Wang Tso-Fu, Liu Shu-Hsin, Kao Chih-Hao K, Chu Sung-Chao, Kao Ruey-Ho, Li Chi-Cheng
Division of Oncology and Hematology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan, ROC.
Intern Med. 2006;45(12):775-8. doi: 10.2169/internalmedicine.45.1618. Epub 2006 Jul 18.
Kimura's disease is a chronic inflammatory disorder that occurs mainly in Asian patients. Most imaging studies focus on the loco-regional involvement of this disorder. Images of the whole body fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan have not been reported in the literature before. The possibility of lymphoid clonality is also discussed frequently despite its clinically benign course. We present a patient of Kimura's disease initially assessed by whole body 18F-FDG PET study and proved by pathologic findings. 18F-FDG-PET scan showed diffusely intense uptake in the neck, axillary, pelvic and inguinal nodal regions bilaterally, as well as in the mediastinal, celiac region. The flow cytometric analysis of lymph node tissue confirmed the absence of clonality. The image of 18F-FDG-PET in Kimura's disease can closely resemble that seen in neoplastic disorders such as lymphoma or metastatic lymphadenopathy. It should be taken into consideration as a differential diagnosis for a generalized lymphadenopathy.
木村病是一种主要发生在亚洲患者中的慢性炎症性疾病。大多数影像学研究聚焦于该疾病的局部区域受累情况。此前文献中尚未报道过全身氟-18氟脱氧葡萄糖正电子发射断层扫描(18F-FDG PET)的图像。尽管其临床过程为良性,但淋巴克隆性的可能性也经常被讨论。我们报告一例木村病患者,最初通过全身18F-FDG PET研究进行评估,并经病理结果证实。18F-FDG-PET扫描显示双侧颈部、腋窝、盆腔和腹股沟淋巴结区域以及纵隔、腹腔区域有弥漫性强烈摄取。淋巴结组织的流式细胞术分析证实不存在克隆性。木村病中18F-FDG-PET的图像可能与淋巴瘤或转移性淋巴结病等肿瘤性疾病的图像非常相似。对于全身性淋巴结病,应将其作为鉴别诊断加以考虑。