Masada Tetsuya, Matsumoto Yoshihito, Kawai Nobuyuki, Tamiya Takashi, Nagao Seigo
Department of Neurological Surgery, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-chou, Kida-gun, Kagawa 761-0793, Japan.
No Shinkei Geka. 2004 Aug;32(8):859-64.
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.
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。