Hoffmann Martha, Kletter Kurt, Becherer Alexander, Jäger Ulrich, Chott Andreas, Raderer Markus
Department of Nuclear Medicine, University of Vienna, Vienna, Austria.
Oncology. 2003;64(4):336-40. doi: 10.1159/000070290.
According to recent reports, nodal marginal zone lymphoma (MZL) appears to be a distinctive lymphoma entity rather than a more advanced stage of extranodal MZL of mucosa-associated lymphoid tissue (MALT). We have therefore retrospectively evaluated all patients diagnosed with nodal or extranodal MZL who have been referred to our unit for imaging using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET).
A total of 21 patients with a diagnosis of MZL upon referral for imaging with (18)F-FDG-PET were identified. Histological reassessment of biopsy specimens confirmed the diagnosis of extranodal MZL of MALT in 14 patients, while a diagnosis of nodal MZL was verified in 6 patients. Lymphoma cell proliferation was assessed immunohistochemically using a Ki-67 antibody. Whole-body (18)F-FDG-PET scans were performed on a GE advanced PET scanner 40 min after intravenous injection of 300-380 MBq (18)F-FDG.
None of the patients with extranodal MZL showed focal tracer uptake within verified tumor sites. In contrast, 5 of the 6 patients with nodal MZL showed significant FDG uptake within the affected lymph nodes. These results did not simply reflect the different growth fractions of the two lymphoma entities since the proliferation indices of the two groups did not differ significantly.
(18)F-FDG-PET visualizes nodal MZL in a high proportion of patients whereas FDG uptake is undetectable in extranodal MZL. Although limited by the small number of patients, this study suggests that imaging with (18)F-FDG-PET might play a potential role in the diagnostic workup of patients with nodal MZL involvement.
根据近期报告，结内边缘区淋巴瘤（MZL）似乎是一种独特的淋巴瘤实体，而非黏膜相关淋巴组织（MALT）结外MZL的更晚期阶段。因此，我们回顾性评估了所有因使用（18）F-氟脱氧葡萄糖正电子发射断层扫描（（18）F-FDG-PET）进行成像而转诊至我院的结内或结外MZL患者。
共识别出21例因（18）F-FDG-PET成像而转诊的MZL患者。对活检标本进行组织学重新评估，确诊14例为MALT结外MZL，6例为结内MZL。使用Ki-67抗体通过免疫组织化学评估淋巴瘤细胞增殖。在静脉注射300 - 380 MBq（18）F-FDG后40分钟，在GE高级PET扫描仪上进行全身（18）F-FDG-PET扫描。
结外MZL患者在经证实的肿瘤部位均未显示局灶性示踪剂摄取。相比之下，6例结内MZL患者中有5例在受累淋巴结内显示出明显的FDG摄取。由于两组的增殖指数无显著差异，这些结果并非简单反映两种淋巴瘤实体不同的生长分数。
（18）F-FDG-PET在高比例的结内MZL患者中可显示病变，而结外MZL中未检测到FDG摄取。尽管受患者数量限制，本研究表明（18）F-FDG-PET成像可能在结内MZL受累患者的诊断检查中发挥潜在作用。
