^(18)F-FDG PET/CT诊断继发性噬血细胞综合征原发病因

^(18)F-FDG PET/CT in diagnosing the primary disease of secondary hemophagocytic syndrome

目的探讨18F-FDG PET/CT诊断继发性噬血细胞综合征原发病因的价值。方法回顾性分析19例继发性噬血细胞综合征患者的18F-FDG PET/CT资料,将诊断结果与临床诊断结果进行对比;采用18 F-FDG PET/CT监测3例淋巴瘤相关噬血细胞综合征疾病进展。结果 13例18F-FDG PET/CT提示为恶性淋巴瘤,表现为多发淋巴结、脾脏或骨髓高代谢灶,其中9例确诊为非霍奇金淋巴瘤,4例诊断不明;6例18F-FDG PET/CT未提示恶性肿瘤,其中2例确诊为系统性红斑狼疮、1例确诊为EB病毒感染、1例确诊为溃疡性结肠炎、1例确诊为成人斯蒂尔病,1例病因不明。3例淋巴瘤相关噬血细胞综合征患者病情改善时18 F-FDG PET/CT示原高代谢灶消失,疾病复发时出现新的高代谢病灶。结论18F-FDG PET/CT对于早期诊断继发性噬血细胞综合征的病因、尤其是鉴别疾病良恶性具有重要价值,亦可监测原发病进展情况。

Objective To explore the value of 18 F-FDG PET/CT in diagnosing the primary disease of secondary hemophagocytic syndrome. Methods ^18F-FDG PET/CT data of 19 patients with secondary hemophagocytic syndrome were retrospectively analyzed, and the outcomes were compared with clinical results. The situation of 3 cases with lymphoma-associatied hemophagocytic syndrome was monitored with ^18F-FDG PET/CT. Results Malignant lymphoma was indicted in 13 patients by ^18F-FDG PET/CT, which presenting as high metabolic lesions of lymph nodes, spleen and bone marrow, among them 9 were diagnosed as non-Hodgkin＇s lymphoma, 4 were not finally diagnosed. Nonmalignant lesions were found in 6 patients with ^18F-FDG PET/CT, among them 2 were diagnosed as systemic lupus erythematosus, 1 as Epstein-Barr virus infection, 1 as ulcerative colitis, 1 as adult onset Still＇s disease, and 1 was not finally diagnosed. Three patients of lymphoma-associatied hemophagocytic syndrome were monitored by ^18F-FDG PET/CT, present as disappearance of high metabolic lesions when clinical symptoms improved, but appearances of new high metabolic lesions when the disease relapsed. Conclusion ^18F-FDG PET/CT is of great value in diagnosing primary disease of secondary hemophagocytic syndrome, especially in differentiating benign and malignant lesions. In addition, ^18F-FDG PET/CT is useful for monitoring the progresses of primary disease.