^(18)F-FDG PET显像对不同亚型淋巴瘤的诊断价值

Diagnostic value of ^(18)F-FDG PET in detecting different subtypes of lymphomas by WHO classification

目的 探讨1 8F 脱氧葡萄糖 (FDG)PET显像对霍奇金淋巴瘤 (HL)和以世界卫生组织(WHO)分类标准分类的不同亚型非霍奇金淋巴瘤 (NHL)的诊断价值。方法 对 2 36例淋巴瘤 (6 2例HL和 174例NHL)患者的FDGPET全身显像结果进行回顾性分析 ,并与WHO病理分型的结果比较。结果 PET显像对淋巴瘤的检出阳性率为 94 % (2 2 1 2 36例 ) ,对HL和NHL的阳性率分别为 97% (6 0 6 2例 )和 93% (16 1 174例 )。在不同NHL亚型中 ,8例套细胞淋巴瘤 ,99% (76 77例 )的弥漫性大B细胞淋巴瘤 (DLBCL) ,95 % (5 5 5 8例 )的滤泡性淋巴瘤 (FL) ,73% (8 11例 )的淋巴结边缘区淋巴瘤(MZL) ,2 3例黏膜相关性 (MALL型 )结外边缘区B细胞淋巴瘤 (MALT MZL) ,5 8例的无其他特征外周T细胞淋巴瘤 (PTCL) ,2 3例的伯基特淋巴瘤 (BL) ,2例间变性大细胞性淋巴瘤和覃样肉芽肿、小淋巴细胞性淋巴瘤和NK T细胞型淋巴瘤各 1例FDG摄取异常 ,而 13例 (3例MZL ,3例PTCL ,3例FL ,MALT MZL、DLBCL、BL和前体T淋巴母细胞淋巴瘤各 1例 )未见异常FDG分布。结论 1 8F FDGPET显像对常见的NHL亚型检出阳性率较高 ,对相对少见的NHL亚型检出阳性率较低。

Objective To determine the clinical diagnostic value of 18 F-fluorodeoxyglucose (FDG) PET in detecting Hodgkin's lymphoma (HL) and various histological subtypes of non-Hodgkin's lymphoma (NHL) based on World Health Organization (WHO) Classification. Methods 18 F-FDG PET images of 236 lymphoma patients (62 HL and 174 NHL) were retrospectively analyzed according to the WHO subtypes. Results The overall sensitivity of PET in detecting lymphoma was 94% (221/236),that in HL and NHL was 97% (60/62) and 93% (161/174),respectively. In NHL subtypes,8/8 of mantle cell lymphomas (MCL),99 % (76/77) of diffuse large B-cell lymphomas (DLBCL),95% (55/58) of follicular lymphomas (FL),73% (8/11) of marginal zone B-cell lymphomas (MZL),2/3 of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-MZL),5/8 of unspecified peripheral T-cell lymphomas (PTCL),2 of 3 burkitt's lymphomas (BL),2 of 2 anaplastic large T-cell lymphomas,1 of 1 mycosis fungoides,1 of 1 small lymphocytic lymphoma and 1 of 1 NK/T cell lymphoma showed FDG distribution abnormalities,whereas 13 cases (3 MZL,3 PTCL,3 FL,1 MALT-MZL,1 DLBCL,1 BL and 1 precursor T-cell lymphoblastic lymphoma ) showed normal FDG distribution. Conclusions 18 F-FDG PET has a high sensitivity (94%) for detecting lymphoma. For most common NHL subtypes such as DLBCL,FL and MCL,the sensitivity of PET is extremely high (95%～100%),for less common subtypes (MZL,MALT-MZL,PTCL and BL),the sensitivity is relatively low (63%～71%).