We reported the rare case of an elderly man with secondary breast lymphoma （SBL） associated with magnetic resonance imaging findings. MR images demonstrated multiple well-defined masses in the left breast, with hete...We reported the rare case of an elderly man with secondary breast lymphoma （SBL） associated with magnetic resonance imaging findings. MR images demonstrated multiple well-defined masses in the left breast, with heterogeneous enhancement on dynamic contrast-enhanced sequences. The time signal-intensity curve rapidly increased during the initial rise phase and washed out during the delayed phase. The apparent diffusion coefficient （ADC） value was 0.649 x 104 mm2/s. Maximum intensity projection （MIP） showed that the masses were distributed in the upper outer quadrant, in the axillary region and in the lower outer region of the left chest wall. The pathology confirmed the diagnosis of non-Flodgkin＇s lymphoma. The combination of morphological and kinetic features, as well as a significantly lower ADC value, are helpful in the diagnosis of breast lymphoma and its differentiation from breast cancer.展开更多
目的:研究原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)MRI图像参数与分子病理的关联性。方法:回顾性分析2020年1月至2023年6月就诊于哈尔滨医科大学附属第一医院26例PCNSL患者资料,根据细胞来源、BCL-2...目的:研究原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)MRI图像参数与分子病理的关联性。方法:回顾性分析2020年1月至2023年6月就诊于哈尔滨医科大学附属第一医院26例PCNSL患者资料,根据细胞来源、BCL-2表达、Ki-67指数,MAP+布鲁顿酪氨酸激酶抑制剂(Bruton's tyrosine kinase inhibitor,BTKi)治疗反应性将患者归纳至非生发中心B细胞(non-germinal center B-cell,non-GCB)组和生发中心B细胞(germinal center B-cell,GCB)组、Ki-67≥75%组和Ki-67<75%组、BCL-2+组和BCL-2-组、对MAP+BTKi方案治疗有反应组和无反应组。提取患者基线期MRI图像一阶参数如平均值、标准差、方差、变异系数、偏度、峰度、熵,比较其在两组间的差异。结果:方差、峰度、偏度、变异系数等4个参数在组间差异无统计学意义;平均数、标准差、熵这3个参数在Ki-67表达、BCL-2表达组间的差异具有统计学意义;平均数、熵这两个参数在细胞来源、治疗是否有反应性两组间差异具有统计学意义(P<0.05);对于Ki-67指数,3个参数的曲线下面积(AUC)分别为0.731、0.831、0.913;对于BCL-2表达,平均数、标准差的曲线下面积(AUC)分别为0.889和0.938。多参数联合分析时其鉴识效果较利用单个纹理分析定量参数更高。结论:平均值、标准差、熵等3个MRI参数有助于预测PCNSL患者Ki-67、BCL-2的表达,对于治疗具有一定评估作用,有利于术前无创性评估肿瘤的恶性程度并为预后和治疗提供新的依据。展开更多
文摘We reported the rare case of an elderly man with secondary breast lymphoma （SBL） associated with magnetic resonance imaging findings. MR images demonstrated multiple well-defined masses in the left breast, with heterogeneous enhancement on dynamic contrast-enhanced sequences. The time signal-intensity curve rapidly increased during the initial rise phase and washed out during the delayed phase. The apparent diffusion coefficient （ADC） value was 0.649 x 104 mm2/s. Maximum intensity projection （MIP） showed that the masses were distributed in the upper outer quadrant, in the axillary region and in the lower outer region of the left chest wall. The pathology confirmed the diagnosis of non-Flodgkin＇s lymphoma. The combination of morphological and kinetic features, as well as a significantly lower ADC value, are helpful in the diagnosis of breast lymphoma and its differentiation from breast cancer.
文摘目的:研究原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)MRI图像参数与分子病理的关联性。方法:回顾性分析2020年1月至2023年6月就诊于哈尔滨医科大学附属第一医院26例PCNSL患者资料,根据细胞来源、BCL-2表达、Ki-67指数,MAP+布鲁顿酪氨酸激酶抑制剂(Bruton's tyrosine kinase inhibitor,BTKi)治疗反应性将患者归纳至非生发中心B细胞(non-germinal center B-cell,non-GCB)组和生发中心B细胞(germinal center B-cell,GCB)组、Ki-67≥75%组和Ki-67<75%组、BCL-2+组和BCL-2-组、对MAP+BTKi方案治疗有反应组和无反应组。提取患者基线期MRI图像一阶参数如平均值、标准差、方差、变异系数、偏度、峰度、熵,比较其在两组间的差异。结果:方差、峰度、偏度、变异系数等4个参数在组间差异无统计学意义;平均数、标准差、熵这3个参数在Ki-67表达、BCL-2表达组间的差异具有统计学意义;平均数、熵这两个参数在细胞来源、治疗是否有反应性两组间差异具有统计学意义(P<0.05);对于Ki-67指数,3个参数的曲线下面积(AUC)分别为0.731、0.831、0.913;对于BCL-2表达,平均数、标准差的曲线下面积(AUC)分别为0.889和0.938。多参数联合分析时其鉴识效果较利用单个纹理分析定量参数更高。结论:平均值、标准差、熵等3个MRI参数有助于预测PCNSL患者Ki-67、BCL-2的表达,对于治疗具有一定评估作用,有利于术前无创性评估肿瘤的恶性程度并为预后和治疗提供新的依据。
