不同病理亚型T和NK/T细胞淋巴瘤的^18F-FDG PET/CT影像分析  

Characteristics of T-and NK/T-cell lymphomas with different pathological subtypes on ^18F-FDG PET/CT

作　　者：伍杨[1] 吴湖炳[1] 王全师[1] 周文兰[1] 李洪生[1] 田颖[1] 董烨[1] 

机构地区：[1]南方医科大学南方医院南方PET中心,广州510515

出　　处：《中华核医学与分子影像杂志》2017年第8期464-469,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 探讨不同病理亚型T和NK/T细胞淋巴瘤的^18F-FDG PET/CT影像表现差异,以更好地了解不同亚型的生物学特性.方法 回顾性分析2006年6月至2016年2月95例（男66例,女29例,平均年龄38.42岁）经病理学确诊的T和NK/T细胞淋巴瘤患者的PET/CT显像结果,从病灶的^18F-FDG摄取高低、肿瘤对结内外病灶的侵犯及分期等方面分析、比较不同病理亚型患者的差异.数据比较采用单因素方差分析、Fisher确切概率法和Kruskal-Wallis H检验.结果 不同病理亚型T和NK/T细胞淋巴瘤在SUVmax、淋巴结侵犯、淋巴结病灶分布、结外器官侵犯及分期等方面差异有统计学意义（F=2.937,P〈0.05;Fisher确切概率法,均P〈0.01;H=19.883, P〈0.01）. NK/T细胞淋巴瘤多数侵犯鼻腔及鼻咽部,肠病相关T细胞淋巴瘤均存在肠道侵犯,皮下脂膜炎性淋巴瘤也均存在皮下侵犯,此3 种亚型在病变侵犯部位方面存在较明显的特殊性.血管免疫母细胞淋巴瘤、外周非特异性T细胞淋巴瘤和T淋巴母细胞淋巴瘤患者大多为Ⅳ期患者,其中血管免疫母细胞淋巴瘤均表现为淋巴结全身广泛侵犯,同时易于侵犯脾、腮腺和浆膜（在7种亚型中最易侵犯腮腺和浆膜）;外周非特异性T细胞淋巴瘤也主要表现为淋巴结侵犯,但结外侵犯脏器分布上较散在,缺乏特征性;T淋巴母细胞淋巴瘤病灶^18F-FDG摄取比除皮下脂膜炎性淋巴瘤外的其他5种淋巴瘤亚型低,病变分布较散在,在结内外病灶分布上也缺乏特征性.间变型大细胞淋巴瘤呈现为Ⅳ期者较少,病灶的^18F-FDG摄取在7种亚型中最高,病变分布以骨髓（骨骼）和淋巴结侵犯为主,但一般不累及脾脏.结论 不同病理亚型的T和NK/T细胞淋巴瘤^18F-FDG PET/CT影像表现存在一定差异,分析这些影像差异可能有助于更好地认识各种亚型不同的生物学特性.Objective To investigate the imaging presentation of T-and NK/T-cell lymphomas with different pathology subtypes on ^18F-FDG PET/CT.Methods A total of 95 patients （66 males, 29 females, average age 38.42 years） with T-and NK/T-cell lymphoma proved by pathology from June 2006 to February 2016 were retrospectively analyzed.^18F-FDG uptake （SUVmax）, nodal invasion, nodal distribution, extra-nodal involvement and staging were compared among 7 pathological subtypes of T-and NK/T-cell lymphomas.One-way analysis of variance, Fisher exact test and Kruskal-Wallis H test were used for data analysis.Results There were significant differences in terms of ^18F-FDG uptake, nodal invasion, nodal distribution, extra-nodal involvement and staging among different pathological subtypes of T-and NK/T-cell lymphomas （F=2.937, P〈0.05;Fisher exact test,all P〈0.01;H=19.883, P〈0.01）.NK/T-cell lymphoma was found to be prone to invade the nasal cavity and nasopharynx, enteropathic type T-cell lymphoma was specific to the intestine, and subcutaneous panniculitis-like T-cell lymphoma presented with subcutaneous infiltration.All those 3 subtypes were quite specific in their extra-nodal involvement.Most patients with angioimmunoblastic T-cell lymphoma （ATCL）, peripheral unspecified T-cell lymphoma （PUTCL） and T immunoblastic lymphoma （TIBL） presented as stage Ⅳ disease.Widespread lymph node disease associated with splenic, parotid and serous membrane involvement were often seen in ATCL patients （most commonly to involve the parotid glands and serous membrane among the 7 subtypes）.Nodal involvement was found in PUTCL patients, but extranodal involvement was rather non-specific.TIBL had a non-specific pattern of nodal involvement with low ^18F-FDG uptake, lower than ATCL and the other 5 subtypes.Anaplastic large cell lymphoma subtypes had the highest ^18F-FDG uptake when compared with the other 6 subtypes, but were less often to manifest as stage Ⅳ disease despite their preponderance for marrow and nodal inf

关 键 词：淋巴瘤 T细胞 自然杀伤T细胞 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R730.44[医药卫生—肿瘤] R733[医药卫生—临床医学]