18F-FDG PET/CT诊断原发性肺淋巴瘤

目的 探讨原发性肺淋巴瘤(PPL)的¹⁸F-FDG PET/CT表现。 方法 回顾性分析11例经病理证实的PPL的¹⁸F-FDG PET/CT影像表现,并测量病灶的最大标准化摄取值(SUV_max)。 结果 11例患者中,结节硬化型霍奇金病2例,非霍奇金病9例,包括支气管黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT)7例、弥漫性大B细胞淋巴瘤1例、血管内大B细胞淋巴瘤1例;其中3例MALT淋巴瘤合并淋巴细胞性间质性肺炎(LIP)。6例病变累及双肺,3例累及右肺,2例累及左肺;共有7例累及右肺中叶。病灶形态表现为单发肿块(结节)4例,肺炎样实变3例,多发结节3例,混合型1例。6例实变或较大肿块病灶中可见充气支气管征,其中的3例可见跨叶分布征。合并LIP的3例患者可见双肺广泛分布的磨玻璃影和多发含气空腔影。大多数病灶表现为放射性浓聚影。 结论 ¹⁸F-FDG PET/CT可以准确地显示PPL病灶的分布、形态和肿瘤活性,其影像表现具有一定的特征性,能够为PPL的诊断提供帮助。

Diagnosis of primary pulmonary lymphoma with 18F-FDG PET/CT

Objective To explore the manifestations of primary pulmonary lymphoma (PPL) on ¹⁸F-FDG PET/CT images. Methods The manifestations of 11 patients with PPL confirmed by pathology were analyzed retrospectively, and the maximal standardized uptake value (SUV_max) were measured. Results There were 2 cases of nodular sclerosis Hodgkin disease and 9 cases of non-Hodgkin lymphoma (NHL). NHL included extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT, n=7), diffuse large B-cell lymphoma and intravascular large B-cell lymphoma (each n=1). Three patients of MALT complicated with lymphocytic interstitial pneumonia (LIP). Six of the 11 cases involved double lungs, 3 involved right lung and 2 involved the left lung. The right middle lobe was involved in 7 cases. The lesion was a single mass (node) in 4 cases, similar to the consolidation caused by pneumonia in 3 cases, disseminated nodes in 3 cases and mixed type lesion in 1 case. Air bronchogram was found in the 6 cases with consolidation or big mass, 3 of which had straddling-lobe distribution. Three cases of MALT complicated with LIP showed the pervasive ground glass opacity and disseminated sign of cavity with air. Most of the lesions had accumulation of radioactivity. Conclusion ¹⁸F-FDG PET/CT could accurately manifest the distribution, morphology and activity of the lesion of PPL. The image findings have some features and are helpful to the diagnosis of PPL.