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[氟代脱氧葡萄糖正电子发射断层扫描在监测中枢神经系统恶性淋巴瘤的模态疗法效果中的应用:三例报告]

[Usefulness of FDG-PET in monitoring effects of the modality therapy for central nervous system malignant lymphoma: report of three cases].

作者信息

Masada Tetsuya, Matsumoto Yoshihito, Kawai Nobuyuki, Tamiya Takashi, Nagao Seigo

机构信息

Department of Neurological Surgery, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-chou, Kida-gun, Kagawa 761-0793, Japan.

出版信息

No Shinkei Geka. 2004 Aug;32(8):859-64.

Abstract

We have reported three cases of central nervous system malignant lymphoma in which FDG-PET was useful in monitoring therapeutic effects. Case 1: A 53-year-old man complained of gait and memory disturbance. An MRI of the patient's brain showed enhanced mass lesions in the bifrontal lobe. An FDG-PET showed markedly high uptake of the tracer, which means a higher metabolism of glucose. The tumor was biopsied and the histological diagnosis was diffuse B cell lymphoma. The patient received chemotherapy and external irradiation therapy. Case 2: A 64-year-old woman suffered memory disturbance and left hemiparesis. An MRI showed a right frontal mass lesion, and FDG-PET showed high uptake of glucose. After the histological diagnosis was determined as diffuse large B cell lymphoma, the patient received the same therapy as case 1. Case 3: A 55-year-old woman suffered right hemianopsia. An MRI showed an enhanced lesion in the right basal ganglia and an FDG-PET showed high uptake of glucose. After the histological diagnosis was determined as diffuse large B cell lymphoma, the patient received the same therapy as case 1 and 2. In all cases, high uptake of glucose disappeared on the PET after initial chemotherapy, although an enhanced lesion continued on MRI even after radiation. FDG-PET was useful in monitoring the therapeutic effects of malignant lymphoma. These results indicate that we were able to confirm the effectiveness of the therapy in the early stage.

摘要

我们报告了3例中枢神经系统恶性淋巴瘤病例,其中FDG-PET对监测治疗效果很有用。病例1:一名53岁男性,主诉步态和记忆障碍。患者脑部MRI显示双侧额叶有强化的肿块病变。FDG-PET显示示踪剂摄取明显增高,这意味着葡萄糖代谢更高。对肿瘤进行活检,组织学诊断为弥漫性B细胞淋巴瘤。患者接受了化疗和外照射治疗。病例2:一名64岁女性,患有记忆障碍和左侧偏瘫。MRI显示右侧额叶有肿块病变,FDG-PET显示葡萄糖摄取增高。在组织学诊断确定为弥漫性大B细胞淋巴瘤后,患者接受了与病例1相同的治疗。病例3:一名55岁女性,患有右侧偏盲。MRI显示右侧基底节有强化病变,FDG-PET显示葡萄糖摄取增高。在组织学诊断确定为弥漫性大B细胞淋巴瘤后,患者接受了与病例1和2相同的治疗。在所有病例中,初始化疗后PET上葡萄糖的高摄取消失,尽管放疗后MRI上强化病变仍持续存在。FDG-PET对监测恶性淋巴瘤的治疗效果很有用。这些结果表明我们能够在早期确认治疗的有效性。

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