18F-FDG PET／CT鉴别诊断多系统累及的结节病

Differentiatiai diagnosis of sarcoidosis involving multiple systems using 18F-FDG PET/CT

结节病是一种病因不明、可侵犯全身多个器官的系统性疾病。病理特点为非千酪样肉芽肿性炎，可累及淋巴结、肺、肝脏、脾脏、心脏、肾脏、眼、胸膜、心包膜、涎腺、胃肠道、骨、骨髓、皮肤及肌肉等多脏器，其中最常累及部位为淋巴结和肺。典型结节病的影像学表现为纵隔及双肺门淋巴结对称性肿大，伴或不伴有肺侵犯。不典型的、多系统累及的结节病在临床影像诊断中常常与其他多系统受累疾病难于鉴别。笔者选取2例18F—FDGPET／CT显像中不易于与恶性淋巴瘤、肺癌伴多发转移相鉴别的多系统累及结节病，从其临床特点及影像学特征等方面进行鉴别诊断，总结分析诊断思路，为临床工作中得出较为准确的影像学诊断提供帮助。

Sacoidosis is a systematic disease that can involve muhiple organs including lymph nodes, lungs, liver, spleen, heart and kidneys, etc. Lymph nodes and lungs are the most common involved places and lymphadenopathy in the mediastinum and bilateral hilum with or without lung invasion is the typical manifestation. It is difficult to differentiate the atypical sarcoidosis and other multiple systems involved disease, such as lymphoma, tuberculosis and lung cancer with metastasis. Two cases and their PET/CT imaging were presented here to discuss and help with differentiation and diagnosis of sarcoidosis in clinical practice.