鼻型结外NK/T细胞淋巴瘤的18F-FDG PET/CT诊断价值

Diagnostic value of 18F-FDG PET/CT in extranodal nasal type NK/T cell lymphoma

关键词:  鼻型结外NK/T细胞淋巴瘤  18F-FDG  正电子发射断层扫描  诊断

Key words:  extranodal nasaltype NK/T cell lymphoma  ¹⁸F-FDG  positron emission tomography  diagnosis

摘要:

目的　总结鼻型结外NK/T细胞淋巴瘤¹⁸F-FDG PET/CT显像特点并探讨其诊断价值。方法　选择2013年2月至2018年6月在福建省立医院被病理确诊为鼻型结外NK/T细胞淋巴瘤并行¹⁸F-FDG PET/CT检查的17例患者，其中男11例，女6例，年龄25～79岁；9例为术后确诊为鼻型结外NK/T细胞淋巴瘤化疗前PET/CT检查；其中有7例患者治疗后加行1次PET/CT检查评价疗效。釆用SPSS17. 0软件进行统计学分析。结果　（1）鼻部病灶累及情况：累及鼻腔、鼻中隔9例，鼻腔及邻近鼻窦6例，累及鼻腔、鼻背部皮下软组织和颌面部2例。（2）合并鼻外其他部位淋巴瘤浸润4例：左侧鼻咽部、双侧颈部淋巴结浸润1例，左乳、心包、肝脏、脾脏、骨骼、全身皮下、胸膜、腹膜多发浸润1例，鼻咽部、口咽部、全身淋巴结、胸腺区、胃壁、阴茎海绵体多发浸润1例，双侧肾上腺、睾丸1例。（3）鼻部病灶SUVmax情况：SUVmax 5.0～25.9（14.06±5.94）；鼻外淋巴瘤浸润病灶SUVmax 8.0～24.9（12.88±7.05）。（4）9例术后患者均发现淋巴瘤残留病灶，1例发现其他部位淋巴瘤浸润。（5）7例化疗后复查，完全缓解4例，部分缓解2例，复发1例。结论　鼻型结外NK/T细胞淋巴瘤以鼻型为主，病灶常范围较广，可累及鼻翼、邻近皮肤及鼻外脏器，¹⁸F-FDG PET/CT显像具有较高的诊断价值。

Abstract:

Objective To analyze the characteristics and the diagnostic value of ¹⁸F-FDG PET/CT imaging in extranodal nasal type NK/T cell lymphoma (ENKTCL). Methods From February 2013 to June 2018, 17 patients who were pathologically diagnosed as ENKTCL and had ¹⁸F-FDG PET/CT in Fujian Provincial Hospital were selected, including 11 males and 6 females aged 25-79 years. Among them, 9 patients were diagnosed as ENKTCL after surgery and received PET/CT examination before chemotherapy. PET/CT examination was added after treatment in 7 patients to evaluate the efficacy. Statistical analysis was conducted using spss 17.0 software. Results (1) Invasion of nasal lesions: nasal cavity and nasal septum in 9 cases, nasal cavity and adjacent sinuses in 6 cases, and nasal cavity, dorsal subcutaneous soft tissue and maxillofacial region in 2 cases. (2) Extra-nasal involvement by lymphoma in 4 cases, including 1 case of left nasopharyngeal and bilateral neck lymph nodes involvement, 1 case of multifocal involvement in pericardium, liver, spleen, bones, whole body skin, pleura and peritoneum, 1 case of multifocal involvement in nasopharynx, oropharynx, whole body lymph nodes, thymus, stomach, and corpus cavernosum, and 1 case of bilateral adrenal glands and testis involvement. (3) Nasal lesions SUVmax 5.0-25.9 (14.06±5.94); extra-nasal lymphoma foci SUVmax 8.0-24.9 (12.88±7.05). (4) Residual lesions were found in all 9 cases after surgery with development of extra-nasal involvement in 1 case. (5) Seven patients were followed-up after chemotherapy with complete remission in 4 patients, partial remission in 2 patients and recurrence in 1 patient. Conclusions Extranodal NK/T cell lymphoma is mainly nasal type with a wide range of lesions, involving the nasal wing, adjacent skin and extra-nasal organs. ¹⁸F-FDG PET/CT imaging has a high diagnostic value.