华氏巨球蛋白血症的18F-FDG PET/CT显像分析

18F-FDG PET/CT Imaging of Waldenstr?m Macroglobulinemia

目的探讨华氏巨球蛋白血症(WM)患者18F-FDG PET/CT图像特点,以期提高对本病的认知。资料与方法回顾性分析经骨髓穿刺病理确诊为WM的7例患者,分析其18F-FDG PET/CT图像特征。结果治疗前PET/CT显像4例,骨髓SUVmax3.4(3.3,4.5)、肝脏SUVmax 4.1(3.7,4.7)、脾脏SUVmax 3.3(2.8,4.2)、淋巴结SUVmax 2.1(1.7,2.7)。治疗后PET/CT显像3例。其中1例转化为弥漫大B细胞淋巴瘤(DLBCL);1例合并降结肠DLBCL;1例继发左上肺低分化鳞癌,并双肾上腺及多发骨骼转移瘤。结论 WM患者18F-FDG PET/CT表现为脾脏、骨髓或(和)淋巴结轻度摄取增高,均略高于肝脏摄取值。全身PET/CT显像可对WM患者骨髓、淋巴结、肝脏和脾脏受累情况进行评估,同时对是否转化为DLBCL或合并其他恶性肿瘤也具有较好的临床辅助诊断价值。

Purpose To study the characteristics of 18 F-FDG PET/CT images of Waldenstr?m macroglobulinemia(WM), and to improve awareness of the disease. Material and Methods Seven WM patients confirmed by bone marrow biopsy were retrospectively analyzed to explore the characteristics of 18 F-FDG PET/CT images. Results Four patients obtained PET/CT images before treatment. Bone SUVmax, liver SUVmax, spleen SUVmax and lymph node SUVmax were 3.4(3.3, 4.5), 4.1(3.7, 4.7), 3.3(2.8, 4.2) and 2.1(1.7, 2.7), respectively. After treatment, three patients obtained PET/CT images. Among, there was one case transforming to diffused large Bcell lymphoma(DLBCL), one case combined descending colon DLBCL, one case secondary poorly differentiated squamous cell carcinoma of left upper lung and bilateral superior renal gland and multiple bone metastases Conclusion 18 F-FDG PET/CT images of WM patients are represented by slightly enhanced uptake of spleen, bone marrow or lymph nodes, which are all slightly higher than uptake value of liver. Full-body PET/CT images can be adopted to evaluate involvement of bone, lymph nodes, spleen and liver in WM patients. It is of good clinical auxiliary diagnostic value in checking whether transformed to DLBCL or combined other malignant tumors or not.