mammary gland, kidney, liver and laryngopharynx. Conclusions Whole-body FDG PET/CT is useful for evaluation of lymphoma disease with specific lung involvement. By analyzing the different types of imaging pattern, it may hopefully add to the details of staging, re-staging and treatment monitoring of this disease entity.