Just Pierre-Alexandre, Fieschi Claire, Baillet Georges, Galicier Lionel, Oksenhendler Eric, Moretti Jean-Luc
Department of Nuclear Medicine, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
AIDS Patient Care STDS. 2008 Sep;22(9):695-700. doi: 10.1089/apc.2008.0174.
This study aims to describe 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) findings in patients with AIDS-related Burkitt lymphoma, at various times of treatment, and to define its utility for a better patient management. We retrospectively studied 13 consecutive HIV-positive patients with Burkitt lymphoma who underwent one or more PET/CT. In 5 of 5 patients imaged before treatment, PET/CT confirmed all involved sites detected at conventional work-up and demonstrated additional sites in 4 of 5 patients. Lymph node involvement, which is known to be uncommon in endemic or sporadic Burkitt lymphoma, was present in 54% of patients. Additionally, in 3 patients, Burkitt lymphoma was predominantly located in parotid lymph nodes, which is also an unusual finding. A negative scan was encountered in 3 of 10 patients imaged during treatment and in 1 of 4 patients imaged after treatment completion and was always associated with lasting complete remission. Presence of residual area of uptake was related to both favorable and unfavorable outcome whether performed during treatment (5/7 and 2/7, respectively) or after (1/3 and 2/3, respectively). Areas of increased uptake could be observed in lung (4 cases) or esophagus (3 cases), and were clinically related to pneumonia or esophagitis. We recommend PET/CT for accurate initial staging of patients with AIDS-related Burkitt lymphoma. PET/CT is also useful to monitor treatment response, as regression of initial disease can be early observed. Furthermore, PET/CT appears to have prognostic value, as a negative scan was always associated with a favorable outcome.
本研究旨在描述艾滋病相关伯基特淋巴瘤患者在不同治疗阶段的18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）表现，并确定其在改善患者管理方面的作用。我们回顾性研究了13例连续接受一次或多次PET/CT检查的HIV阳性伯基特淋巴瘤患者。在5例治疗前进行PET/CT检查的患者中，PET/CT证实了所有在传统检查中发现的受累部位，并在5例患者中的4例中发现了额外的部位。已知在地方性或散发性伯基特淋巴瘤中不常见的淋巴结受累在54%的患者中出现。此外，在3例患者中，伯基特淋巴瘤主要位于腮腺淋巴结，这也是一个不寻常的发现。在10例治疗期间进行PET/CT检查的患者中有3例以及在4例治疗完成后进行PET/CT检查的患者中有1例扫描结果为阴性，且均与持久的完全缓解相关。无论在治疗期间（分别为5/7和2/7）还是治疗后（分别为1/3和2/3）进行检查，摄取残留区域的存在与预后好坏均有关。在肺部（4例）或食管（3例）可观察到摄取增加区域，临床上与肺炎或食管炎有关。我们建议对艾滋病相关伯基特淋巴瘤患者进行PET/CT以进行准确的初始分期。PET/CT对于监测治疗反应也很有用，因为可以早期观察到初始疾病的消退。此外，PET/CT似乎具有预后价值，因为扫描结果为阴性总是与良好的预后相关。
