Bianchi Elena, Pascual Manuel, Nicod Marie, Delaloye Angelika Bischof, Duchosal Michel A
Service of Hematology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Transplantation. 2008 Mar 15;85(5):707-12. doi: 10.1097/TP.0b013e3181661676.
Posttransplant lymphoproliferative disease (PTLD) is, aside skin cancer, the most common malignancy occurring after solid organ transplant in adults. Fluorodeoxyglucose (FDG) positron emission tomography (PET) has proved useful in the management of lymphomas.
We report our experience with the use of FDG-PET inline with computed tomography (CT) scanning in the management of four transplant recipients with histologically confirmed PTLD, including three monomorphic PTLDs and one polymorphic PTLD.
FDG-PET/CT scan at diagnosis showed increased FDG uptake in all examined PTLD lesions, and the disease was upstaged on the basis of FDG-PET/CT scan results over conventional CT scanning in one patient. At the end of treatment, PET/CT scans no longer demonstrated FDG uptake in the original PTLD lesions in all patients. Complete remission of disease persisted for at least 1 year after diagnosis in all.
Our results strongly support that FDG-PET scanning is highly specific for diagnosis and follow-up of PTLD. The clinical relevance of including FDG-PET/CT scanning in the management of PTLD should be evaluated in a larger prospective cohort study.
移植后淋巴细胞增生性疾病（PTLD）是成人实体器官移植后除皮肤癌外最常见的恶性肿瘤。氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）已被证明在淋巴瘤的管理中有用。
我们报告了在4例经组织学证实为PTLD的移植受者的管理中使用FDG-PET联合计算机断层扫描（CT）扫描的经验，其中包括3例单形性PTLD和1例多形性PTLD。
诊断时的FDG-PET/CT扫描显示所有检查的PTLD病变中FDG摄取增加，并且基于FDG-PET/CT扫描结果，1例患者的疾病分期高于传统CT扫描。治疗结束时，PET/CT扫描在所有患者的原始PTLD病变中均未再显示FDG摄取。所有患者在诊断后疾病完全缓解持续至少1年。
我们的结果有力地支持FDG-PET扫描对PTLD的诊断和随访具有高度特异性。应在更大规模的前瞻性队列研究中评估将FDG-PET/CT扫描纳入PTLD管理的临床相关性。
